HazMat Emergencies:

HazMat Emergencies:

“HazMat Emergencies: Decontamination and Victim Chain of Survival,” by Gunderson, Helikson, and Heffner (2014), and write a review. Your review must include the following:

 Summarize the key points presented in the article.

 Describe the key elements of a solid emergency response program.

 Discuss why proper decontamination of victims is important.

 Discuss your opinion or what you can conclude from the article.

Your response must be at least 800 words in length. All sources used, including this article, must be referenced. Paraphrased and/or quoted materials must have accompanying in-text and reference citations in APA format.

Program Development Peer-Reviewei HazMat era K ^ ences Decontamination & Victim Chain of Survival By Scott Gunderson, Cameron Helikson & Michael Heffner C onsider the following hypothetical scenarios of workplace emergency decontamination incidents involving hazardous materials: BRIEF •HazMat emergencies represent a significant response challenge, especially when employees are exposed and the response involves a victim. í •A growing body of literature and I standards guides emergency medical – services (EMS) and hospital professionals in HazMat victim response and treatment. But, the SH&E professional must navigate separate standards: HazWOPER for HazMat emergencies and standard first aid for HazMat victim response. »What strengths each standard may have in isolation are lacking when [ coupled with each other or as explicit ‘ preparation for the more advanced response that follows when EMS arrives. •The authors review these standards and integrate several key concepts for effective response to HazMat victim emergencies in the workplace to make the most of the critical time hetween employee exposure and EMS arrival. A pressurized hose recirculating potassium goid cyanide into a clean room eiectroplating bath breaks ioose from the ciamps holding it against the bath wall. The hose whips around and sprays the corrosive iiquid onto a nearby empioyee. She hits the emergency “off” button, and as the chaos quiets, she and her coworkers realize she is standing in a puddie of plating solution, with the liquid dripping from her cleanroom clothing. Her first impulse is to go change her clothes in the locker room, but her supervisor orders her to an enclosed emergency shower stail with a drain. She walks from the puddle to the shower, trailing a path of wet footprints. At another company, an employee ioses his hold of a heavy product and drops it into an acid etching tank. The fuiifront apron, gloves, face shield and goggles protect him from the splashing acid. But, his coworker who has his back turned feeis the acid spiash on his back, buttocks and legs at the gaps between his apron ties. He pulls the handle of the emergency shower, an open unit against the wall, and removes his clothing as acid and rinse water cascade across the floor. Workplace HazMat emergency response is well-defined in standards and regulations such as HazWOPER, and workplace medical emergency response is equally well-defined in practices such as first aid. However, combining the two is complicated because the urgency of first-aid response tends to collide with the systematic and planned sequences of HazWOPER. This article addresses issues around HazMat emergencies with employee exposure, and focuses on safe and effecfive emergency decontamination of HazMat victims in occupational settings such as manufacturing, warehousing and laboratories (see “Maximizing HazMat Victim Care”). The authors have excluded transportation emergencies, nonoccupational exposures, and criminal, combat or terrorism events due to the broad nature of these subjects and their integration with issues such as traffic control, security and tactical operations. Transportation involves potential exposure to the nonoccupational general public, and in the case of highway incidents, the absence of readily available emergency decontamination faciliI Scott Gunderson, CSP, CHMM, is a safet}’ compliance officer at Oregon OSHA, with prior workplace emergency response experience in various industries including semiconductor manufacturing and chemical processing. He has published articles in Professional Safety, Systems Engineering and Journal of System Safety. Gunderson holds a B.A. from Western Oregon University and an M.A. and an M.Eng. from Portland State University. He is an Oregon emergency medical technician (EMT), an American Heart Association Basic Life Support instructor and a professional member of ASSE’s Columbia-Willamette Chapter. eron Helikson is the environment, health and safety (EHS) manager at Tosoh Quartz Inc. in Portland, OR. He has been in EHS for 14 years and has specialized in developing emergency response teams and in using technology in EHS. Helikson is an Oregon-licensed EMT-Intermediate and has been a volunteer with the Newberg Fire Department for 19 years. He is an American Heart Association BLS instructor and is a certified in HazMat technician (40-hour), advanced cardiac life support, advanced medical life support and prehospital trauma life support. He holds a B.S. in Business from Portland State Universit)’, and has been published in Professional Safety. Helikson is a professional member of ASSE’s Columbia-Willamette Chapter. Michael Heffner, B.S., EMT-P, is a captain with the Cit)- of Salem Fire Department where he is assigned to one of Oregon’s 13 regional HazMat response teams. He is an Oregon-licensed paramedic and a certified HazMat technician. Heffner teaches emergency medical care, HazMat response and hospital first receiver classes throughout Oregon. He holds a B.S. from Portland State University and Eastern Oregon University. 4 0 ProfessionalSafety MARCH 2014 www.asse.org fies such as emergency showers. Addifionally, law enforcement, military or other potential mass casualty emergencies, such as terrorist attacks with chemical weapons, involve even more issues, such as significant public exposure, potentially long periods wifh unidenfified contaminants and ongoing tactical threats (e.g., acfive shoofer and secondary explosives timed for arrival of emergency responders). Magnitude of Problem Agency for Toxic Substances and Disease Regisfry (ATSDR, 2009) surveyed data from 13 sfafes in the firsf half of 2009, cataloging 3,458 HazMat emergencies. These emergencies involved 1,050 victims, of whom 44 died. Of these emergencies, 68% were in fixed facilities, with manufacturing representing the highest number (27%). Of the victims, 91% were in fixed facilities, with employees representing the highest number of victims (44%). In the second half of 2009, six states reported 1,352 HazMat emergencies wdth 319 victims and 8 fatalities. Like the first half of the year, fixed facilities and manufacturing represenfed the highest (99% and 27%, respectively). These fixed facilities again reported the highest number of victims (83%), with employees representing 10% (ATSDR, 2009). mediately reducing contamination of individuals in potentially life-threafening situafions with or without the formal establishment of a decontamination corridor” (NFPA, 2008b). This is what workplace emergency responders perform when they assist an employee in an emergency shower until emergency medical service (EMS) personnel arrive, and it is the primary focus of this article. 2) Gross decontamination. This may be an initial part of emergency decontamination of victims, or the first step in technical deconfaminafion of responders exifing the hot zone through a supervised decontamination corridor. In both cases, as high a percentage as feasible of contaminafion is rinsed off prior fo further deconfaminafion. 3) Mass decontamination. “The physical process of reducing or removing surface contaminants from large numbers of vicfims in pofentially lifethreatening situations in the fastest time possible” (NFPA, 2008b). This may be an emergency decontamination or a gross decontamination, and simply describes the fact that more than one person undergoes decontamination. Although typically performed by FMS personnel, the authors are aware of two separate workplace incidents with two exposed employees each, forcing fhem to each walk to separate emergency showers; in one incident. HazMat Victim Decontamination Decontamination practices have evolved since the NFPA 472 standard was created and replaced NFPA 471, which spent much of its decontaminafion section on standardized procedures for controlled entry and exit through an established corridor linking the operational areas of the hot zone (e.g., exclusion or contamination area), warm zone (e.g., transition or contamination reducfion area) and cold zone (e.g., support or clean area). Although this separation of operational areas is ideal in principal, NFPA 472 acknowledges the more realistic pofenfial for chaos as emergency responders arrive, with five categories of decontaminafion. 1) Emergency decontamination. “The physical process of imr Maximizing HazMat Victim Care Transitioning From Workplace Emergency Responders to Emergency Medical Services SH&E professionals can do much to establish safe and effective HazMat victim response and strong links in the response chain between workplace responders and emergency medical services (EMS). Prevention remains the best sfrafegy, and design for safety and training for safe operafion is paramount, but a solid emergency response program should at a minimum include the following: •Hardware. Functioning and appropriately located emergency eyewash and shower systems, PPE for employees and workplace responders, first-aid supplies and response supplies such as absorbents on reserve and dedicated for emergency-only use. All hardware must be inspected regularly, maintained and tested periodically. •Information. Safet)’ data sheets and a sitespecific emergency response plan at a minimum, ideally including HazMat-specific procedures for highly hazardous maferials such as hydrofiuoric acid fhat require rapid response. •Internal communications. HazMaf victims must be able fo summon assistance and workplace responders musf be able fo gather feam members. Depending on operafion size and complexity, internal communications can be as simple as verbally shouting across the room, using handheld radios or public address systems, or emergency shower fiow alarms connected to central alarm systems with security personnel on staff able fo monitor and notify workplace responders. •External communications. Typically 9-1-1 in fhe U.S. If sife telephones require dialing a special number for an outside line, then this musf be included in employee training. Caller identification may or may nof be present at the 9-1-1 call center, and the physical address must be either known by employees or posted in visible locations in the workplace so thaf it can be communicated fo the dispatcher. •Coordinating with EMS upon arrival. Workplace emergency responders must greet EMS upon arrival, direct fhem to the specific locafion of fhe emergency and rapidly provide accurate informafion about the emergency. Emergency locations may be far removed from typical entry points such as front gates, front doors or shipping bays. Addifionally, fire and ambulance services may arrive separately, and fhe greef-direcf-communicafe sequence may need fo be repeafed. •Training. Workplace emergency responders musf know fhese procedures, fhe proper use of their resources and effective communication to EMS during an emergency. Workplace emergency responders must also understand the role of EMS and how workplace responders and EMS can best work together on site. www.asse.org MARCH 2014 ProfessionalSafety 4 1 r Table 1 HazMat Emergency & Victim Decontamination Responsibilities Personnel Workplace emergency responders Emergency medical services (EMS) personnel Hospital personnel Role Initial response; notify EMS; emergency decontamination Arrive at scene; assume control of response; emergency, mass, gross and/or technical decontamination; emergency medical treatment; transport victim(s) Receive victim(s); definitive decontamination and treatment Expected levels of contamination High, both scene and victim(s) High, transitioning to as IOVÍÍ as possible for victim(s) Low, with exception of selftransported “walking wounded”; emergency and technical decontamination capabilities but preference for receipt of decontaminated victim(s) the spill size in the facility was doubled with drops and wet

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