Hanyang Med Rev.  2015 Aug;35(3):146-151. 10.7599/hmr.2015.35.3.146.

Prevention and Decontamination of Chemical, Biological, Radiological, and Nuclear Contaminants for the Emergency Medical Personnel during Ambulance Services

• Shin DM

• KMID: 2168360
• DOI: http://doi.org/10.7599/hmr.2015.35.3.146

Abstract

This paper will review proper protocol for Emergency Medical Technicians (EMTs) between the ambulance station, scene and hospital. EMTs must know how to protect themselves both inside and outside the ambulance from chemical, biological, radiological, and nuclear (CBRN) contaminants in order to provide the best quality care. EMTs should also know how to remove contamination after taking a patient to the hospital. A CBRN protocol at the scene of exposure is the best defense strategy for protecting both EMTs and the emergency ambulance vehicle from contamination. If EMTs and the emergency ambulance vehicle are exposed to CBRN, neither will be of great service as they both play a critical part in the quality of care given to a patient. In the event of possible exposure, EMTs should dress in high perceptibility personal protective equipment (PPE). Those who have been trained prior should arrive to the scene with an air purifying respirator. Before a patient with possible exposure is placed inside an emergency ambulance vehicle, all patients' compartments should be completely covered and sealed with plastic film. Once the emergency medical crew reaches the hospital and the patient is discharged from the emergency vehicle, all plastic film inside the ambulance, from the cockpit ceiling to the floor, should be removed and properly discarded. The patient's clothing and shoes should be placed into a double layered plastic bag. Adhering to proper protocols, within 10 minutes of arrival at hospital, a contaminated ambulance should undergo pre-washing, decontamination and rinsing operations.

Keyword

Emergency Medical Technicians; CBRN Ambulances; Decontamination

MeSH Terms

Ambulances*
Clothing
Decontamination*
Emergencies*
Emergency Medical Technicians
Humans
Plastics
Shoes
Ventilators, Mechanical
Plastics

Figure

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  Fig. 1 CAPSULS™ Patient Isolation Unit (ISOVAC) from [5].

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  Fig. 2 NHS standard level C chemical protective PPE from [11].

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  Fig. 3 Ambulance completely covered and sealed in plastic film from [11].

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  Fig. 4 EKG monitors and some hard surface equipment do not need plastic film covering from [11].

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  Fig. 5 Take out plastic films from closer to driver side from [11].

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  Fig. 6 Large double layered plastic bags from [11].

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  Fig. 7 Verify, remove and seal contaminated items in plastic bags from [11].

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  Fig. 8 Put it everything into the plastic bags from [11].

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  Fig. 9 Use Allen-Vanguard's surface decontamination foam from [6].

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  Fig. 10 Wipe down patient compartments from [8].

Reference

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