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Response Continued

14.0 Decontamination Procedures (ERT Personnel and Equipment):
14.1 The Decontamination procedures shall be modeled after the Environmental Protection Agency Models.
     14.1.1 The Decon corridor shall consist of a minimum of a tool drop, an Emergency Corridor, one gross reduction station, one rinse station and a PPE drop.  The corridor may be expanded to as many stations as necessary based on the incident.
     14.1.2 Gross Decon is accomplished by brushing away, vacuuming or removal of special PPE covers for removal of dry materials.  Wet materials may be reduced by removal of special PPE covers, absorbing the materials with some appropriate method or product or when not water reactive by washing with water or solutions appropriate for the materials involved.  The objective of gross Decon is to remove the bulk of the hazardous material from the surface of the PPE or equipment.  Dry and fluid materials created by Decontamination shall be contained for proper disposal.
     14.1.3 The next step is the wash/rinse station, where residual contaminates is scrubbed away with brushes and detergent solution.  Contaminants are then rinsed away with a water spray. All materials removed during this process shall be retained for proper disposal.
     14.1.4 After rinsing, PPE is carefully removed and set aside for disposal or testing.  Once the PPE is removed, the SCBA or respiratory protection may be removed and set aside for cleaning.  If the Team member is to be recommitted during this stage, PPE would be removed to the point necessary to effect the cylinder change.  The Mitigation officer would be notified that the ERT member is prepared for return to the Hot or other work zone where PPE is required.  Upon removal of all PPE, ERT members shall be sent to the Medical Section for evaluation, rehab and final disposition.

15.0 Emergency Decontamination Procedures:
15.1 Emergency Decontamination may be required in the following situations:
     15.1.1 When PPE fails, including SCBA failure, accidental breach or degradation of PPE, or when personnel become accidentally contaminated.
     15.1.2 When personnel have been injured or in immediate need of medical attention and have not been exposed to hazardous materials.

15.2Emergency Decontamination where the ERT member has been contaminated:
     15.2.1 Immediate flush exterior of PPE with copious amounts of water, move to an area with the Decontamination area where recontamination is not likely to occur and remove PPE (if respiratory protection is in place, do not remove unless it is compromising the victim).
     15.2.2 Remove as much contamination as possible, and move the individual to the Medical Decontamination area for further management.
     15.2.3 Dress the injured/exposed individual in a hospital gown or other suitable clothing.
     15.2.4 Move the injured/exposed individual into the Emergency Department for further treatment.

16.0 Emergency Decon Measures for an Injury/Medical Emergency where the Individual has not been exposed or contaminated:
16.1 Assess the condition of the member in the suit.  Does the emergency in the suit exceed the severity of the threat from exposure to the material?

16.2 Choose either the standard decontamination operation or the Emergency Decon.

16.3 Follow standard decon procedures with care for the members condition.

16.4 Turn the individual over to the Medical Branch after decontamination is complete for medical management.

17.0 Termination Procedures:
17.1 All tools must be cleaned prior to returning them to service.

17.2 All tools, equipment, and PPE contaminated beyond the Decon capabilities on site will be inventoried and placed in containers, marked and set aside for cleaning and/or disposal.

17.3 All Decon water will be considered as contaminated, or testing must b e provided to eliminate the possibility of contamination.  All wastewater from the Decon site will be considered contaminated and removed by Ego Logical Environmental.

17.4All Decon Team members must decontaminate each other or themselves.

17.5All materials used by the ERT during decontamination operations must be documented by the Decon officer or designated individual.

17.6All Decon Team members will report to the Medical Branch for evaluation.

18.0 Logistic Officer:
18.1 The Logistics Officer will be at least a qualified Hazardous Materials Technician and shall be assigned by the Incident Commander on all incidents.

18.2 The Logistics Officer shall assume responsibilities for procurement of resources required for hazardous materials operations and the documentation of resources and equipment utilized.
     18.2.1In consultation with the Incident Commander, he/she shall select a staging area for equipment and supplies.
     18.2.2Coordinate with the Incident Commander, Safety Officer and the Resource Officer to determine the type of operation to be conducted and possible equipment needed.
     18.2.3Coordinate with outside supply agencies when necessary to provide any required supplemental equipment or supplies.
     18.2.4Maintain a record of all equipment and supplies issued.
     18.2.5Account for all tools, equipment, and supplies used during the incident.
     18.2.6Provide the Incident Commander with a list of tools, equipment and supplies that were used and that need to be replaced.
     18.2.7Assure that any equipment utilized by First Responders is appropriately decontaminated or isolated.
     18.2.8Complete the Hazardous Materials Logistics Check List.

19.0 Medical Documentation Specialist (MDS): The MDS position shall be activated for any ERT operation if the Incident Commander deems it necessary. (Must be at least a R. N.)
     19.1The MDS shall be assigned by the Incident Commander as required.
     19.2The MDS shall be responsible for the following:
     19.2.1Assist in coordination between ERT and the Emergency Department during victim decontamination operations.
     19.2.2Assist in communications between the ERT and various medical departments of the hospital.
     19.2.3Assist the Medical Officer in the coordination and delivery of medical monitoring and care to ERT members.
     19.2.4Assist the PIO in communication with information to be communicated to the public through the news media.

20.0 Public Information Officer:
The Public Information Officer (PIO) shall be activated through the Community Relations Department.  A PIO will be present during any activation of the ERT in which the team is deployed or where then nature of the hazardous materials incident might require information to be provided to the news media, or in response to inquiries by the news media.

20.1 The PIO shall be responsible for assuring appropriate information is released to the news media on all incidents that involve the operation of the ERT.

20.2 The PIO shall be responsible for release of information concerning the status of any individual that has been managed by the ERT and is being or has been treated at Medical Center Hospital.  Any release of information is subject to CONFIDENTIALITY of patient information.

21.0 Radiation Incident Safety Officer:
The Radiation Incident Safety Officer shall be activated for any response or potential activation of the ERT in which involves radioactive materials.  The Radiation Incident Safety Officer has authority over all elements of any incident in which radioactive materials are involved in conjunction with the ERT Incident Commander.   He/she shall devise and implement all necessary actions for mitigation of the incident.

21.1 The Radiology Safety Officer for Medical Center Hospital shall appoint the Radiation Safety Officer.  He/she shall assume responsibility for safe and acceptable methods of site and victim decontamination for any incident in which radioactive materials have been or are involved.

21.2 He/she shall advise the Incident Commander in the development and implementation of a plan of action in all incidents involving radioactive materials to assure the safest and most effective response.

21.3 He/she shall advise the Decon Officer to assure that an effective plan is formulated for the decontamination system for the ERT to assure that all radioactive sources are contained.  This shall include the provision of technical and monitoring activities to assure the effective decontamination of victims, entry personnel and/or areas contaminated by radioactive materials.

21.4Shall assist the Resource Officer in providing necessary information to the Incident Commander, the Emergency Department and other departments to assist in the proper response to any incident that involves radioactive materials.

21.5Shall assist PIO in providing information to the news media and public in case of incidents that involve radioactive materials.

21.6Shall be responsible for notifying all regulatory agencies and officially represents the Incident Commander with these agencies in all aspects of the incident.

21.7Shall be responsible for the management of all radioactive waste materials are managed in accordance with appropriate regulations.

21.8Shall report all possible exposures to the Hospital Radiation Safety Officer.

22.0 Resource Officer:
A Resource Officer shall be established for any activation of the ERT that the Incident Commander deems necessary. (Must be at least a �Hazardous Materials Technician�).

22.1 The Resource Officer shall operate under the Incident Command System and shall support the operations of the ERT during any activation the Incident Commander deems necessary.

22.2 The Resource Officer shall be responsible for providing the Incident Commander with information specific to the hazards presented by the materials involved in the incident.  This information includes but is not limited to:

     22.2.1 The potiential harm presented by the materials such as, health hazards, flammability, reactivity to the victims, the ERT, bystanders and the environment.

     22.2.2The recommended PPE necessary to provide adequate protection of the ERT members during victim management and/or mitigation of the incident.

     22.2.3The recommended solutions to be used to decontaminate victims and/or areas contaminated by the hazardous materials.

     22.2.4Provide information to the Emergency Department on specific additional treatments recommended for the medical management of victims by resources available to the Resource Officer.
     22.2.5Provide contact sources for the ERT to outside resources.

23.0 Training:

23.1Requirements for training of ERT members are specified in Federal Regulations with 29 CFR 1910.120.  MCH ERT endeavors to achieve a Hazardous Materials Specialists certification for each member.  It is recognized that due to turn-over and course availability, at any one time, several members may function at less than this level.  At no time will a ERT member act beyond their current level of training as documented by the ERT.

23.2In addition, the ERT enlists the assistance of individuals that due to their expertise can provide specialized supportive functions.  An example of this function would be the Radiation Incident Safety Officer.  This use of specialized individuals is recognized by 29 CFR
1910.120, and the ERT is compliant with conditions and restrictions established within this document.

23.3Training for ERT members and specialized individuals is achieved  in the following manner:
     23.3.1Each CRT member is certified through a training program to have achieved the requirements of a Hazardous Materials Specialist.  Due to availability of this course, new members are placed into the ERT Training Program with scheduling of Hazardous Materials Specialists Training scheduled when possible.  There is no requirement for specific training prior to acceptance for membership on the ERT.
     23.3.2Each ERT member receives at least eight (8) hours of specialized training per month.  This training is compliant with 29 CFR 1910.120  and meets requirements of content,  delivery, documentation and evaluation, and;
     23.3.3On a routine basis, attendance is encouraged in specialized training issues as presented by other groups, organizations and vendors, or as offered by MCH ERT to internal or external groups or organizations.  Participation in these sessions by ERT members is documented for inclusion as meeting or in addition to specific training requirements for the ERT.
     23.3.3.1Documentation and Recognition of certified training received during ERT Training, and/or training received from other individuals, groups, professional organizations or educational institutions;
     23.3.3.2Documentation of training received during routine drills or activation of the MCH ERT.
     23.3.3.3Routine evaluation by testing and observation of performance during the actual delivery of skills during training and actual activation's.  The results of these tests and observations are noted for each ERT member.  This documentation is used to demonstrate compliance in 29 CFR 1910.120, ability to function at specified levels or positions during ERT operations, and to establish individual specific continuing training needs for each ERT member.  Evaluations and observations are made by senior (higher training levels and/or experience) ERT members, specialized team support individuals, and other professionals that assist in the delivery of continuing training of the ERT.
     23.3.3.4The above evaluations of competence are used to determine the levels of ability and function. In the event that a ERT member fails to meet expected levels of proficiency, (considered normal for individuals with their level of service and training), it may be used to refer this individual to the Advisory Board so that a plan of correction can be developed and implemented.  In the event the member continues with unacceptable proficiency, the Advisory Board may remove said member from the ERT membership.

US Patent Numbers 7,720,998 B2, 7,836,207