In message <"/GUID:8DA3EAB2218ED411911D00805F35A6DC"@MHS>,
[log in to unmask] writes
>Thanks to the modernisation fund I now have a large "decontamination room" in my
>department. This was a nice office and a store but is now a part tiled space
>with a shower in one corner, drains running along the wall with the showers and
>the usual oxygen/suction etc. in the opposite corner. We have never in my
>experience had a chemically contaminated casualty needing that level of facility
>but no matter we are prepared. We have the fancy suits in a box but no-one
>knows how to put them on yet. My question to the group is what do we put in the
>room to decontaminate people with? A mop & bucket? How do we divide the space
>between contaminated and clean? Do we store clean gowns in the room?
>
>C C Scott
>A&E Consultant, Southport
>
>
The answer here is to train. In Harlow (industrial town with some high
tech industries i.e. lots of nasty chemicals) we have opted for the
inflatable decon facility. Now we have it, we sat down, thought about
how to use it and we have a forthcoming training exercise.
In terms of how to put the suits on, I suggest that you find out who in
your department is in the TA and has recently received NBC training.
There are rules about donning this kit safely and cleanly to minimise
self-contamination. The Army train for this extensively. The fire
brigade are also an excellent resource and their kit might be closer in
design to that used in hospitals.
Cleaning casualties relies on showering, brushing, wound cleansing and
for persistent agents, fuller's earth. The latter substance is found in
granules in certain brands of cat litter (and takes the dye out of ag-
diesel!).
Once your patient is clean and decontaminated, they should be moved on.
Ambulant casualties should be given fresh gowns and moved on. Trolley
patients must be put on a fresh clean trolley.
Vehicles should move around a circuit and be washed down. Trolleys
should also be confined to either a dirty side, if dirty or a clean side
if clean. This should be enforced strictly by the decon team. Division
of the spaces should be physical and well marked.
Consent is an issue. So is privacy. Recently near us a lab technician
was forced to strip and was marched naked into a decon unit and was
scrubbed down by people she allegedly knew. (I truly hope this is urban
myth, but would not wish to let the truth get in the way of a good
story!)
With all that lovely water splashing about and going into the drains
ready to go into your next cup of tea, drainage is an issue. Certain
chemicals and radioactive materials might cause a problem here. Disposal
of contaminated clothing is an issue.
Our Chemical exercise is happening in mid-October. If I am not thrown
off this list for my prescriptive views on decon, would you like to hear
how we get on?
--
Stephen Hughes SpR Harlow
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