Author: Susan M. Cibulsky, PhD, Medical Countermeasure Strategy and Requirements Division, ASPR Office of Policy and Planning
Large quantities of hazardous chemicals are made, transported, stored, and used in homes, offices or industrial settings every day in the United States. Even taking every safety precaution, there still is a risk that the chemicals could be released into the environment either by accident or intentionally to cause harm.
Many toxic chemicals are readily absorbed into the body and cause injury and illness quickly. Decontaminating patients can prevent or limit absorption of the chemical and minimize adverse health effects. Decontamination also can prevent the spread of contamination to other people (including responders and receivers) and to health care equipment and facilities. In fact, since it can protect health, patient decontamination is considered a medical countermeasure.
To respond effectively to an event that involves the release of hazardous chemicals, our communities’ first responders, medical providers, and public health officials need guidance based on scientific evidence on decontaminating patients in ways that improve health outcomes. Now the nation’s first draft guidance is available for comment.
ASPR and the U.S. Department of Homeland Security’s Office of Health Affairs led the effort to develop this evidence-based guidance. Joining us were experts in emergency response, emergency medicine, toxicology, risk communication, behavioral health, and other relevant fields from academic and non-government organizations and federal, state, and local agencies.
To shape and substantiate the recommendations, this working group of experts sought out and used all of the evidence available. The draft guidance covers mass casualties, chemical release, external contamination, and decontamination of people (not animals, not inanimate objects, not facilities).
In drafting the guidance, the working group recognized that the primary goal of patient decontamination should be improved health outcomes. The group also recognized that as a medical countermeasure, patient decontamination needs to be coordinated with other medical aspects of the emergency response and that patient decontamination is a whole community issue.
The draft guidance also recognizes that a risk and crisis communication strategy should be in place pre-incident to reach all community members, and that system-wide coordination is essential, especially between on-scene responders and hospital-based receivers. The working group recommended a tiered, risk-based approach which matches the nature and extent of decontamination to the characteristics of the incident.
For ease-of-use, the guidance organizes recommendations by functional components of a response. In this extensive process to develop this guidance, the working group found that more research is needed to answer many of the essential questions. So the guidance will be updated periodically as new evidence becomes available.
We’d like your comments on that draft, called “Patient Decontamination in a Mass Chemical Exposure Incident: National Planning Guidance for Communities.” The guidance can be found in the Federal Register and is open for comment through May 19. Responders and public health officials: let us know what you think.
