Patient Decontamination in Mass Casualty Chemical Events

Situation/problem: The importance to effectively plan, coordinate and conduct patient decontamination in a mass casualty chemical event is critical to saving lives, and to quickly restore affected infrastructure.  The challenge in current decontamination guidance is the lack or insufficient scientific evidence to substantiate why certain processes are used in such incidents.  Much guidance is, thus, based on anecdotal understanding of the chemical contamination problem.  

Resolution: Over the past four years, Department of Homeland Security/Office of Health Affairs and Department of Health & Human Services/Office of the Assistant Secretary for Preparedness and Response worked together with a diverse subject matter expert pool to define the decontamination problems and to develop evidence-based strategic guidance for planners, emergency managers, first responders and hospital first receivers in dealing with a mass chemical casualty incident.  Where scientific evidence is not available, a methodology was developed to attain consensus on the appropriate guidance for patient decontamination.

Results: A national guidance document is in final draft stages for White House Office of Management and Budget clearance, and eventually, public comment.  The document breaks down the decontamination guidance into six functional areas: (a) determining the need for patient decontamination; (b) optimized technical practices; (c) evaluating the effectiveness of decontamination; (d) patient prioritization for decontamination; (e) system-wide coordination for patient decontamination; (f) crisis and emergency communication.