Episode 4

DECONTAMINATION

Episode 4

Protect yourself

PPE and Control Zones

Learning Objectives

Upon completion of this module you should be able to

Objective 3

Objective 1

Objective 2

Differentiate between OSHA Cateogry A, B, C, and D level of PPE

Describe methods to prevent self from being contaminated if contact with contaminated patients is required

Develop plan for extablishing control zones within one's own work place during a contamination event

you can keep yourself safe by maintaining distance from contaminated patients

when you cannot maintain distance from contaminated patients you can protect yourself with personal protective equipment

PPE

Control Zones

Continue

Control Zones

What are control zones?

Areas that ED staff designate in order to...

Prevent secondary contamination

Prevent recontamination

Prevent contaminated persons leaving the area so they can be decontaminted

What are control zones?

The control zones define...

the degree of risk in the area

the type of work done in that area

where untrained personnale/public should avoid

Control Zones

Will our control zones be concentric rings?

Consider your facility's layout

• There is no specific geometry that must be used
• What is vital is that there is no secondary contamination or recontamination

Equpiment needed

• There should acutal physical markers to help everyone know where each zone starts and ends
• cones
• tape
• signs

Personnel Needed at minimum

• Registration
• patient tracking
• Security
• crowd control
• Clinical staff (RN, MD, EMT)
• triage
• life saving interventions
• decontamination
• Facilities
• clean up after the event

Roles within the HOT ZONE

• Staff MUST wear PPE here
• Registration (NOT physically in the HOT ZONE)
• identify patients

• Medical personnel
• triage patients
• provide life saving intervention
• gross contaminants and clothing removed

• Security
• prevent others from entering into the decontamination area

Roles within the WARM ZONE

• Staff MUST wear PPE here
• Medical personnel
• Perform decotamination
• Dry and dress patient patient

Roles within the COLD ZONE

• Medical personnel
• Re-triage patient after decontamination
• Guide them to their room within the ER where they can recieve standard care

Moving between control zones

When staff move between zones

If they are moving from COLD>WARM>HOT, no special action needs to be taken

If they are moving from HOT>WARM>COLD, they are CONTAMINATED and MUST undergo DECONTAMINATION

PPE

what if I have to go into the hot or warm zone?

HAZMAT vs radiological vs biological PPE

Response to a HAZMAT event generally requires higher levels of PPE than radiologic or biologic threats

Important componets of all HAZMAT PPE

OSHA catetories of PPE for HAZMAT

+ Info

+ Info

+ Info

+ Info

knoweldge checkpoint

Thank youso much

Coming up next:

How we actually do the work of removing chemical contaminants from a patient's body

References

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Clinical review: Tokyo - protecting the health care worker during a chemical mass casualty event: an important issue of continuing relevance. Critical care (London, England), 9(4), 397–400. https://doi.org/10.1186/cc3062Parkinson, C. (2024, November 8). How to wash your body according to statistics. Plumbworld. https://www.plumbworld.co.uk/blog/how-to-wash-your-bodyPaschall, J. [Jeremy Paschall]. (2021, March 25). Hazmat Ops Lesson 7 [Video]. YouTube. https://www.youtube.com/watch?v=SPuTbtAJZ4kThe Radiation Emergency Medical Management [REMMWebSite]. (2014, November 18). Decontamination of children [Video]. YouTube. https://www.youtube.com/watch?v=-50bBNTRcrkRicharz, A. (2019). A Terrorist Attack Led Japan to Remove All Its Trash Cans. Now They’re Making a Comeback. Pacific Standard. https://psmag.com/environment/trash-cans-are-coming-back-to-japanSafety Data Sheets. (n.d.). FRONTIERSMAN Bear Attack Deterrent. 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In Office of Emergency and Preparedness Management. https://www.massgeneral.org/assets/mgh/pdf/emergency-medicine/strategies-for-first-receiver-decontamination.pdfWRAP-EM. (2023, October 4). Decontamination [Video]. YouTube. https://www.youtube.com/watch?v=reU6gN0aY0w地下鉄サリン事件】除染活動に向かう自衛隊員. (n.d.). Wikimedia Commons. https://commons.wikimedia.org/wiki/File:%E3%80%90%E5%9C%B0%E4%B8%8B%E9%89%84%E3%82%B5%E3%83%AA%E3%83%B3%E4%BA%8B%E4%BB%B6%E3%80%91%E9%99%A4%E6%9F%93%E6%B4%BB%E5%8B%95%E3%81%AB%E5%90%91%E3%81%8B%E3%81%86%E8%87%AA%E8%A1%9B%E9%9A%8A%E5%93%A1.jpg Name

OSHA Cat D PPE

• Gown
• Eye protection (if possible splash exposure)
• Surgical mask
• Surgical gloves
• Water resistant shoe covers (if possible splash exposure)

OSHA Cat A PPE

• Fully encapsulated vapor resistant suit
• Self-contained breathing apparatus
• Chemical resistant inner and outer gloves
• Chemical resistant boots

Cold Zone

Also called the support zone

• The patient should be clean from contamination before entering into the cold zone
• No HAZMAT PPE required
• although standard precautions should be taken will all patients!
• Exreme care must be taken to prevent the contmaination of this zone

Example

• Any part of our emergency department
• Sed do eiusmod tempor incididunt ut.
• Labore et dolore magna aliqua.

Warm Zone

Also called contmaination reduction zone

• Where we are actively decontaminting the patient
• Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore.
• Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt.

• Lorem ipsum dolor sit amet.
• Consectetur adipiscing elit.
• Sed do eiusmod tempor incididunt ut.
• Labore et dolore magna aliqua.

OSHA Cat B PPE

• Chemical resistant suit (not vapor resistant)
• Self-contained breathing apparatus
• Chemical resistant inner and outer gloves
• Chemical resistant boots

Hot Zone

Also called the exclusion zone

• area where the most contamintion is
• Maximum PPE is required to be in this area
• called the exclusion zone because nobody who is not already in it should be entering it
• No person or piece of equipment can leave this area without first being decontaminated

• Examples:
• The ambulance bay where EMS dropped off the patient to us

OSHA Cat C PPE **used at UVMMC ED**

• Chemical resistant suit
• Powered air purifying respirator or N95 mask
• Chemical resistant inner and outer gloves
• Chemical resistant boots