A Decontamination Game Changer

Last week, the way we remove chemical contamination from victims of a terror attack or chemical accident has changed… well, not quite yet, but it should soon.  A partnership between the US Department of Health and Human Services’ (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR) and the University of Hertfordshire in England and Public Health England found that “…removing clothes removes up to 90 percent of chemical contamination and wiping exposed skin with a paper towel or wipe removes another nine percent of chemical contamination.  After disrobing and wiping with a dry cloth, showering and drying off with a towel or cloth provides additional decontamination, bringing contamination levels down 99.9 percent.”

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Essentially, what they discovered was that despite recommendations for doing so, victims have often not been required to disrobe for decontamination.  When victims would progress through a decontamination (water spray down), much of the chemical they have been exposed to remains in the clothing and trapped against the skin.  Clearly this is not effective.

I see this new methodology being a significant change to how we decontaminate victims.  As the study hypothesizes, decontamination is much more effective when the chemical is wiped from the body after the victim disrobes.  Following this, they may progress then through a water spray.  This, essentially, adds a step to the typical protocols used in North America, Europe, and other locations.  I’m told the wipe methodology has been used in Japan for some time now.  I also believe that wipes have been in use by the US (and other) military forces for units in the field.

Links of interest:

HHS Press Release on the study.

Implementation of new protocols in the UK and other European nations

Many thanks to my colleague Matt for passing this information on to me.

As with any new procedure, the devil is in the details.  Standards must be established and adopted, supplies and equipment must be identified and obtained, personnel must be trained, and exercises must be conducted to validate.

I’m interested to hear opinions on these findings and recommendations, as well as thoughts on implementation in the US and abroad.

© 2016 – Timothy Riecker, CEDP

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H.R. 4397 – The Rail Safety Act

A few days ago I came across a notice of the introduction of HR 4397, aka the Rail Safety Act.  Text of the bill can be found here: https://www.govtrack.us/congress/bills/114/hr4397/text.  This bill was introduced by Rep. Ron Kind (D-WI) and had been assigned to House Committee on Transportation and Infrastructure on January 28th.  The essence of the bill… “To direct the Administrator of the Federal Emergency Management Agency to provide for caches of emergency response equipment to be used in the event of an accident involving rail tank cars transporting hazardous material, crude oil, or flammable liquids.”

If you follow the link provided above, you will get the full text of the bill, which honestly doesn’t tell much more.  I’m rather ambivalent about things like this.  We have a history of pre-positioning equipment and supplies for a variety of disasters.  Organizations such as the American Red Cross function this way, as do various agencies of the US federal government.  In 1999 the National Pharmaceutical Stockpile (NPS) was expanded to preposition medical supplies around the nation as a preparedness effort for a biological or chemical attack.  This program expanded in 2003 and became the Strategic National Stockpile (SNS).  In 2006, FEMA/DHS developed a program to pre-position disaster supplies (mostly mass care types of supplies) in certain disaster prone areas around the nation.  While we also have a variety of specialized teams, that’s a slightly different matter.

One key struggle of prepositioning supplies and equipment largely boils down to who will be responsible for them.  Supplies and equipment need to be secured and maintained.  This requires some regularity of check in to ensure they are ready to be deployed at a moment’s notice.  Each location needs a deployment plan, identifying how these assets will be deployed.  As part of this planning, there must be a trigger mechanism for requesting these supplies.  The supplies must deploy and reach their destination in such a time frame to be effective.  Of course upon arrival of the cache, responders must be familiar with what is there, take time to unpack it and inspect it, and be readily able to use it (therefore they must be pre-trained in the use of the equipment).  So who will be responsible for these caches?  State governments?  Local governments?  Rail carriers?  First responders?

Hazardous materials response is one of the most highly regulated aspects of public safety.  It is governed in the US by the Occupational Health and Safety Administration (OSHA) regulation 1910.120.  There is a strong emphasis on preparedness and protocol.  Only individuals trained to certain levels can conduct certain actions in a hazardous materials response.  Most responders, due to the fairly low ranking hazard of a major hazardous material release in their jurisdiction, do not have the degree of training needed to utilize some of what I expect would be in a cache of supplies as ordered by the Rail Safety Act.  That said, every jurisdiction in the US has access to a hazardous materials team – either from a nearby jurisdiction or from the state.  These teams have the specialized training and equipment needed to address a hazmat incident.  Now that we’ve gotten to that, what, exactly, is the need that the Rail Safety Act is addressing?

Sure, these caches of supplies may provide more of whatever is needed, but there are a few issues here.  First of all, it will take people to examine what is being delivered, to unpack it, and to ready it for deployment.  Often, the biggest issue on a response such as this is a lack of trained personnel.  Second, will the materials being provided by the cache be interoperable with what the hazmat team is using?  While we have gotten better at standardizing equipment, there are still many issues out there.  Tab A requires Slot A.  Slot B simply won’t work.

I suppose what I’m really interested in here is a definition of need.  Has there been any type of needs assessment or feasibility study conducted for this?  I’m doubtful.  Most bills are generally introduced at a whim by well-intentioned but ill-informed politicians.  The last thing we need is another requirement to work within that does us little good – even if it is to be funded by the rail carriers.

I’m curious if anyone out there happens to know about this bill or any need supporting it.

© 2016 – Timothy Riecker

Course Review: AWR-147 Rail Car Incident Response

This past weekend I had the opportunity to attend AWR-147 Rail Car Incident Response conducted by the Rural Domestic Preparedness Consortium (RDPC) and Findlay University.  This is a one day awareness level course that focused on response to incidents involving freight rail cars and hazardous materials.

AWR-147 Participant Manual

AWR-147 Participant Manual

All in all this was a good course which I recommend to anyone who has the opportunity to attend it.  For those not familiar with the RDPC you can find their website at https://www.ruraltraining.org/.  Although only an awareness level course, it is suitable for any responder or emergency manager who has a jurisdiction with freight rail lines.  It’s also quite suitable as additional training for HazMat teams, as the information provided relative to the identification of the different types of rail cars and potential hazards associated with them is excellent.

The course construction follows the usual DHS format, including a pre and post test, plenty of student materials, and a mix of instruction, videos, and participant interaction and discussion.  Given the variety of rail cars which can be encountered and rail incidents do dissect, there are plenty of visuals and case studies to drive the program.

I would have liked to have seen the inclusion of a unit to discuss current topics, particularly Bakken crude and even a bit on HazMat associated with passenger train incidents.  Also, while the course focused on response, there was little mention of community preparedness measures which can/should be taken.  Of course I had a small ulcer form with one of the final units which was on NIMS/ICS.  I see little value in rehashing the primary components of NIMS and showing an ICS org chart, particularly when there is little/no discussion on the nuances of applicability relative to a rail incident.  It was all rather gratuitous.

There were some great activities which reinforced use of the DOT Emergency Response Guidebook as well as other sources of information which can be referenced during a rail response, including a worksheet which could easily be used as a job aid for real life application.  Along with the participant manual, all students received a copy of the current DOT Guidebook as well as the Association of American Railroads Field Guide to Tank Cars, which is a handy reference to help you identify the specific type of tank car you are dealing with and where key infrastructure on each (brakes, vents, valves, etc.) can be located.

This was the first course I had taken from the RDPC, although I have been aware of their course selection for quite some time and have referred others to their great array of courses.  Don’t let the term ‘rural’ fool you – the material they teach is relevant to rural, suburban, and urban responders alike.  I had taken CSX’s rail response course several years ago and this course blows it away.  Overall well done and highly recommended.

© 2015 – Timothy Riecker

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