Evaluation of US Federal Guidelines (Primary Response Incident Scene Management [PRISM]) for Mass Decontamination of Casualties During the Initial Operational Response to a Chemical Incident.
Journal
Annals of emergency medicine
ISSN: 1097-6760
Titre abrégé: Ann Emerg Med
Pays: United States
ID NLM: 8002646
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
30
11
2017
revised:
20
06
2018
accepted:
22
06
2018
pubmed:
28
8
2018
medline:
6
2
2020
entrez:
28
8
2018
Statut:
ppublish
Résumé
The aim of this study was to evaluate the clinical and operational effectiveness of US federal government guidance (Primary Response Incident Scene Management [PRISM]) for the initial response phase to chemical incidents. The study was performed as a large-scale exercise (Operation DOWNPOUR). Volunteers were dosed with a chemical warfare agent simulant to quantify the efficacy of different iterations of dry, ladder pipe system, or technical decontamination. The most effective process was a triple combination of dry, ladder pipe system, and technical decontamination, which attained an average decontamination efficiency of approximately 100% on exposed hair and skin sites. Both wet decontamination processes (ladder pipe system and technical decontamination, alone or in combination with dry decontamination) were also effective (decontamination efficiency >96%). In compliant individuals, dry decontamination was effective (decontamination efficiency approximately 99%), but noncompliance (tentatively attributed to suboptimal communication) resulted in significantly reduced efficacy (decontamination efficiency approximately 70%). At-risk volunteers (because of chronic illness, disability, or language barrier) were 3 to 8 times slower than ambulatory casualties in undergoing dry and ladder pipe system decontamination, a consequence of which may be a reduction in the overall rate at which casualties can be processed. The PRISM incident response protocols are fit for purpose for ambulatory casualties. However, a more effective communication strategy is required for first responders (particularly when guiding dry decontamination). There is a clear need to develop more appropriate decontamination procedures for at-risk casualties.
Identifiants
pubmed: 30146445
pii: S0196-0644(18)30573-0
doi: 10.1016/j.annemergmed.2018.06.042
pii:
doi:
Substances chimiques
Chemical Warfare Agents
0
Types de publication
Journal Article
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
671-684Informations de copyright
Copyright © 2018 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.