HAZARDOUS
MATERIALS
AWARENESS
Scope of Hazardous Materials
• Hazardous material defined as “any substance or
material capable of causing an unreasonable risk to
health, safety, and property”.
• Possible causes of hazardous materials incidents:
1. Motor vehicle crashes.
2. Mishaps in storage of materials and manufacturing
operations.
3. Illegal drug manufacturing.
4. Acts of terrorism.
5. Household chemicals.
6. Pesticides.
7. Industrial toxins.
Laws and regulations
• Rules for workers at uncontrolled hazardous waste sites
and those responding to hazardous chemical releases or
spills:
1. Training requirements.
2. Emergency plans.
3. Medical checkups.
4. Other safety precautions.
Identification of Hazardous
Materials
I. Informal product identification.
• Used as quick means to determine presence of any
hazardous materials:
1. Visual inspection of scene before entering site.
2. Verbal reports by bystanders or other individuals.
3. Occupancy type: as fuel storage or pesticide plant.
4. Incident location: probable for hazardous
materials.
5. Location within building: what is stored in.
6. Visual indicators: vapor clouds, smoke, leakage.
7. Vehicle types: named carriers or company.
8. Container characteristics:
▪ Size, shape, color & deformed containers.
9. Senses: smell reported by bystanders.
10. Signs and symptoms of victims of exposure.
II. Formal product identification.
• Always identify product formally before taking
any action.
1. label to identify specific hazard:
✓ Explosives.
✓ Flammable liquids.
✓ Radioactive materials.
✓ Poisonous.
2. labels and placards with pictographs.
3. pictographs, symbols, or both.
4. pictographs that indicates written emergency
precaution measures in case of incident.
5. color and numerical rating scale to identify degree
of hazard for health, fire, and reactivity.
6. material safety data sheets.
❖ Material safety data sheet:
• Required by OSHA for each chemical produced,
stored, or used:
1. Supplied by manufacturer.
2. Contain information for safe and proper handling
and storage of material.
3. Have information on emergency actions to take.
4. Classify potential of health hazards from exposure
to material.
❖ Other
resources available for hazardous
materials reference:
1. Books.
2. Telephone support though emergency hazmat
agencies.
3. Computer databases.
4. Internet sources.
• Emergency Response Guidebook lists more than
1000 hazardous materials including:
a. First aid procedures for managing exposure.
b. Names & identification numbers of substances.
c. Free reference is carried in emergency vehicles to
assist only first responders with initial actions for
evacuation.
d. Includes distance and area from incident that
should be evacuated.
Personal Protective Clothing
and Equipment
I.
Protective Respiratory Devices:
1) Air purification devices:
– relies on respirators or filtration devices.
– Remove particulate matter, gases, or vapors from
atmosphere.
– Do not use separate source of air.
– Not recommended for use in hazardous materials
release.
– Cannot be used in environment with low oxygen
concentration.
2) Atmosphere-supplying devices:
– Rely on separate source of positive pressure to
supply air.
– Provide highest level of respiratory protection.
– Two basic types available:
a) Self-contained breathing apparatus (SCBA):
✓ Considered excellent protection in hazardous
environments.
b) Supplied-air breathing apparatus (SABA), or air
lines:
✓ Used at hazardous material sites when
extended working times are required.
II.
Protective Clothing:
• Protective clothing is categorized in two ways
disposable or reusable.
• Made from variety of materials designed
specifically for certain chemical exposures.
• Classification:
1) Level A:
– Provides highest level of skin, respiratory, and eye
protection.
– Typically, is used by hazmat teams for entry into
incident site.
2) Level B:
– Provides highest level of respiratory protection &
lower level of skin protection.
– Typically worn by decontamination team.
3) Level C:
– Used during transport of contaminated patients
4) Level D:
– Work uniform that affords minimal protection.
– Used for nuisance contamination only.
• The following points should be of concern to any
rescuer involved in hazmat response:
1. Protective clothing should not be affected adversely
by hazardous materials involved.
2. Protective clothing should seal all exposed skin.
3. Contact with hazardous materials should be of
absolute minimal duration required.
4. Protective clothing and equipment should be
decontaminated/discarded properly.
Health Hazards
• Hazardous materials may enter human body by:
1. Inhalation.
2. Ingestion.
3. Injection.
4. Absorption.
• Exposure to poisons can produce:
1. Acute toxicity.
2. Delayed toxicity.
3. Local and systemic effects.
• How body responds depends on concentration of
chemical. Also called dose response.
• Entry by means of any of these routes may result in
internal and external damage to rescuer.
I.
External damage.
• Many substances have corrosive properties or
become corrosive when mixed with water.
• Exposure to substances may produce chemical
burns and severe tissue damage.
• Examples:
✓ Hydrochloric acid.
✓ Hydrofluoric acid.
✓ Caustic soda.
1) Soft Tissue Damage:
• Exposure to Corrosives, acids or bases (alkaline)
may cause pain on contact.
• Alkalis generally burn more extensively than acids.
• Exposing human tissue to base corrosive may result in
liquefaction (a breakdown of fatty tissue).
• decontamination should begin by brushing off dry
powder and flushing skin with copious amounts of
water.
• Cryogenics:
✓ Refrigerant liquid gases that can freeze human
tissue on contact that may cause tissue damage.
✓ Can produce freeze, burns, frostbite &other coldrelated injuries.
✓ Examples:
Freon, liquid oxygen, liquid nitrogen.
2) Chemical Exposure to the Eyes:
• May cause eye damage, ranging from superficial
inflammation to severe burns.
• Patients with these conditions have:
✓ Local pain.
✓ Visual disturbance.
✓ Tearing.
✓ Edema.
✓ Redness of surrounding tissues.
• Basic management guidelines include immediately
flushing eyes with water.
Should be done using mild flow from:
✓ Hose.
✓ IV tubing.
✓ Water from container.
✓ Irrigation lens (per protocol).
• Rapid assessment of visual acuity is important.
(Assessment should not delay flushing or irrigation of
eyes)
II.
Internal damage.
• Internal damage to human body from exposure to
hazardous materials may involve:
✓ Respiratory tract.
✓ CNS.
✓ Other internal organs.
• Some substances injure all cells on contact & others
injure specific organs (target organs).
• Depending on hazardous materials, physical injury
may range from minor irritation to more serious
complications:
✓ Cardiorespiratory compromise.
✓ Death.
✓ Chronic illness.
✓ Cancer.
✓ Some substances can cause abnormal fetal
development.
✓ Penetrating radiation can lead to cell and
chromosomal changes, genetic changes, cell death,
sterility.
1) Irritants:
• Affect skin &mucous membranes of eyes, nose, mouth,
throat& respiratory tract.
• Chemical irritants include hydrochloric acid,
halogens, ozone.
2) Asphyxiants:
• Gases that displace oxygen in air and dilute oxygen
concentration of air.
• Simple asphyxiants:
✓ Carbon dioxide.
✓ Methane.
• Blood poisons or chemical asphyxiants:
Gases not only displace oxygen in air but also interfere with
tissue oxygenation.
✓ Carbon monoxide.
✓ Hydrogen sulfide.
3) Nerve poisons, anesthetics& narcotics:
• Act on nervous system affecting either
cardiorespiratory mechanisms of brain or ability to
transmit impulses required for adequate heart and
lung function.
• Examples of these poisons:
✓ Carbamates.
✓ Organophosphates.
4) Hepatotoxins:
• Poisons accumulate in body and destroy ability of
liver to function.
• Examples: Hydrocarbons.
5) Cardiotoxins:
• Hazardous materials that can cause myocardial
ischemia and dysrhythmias.
• Examples:
✓ Some nitrates.
✓ Ethylene glycol.
6) Nephrotoxins:
• Hazardous materials that are especially destructive to
kidneys.
• Examples:
✓ Lead.
✓ Inorganic mercury.
7) Neurotoxins:
• Poisons affect nervous
• Examples:
✓ Arsenic.
✓ Lead.
✓ Mercury.
system.
8) Hemotoxins:
• Hazardous substances that may cause destruction of
red blood cells resulting in hemolytic anemia.
• Examples:
✓ Lead
✓ Mercury
✓ Arsenic
✓ Copper
9) Carcinogens:
• are cancer-causing agents.
• Short-term exposure to specific agents is known to
produce long-term effects.
Response to Hazardous Materials
Emergencies
• Risk
levels vary are influenced by several
factors:
1. Hazardous nature of material involved.
2. Quantity of the material involved.
3. Weather conditions that might affect scene adversely.
4. Proximity of exposures (e.g., schools, nursing homes, and
shopping centers).
5. Level of available resources.
6. Lead time for mutual aid.
• Approaching the Scene:
1. Approach scene cautiously from uphill and upwind.
2. Identify hazards.
3. Evaluate all of them
4. before you place yourself or others at risk.
5. Secure scene.
6. Obtain help.
7. Decide on site entry.
• Control of the Scene:
1. Detect and identify materials involved.
2. Assess risk of exposure & risk of fire or explosion.
3. Gather information from personnel or other sources.
4. Confine and control incident.
5. Establish command.
6. Must define safety distances and zones.
• Safety Zones:
1) Hot zone:
– Area of incident that includes hazardous material.
– Refer to hot zone as restricted area, or red zone.
2) Warm zone:
– Larger, buffer area that surrounds hot zone.
– Where most EMS activities, such as decontamination
and patient care activities, are performed.
– Refer to this zone yellow zone.
3) Cold zone:
– Area that surrounds warm zone.
– Usually is considered safe, requiring only minimal
protective clothing.
– Contains command post and other support agencies
necessary to control incident.
– Referred to by some agencies as support zone or green
zone.
Rehabilitation and Medical Monitoring
❖ Rehabilitation
• Area (or areas) usually established near incident but
away from operations.
• Activities that may take place in rehab sector:
1. Relief from environmental extremes (active or passive
cooling or warming).
2. Rest and recovery.
3. Rehydration.
4. Food and drink replacement.
❖ Medical
Monitoring
• Should include "presuit" examination before
entering hazardous area.
• After incident, rescue personnel should be
reevaluated in “rehab sector,” using same
parameters as in presuit examination.
Emergency Management of
Contaminated Patients
• Primary goals of decontamination:
1. Reduce patient’s dosage of material.
2. Decrease threat of secondary contamination.
3. Reduce risk of rescuer injury.
• Guidelines for rapid decontamination:
1) Do not enter contaminated area or initiate care without
adequate PPE.
2) Victims who can walk should be encouraged to extricate
themselves from scene.
3) Patients who cannot walk should be removed from hot
zone by trained personnel.
4) Patient care activities in hot zone should be limited to:
✓ Gross airway management.
✓ Spinal immobilization.
✓ Hemorrhage control.
5) Decontamination and further patient care should be
done in warm zone by properly equipped
decontamination team.
6) IV therapy should be administered only under
physician’s direction:
7) When hazardous material is a dry agent, lightly brush
material from patient.
8) Wash patient with copious amounts of water and mild
detergent soap.
• Preparing Ambulance for Patient Transfer:
– Contamination of ambulances and equipment can be
minimized by preparing vehicle before transporting partly
decontaminated patient:
1. Using as much disposable equipment as necessary.
2. Removing all items from cabinets that will not be
needed for patient use.
3. Patient should be covered in plastic and secured to
stretcher.
• Decontamination of Rescue Personnel and
Equipment:
1. Outer gloves and boots are removed.
2. Gross surface contamination is removed by washing
with copious amounts of water.
3. Contaminated SCBA bottles are removed.
4. Protective clothing is removed and handled as required.
5. Personnel wash their bodies using overhead showers.
6. Personnel should receive medical evaluation.
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