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Evidence-Based Patient Decontamination: An Integral Component of Mass Exposure Chemical Incident Planning and Response

Published online by Cambridge University Press:  27 May 2014

Adam D. Leary ,
Michael D. Schwartz ,
Mark A. Kirk ,
Joselito S. Ignacio ,
Elaine B. Wencil  and
Susan M. Cibulsky
Adam D. Leary
Affiliation:
Medical Countermeasure Strategy and Requirements Division, Office of Policy and Planning, Office of the Assistant Secretary for Preparedness and Response, Washington, DC
Michael D. Schwartz
Affiliation:
National Center for Environmental Health, Centers for Disease Control and Prevention, Washington, DC
Mark A. Kirk
Affiliation:
US Department of Health and Human Services, Chemical Defense Program, Office of Health Affairs, US Department of Homeland Security, Washington, DC
Joselito S. Ignacio
Affiliation:
US Department of Health and Human Services, Chemical Defense Program, Office of Health Affairs, US Department of Homeland Security, Washington, DC
Elaine B. Wencil
Affiliation:
Medical Countermeasure Strategy and Requirements Division, Office of Policy and Planning, Office of the Assistant Secretary for Preparedness and Response, Washington, DC
Susan M. Cibulsky*
Affiliation:
Medical Countermeasure Strategy and Requirements Division, Office of Policy and Planning, Office of the Assistant Secretary for Preparedness and Response, Washington, DC
*
Correspondence and reprint requests to Susan M. Cibulsky, PhD, JFK Federal Building, 15 New Sudbury St, Ste 2126, Boston, MA 02203 e-mail susan.cibulsky@hhs.gov.
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Abstract

Decontaminating patients who have been exposed to hazardous chemicals can directly benefit the patients’ health by saving lives and reducing the severity of toxicity. While the importance of decontaminating patients to prevent the spread of contamination has long been recognized, its role in improving patient health outcomes has not been as widely appreciated. Acute chemical toxicity may manifest rapidly—often minutes to hours after exposure. Patient decontamination and emergency medical treatment must be initiated as early as possible to terminate further exposure and treat the effects of the dose already absorbed. In a mass exposure chemical incident, responders and receivers are faced with the challenges of determining the type of care that each patient needs (including medical treatment, decontamination, and behavioral health support), providing that care within the effective window of time, and protecting themselves from harm. The US Department of Health and Human Services and Department of Homeland Security have led the development of national planning guidance for mass patient decontamination in a chemical incident to help local communities meet these multiple, time-sensitive health demands. This report summarizes the science on which the guidance is based and the principles that form the core of the updated approach. (Disaster Med Public Health Preparedness. 2014;0:1–7)

Keywords

decontaminationchemical hazard releasechemical warfareemergency preparednesshazardous substances
Type
Concepts in Disaster Medicine
Information
Disaster Medicine and Public Health Preparedness , Volume 8 , Issue 3 , June 2014 , pp. 260 - 266
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2014 

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