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Decontamination procedures 1 General decontamination • Decontamination prevents spreading of the contamination. • Always decontaminate from top to bottom, or from head to feet. • At decontamination, water should have a temperature between 15-35 °Celsius or 59-95 °Fahrenheit. • Beware of secondary contamination. 2 General decontamination • Decontamination prevents spreading of the contamination • Decontaminating people is meant to prevent further spreading of the contamination. 3 General decontamination • Water temperature at decontamination may not be lower than 15°C or 59°F otherwise this causes increased chance of hypothermia and increases adsorption. • Water temperature at decontamination may not be higher than 35°C or 95 °F otherwise this causes increased chance of sweat excretion and increases adsorption. 4 General decontamination Always decontaminate form head to feet. When proceeding in this manner, you keep the casualties’ head best protected. • The head is decontaminated first. • The head cannot be contaminated again during decontamination. At decontamination, clean areas must be kept clean. Do not use hard brushes 5 General decontamination Decontaminating personel should wear protective clothing at all times. Always install flow of decontamination opposite of the wind direction, so people cannot be contaminated anew. 6 Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External radiation External External External contamination Internal contamination 7 Contamination Viral contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination • Rescue personnel should be vaccinated and clothed in protective clothing. • Isolate and/or quarantine people who have been exposed to the virus, and decontaminate them. • Destroy contaminated animals and foodstuff, dead animals should be incinerated or buried. • Vehicles and persons coming out of the contaminated zone must be decontaminated. • Contact between contaminated and clean zone should be kept to a minimum. • The least amount possible traffic between the zones. • No transportation of animals and as little as possible transportation of people. 8 Contamination Viral contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Rescue personnel are the first to come in contact with the casualties and/or the contaminated area, they must be protected against (secondary) contamination. • Rescue personnel must be vaccinated against the particular case of virus. • Rescue personnel must be wearing protective clothing. 9 Contamination Viral contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination People from the contaminated area must be isolated or be put in quarantine. • Isolation: People contaminated with the virus must be kept separated from the rest of the population to prevent spreading. These people will be decontaminated and cured of the virus. • Quarantine: People who have been exposed to the virus, but have not become ill, will be separated from the rest of the population to prevent spreading. These people will be decontaminated. 10 Contamination Viral contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Animals involved with the virus must be destroyed. • Involved animals include: • Animals from which the virus originates. • Animals that could be infected with the virus that have lived in the contaminated area. • Foodstuffs of animals originating from one of the above criteria. • Destruction: 1.Slaughtering of the animals 2.Burning or burying of the animals and foodstuffs. 11 Contamination Viral contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination To keep spreading of the virus as limited as possible, it is essential to act as fast as possible. 12 Contamination The Area Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination cold zone The decontamination area is divided in three zones; hot zone •The hot zone •The warm zone hot zone Wind •The cold zone Source The area is set up in opposite direction of the wind direction! Decon 13 Contamination The Area Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination cold zone Hot zone: This is the area directly around the source of the virus. This is where the virus rages. Only rescue personnel wearing protective clothing may enter this area. hot zone Wind hot zone Source Decon 14 Contamination The Area Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Cold zone Warm zone: This is the area Warm zone Wind Hot zone Source Decon around the hot zone. The fire department states what the measurements of this area are. Distance from the hot zone to the cold zone must be at least 25 meters, because certain substances are able to advance 10 meters against the wind direction. In this zone, people can be isolated or quarantined. Life saving medical treatments and the decontamination of people and vehicles will be carried out in this zone. Medical personnel is active in this zone. All rescue personnel wear protective clothing. Decontaminated peope and vehicles exit to the cold zone. 15 Contamination The Area Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination cold zone Cold zone: This is the hot zone Wind hot zone area where the virus is eliminated. Severely injured people are transported to the hospital with ambulances. People can be isolated or quarantined here as well, under certain circumstances, abiding special countermeasures Source Decon 16 Contamination Quarantine and Isolation Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination For putting people in quarantine or isolating them, you have two options. • • Proceed in the warm zone Proceed in the cold zone For putting people in quarantine and isolating people, the same system can be applied, however, you cannot keep both groups together in the same system. 17 Contamination Warm zone Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination In the warm zone the virus rages outside the shelter. People must be separated from the outside world, therefore, overpressure is required inside the shelter. Clean air from the cold zone is sucked in and blown in the shelter. By keeping the pressure inside the shelter higher than outside, air is constantly blown out of the shelter. No contaminated air can get into the shelter. 18 Contamination The Area Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination cold zone hot zone Wind hot zone Source Decon 19 Contamination cold zone Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination In case the shelter is placed in the cold zone, under pressure is required inside the shelter. Inside the shelter virus rages, but outside the air is clean. By constantly sucking air out of the shelter and filtering it, contaminated cannot get out of the shelter. Through the underpressure inside the shelter, clean air is drawn in. Air drawn out of the shelter can be collected, but also mixed with the outer air after filtering. 20 Contamination The Area Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination cold zone hot zone Wind hot zone Source Decon 21 Decontamination of non injured persons Contamination • • • • Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Vaccinate Administer antiviral agents Post decontamination checking Cold zone 22 Decontamination of non injured persons Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Cold zone: • Once the casualty is clean and post checked, he/she may proceed to the cold zone. Post checking: • Post decontamination check to ascertain the casualty is clean. If the casualty is not clean, the decontamination process must be repeated. Vaccinate: • Contaminated people must be vaccinated to lose the influenza contagion they have acquired. 23 Contamination Decontamination of injured persons Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination • Injured persons proceed from the hot zone to the warm zone. • Life saving medical treatments are applied. • Decontaminate. • Hospital. 24 Contamination Decontamination of injured persons Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Life saving medical treatments are applied: • Medical rescue personnel carry out life saving procedures. Injured persons proceed from the hot zone to the warm zone: • Injured persons are escorted to the warm zone by the rescue personnel. When the casualties cannot walk, they will be carried into the shelter. Decontaminate: • contaminated injuries are first decontaminated with water and soap with a neutral pH-value. Hospital: • After treating directly life threatening issues, injured persons will be transported to the hospital, where they will receive further help with their injuries. After being treated at the hospital for their injuries, they will be completely decontaminated, and in case of a lowered immunesystem, will have an antiviral agent administered. 25 Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External radiation External External External contamination Internal contamination 26 Chemical contamination Contamination Remove clothing Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External Perform life-saving actions Contamination with gas Contamination with fluids Contamination with solids radiation External contamination Internal contamination? Internal contamination Yes No Hospital Chemical contamination Remove clothing Perform life-saving actions Contamination with gas Contamination with fluids Contamination with solids Internal contamination? Yes No Hospital 27 Contamination Chemical decontamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Chemical contamination can be internal and external by; • Gasses • Fluids • Solids 28 Contamination The Area Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination cold zone The decontamination area is divided in three zones; hot zone •The hot zone •The warm zone hot zone Wind •The cold zone Source The area is set up in opposite direction of the wind direction! Decon 29 Contamination The Area Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination cold zone hot zone Wind hot zone hot zone: This is the area directly around the source of the contamination. Only rescue personnel wearing protective clothing may enter this area. Source Decon 30 Contamination The Area Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination cold zone hot zone Wind hot zone Source Decon warm zone: This is the area around the hot zone. The fire department states what the measurements of this area are. Distance from the hot zone to the cold zone must be at least 25 meters, because certain substances are able to advance 10 meters against the wind direction. In this zone, people can be isolated or quarantined. Life saving medical treatments and the decontamination of people and vehicles will be carried out in this zone. Medical personnel is active in this zone. All rescue personnel wear protective clothing. Decontaminated peope and vehicles exit to the cold zone. 31 Contamination The Area Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination cold zone cold zone: This is the area where there’s no danger. hot zone Severely injured people are transported to the hospital with ambulances. Wind hot zone Source Decon 32 Chemical contamination Contamination Remove clothing Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External Perform life-saving actions Contamination with gas Contamination with fluids Contamination with solids radiation External contamination Internal contamination? Internal contamination Yes No Hospital Chemical contamination Remove clothing Perform life-saving actions Contamination with gas Contamination with fluids Contamination with solids Cut contaminated clothing on the back upward. Clothing will then fall away from the face. Do not pull away clothing which sticks to the skin due to frostbite or burns. Have it removed by qualified medical personel. Internal contamination? Yes No Hospital 33 Chemical contamination Contamination Remove clothing Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External Perform life-saving actions Contamination with gas Contamination with fluids Contamination with solids radiation External contamination Internal contamination? Internal contamination Yes No Hospital Chemical contamination Always perform live saving actions first! Remove clothing Perform life-saving actions Contamination with gas Contamination with fluids Contamination with solids Internal contamination? Yes No Hospital 34 Chemical contamination Contamination Remove clothing Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External Perform life-saving actions Contamination with gas Contamination with fluids Contamination with solids radiation External contamination Internal contamination? Internal contamination Yes No Hospital Chemical contamination Remove clothing Perform life-saving actions Contamination with gas Contamination with fluids Contamination with solids Internal contamination? Yes If toxins react with water use a mineral oil or oil used for food preparation. If toxins react with air, keep the victim wet at all times, continuous showering or using wet towels, bandages or alike. In this case, do not use oils. This might cause absorption of the toxins in the skin. No Hospital 35 Chemical contamination Contamination Remove clothing Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External Perform life-saving actions Contamination with gas Contamination with fluids Contamination with solids radiation External contamination Internal contamination? Internal contamination Yes No Hospital Chemical contamination Remove clothing Perform life-saving actions Contamination with gas Contamination with fluids If casualties have been exposed to toxic gasses, after removing clothing, there can only be internal contamination. Always transport casualties to a hospital for examination. Contamination with solids Internal contamination? Yes No Hospital 36 Chemical contamination Contamination Remove clothing Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External Perform life-saving actions Contamination with gas Contamination with fluids Contamination with solids radiation External contamination Internal contamination? Internal contamination Yes No Hospital Chemical contamination Remove clothing Perform life-saving actions Contamination with gas Contamination with fluids Contamination with solids If casualties have been exposed to liquid contaminants, always check the kind of liquid(s) and decontaminate accordingly. Clothing and personal belongings should be packed in airtight bags or shelters. Internal contamination? Yes No Provide emergency clothing after decontamination. Hospital 37 Contamination Contamination with fluids Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Risk of absorption of fluids by the human body can increase if the following is not taken into account; • large surface of contact; clothing, blankets... • temperature increase of the contaminant by body temperature, remove clothing as fast as possible • air humidty • increased room temperatures also may cause absorption of the contaminants in the skin due to perspiration and vasodilation. 38 Contamination Contamination with fluids Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination When contaminated with dangerous fluids, there are two ways of decontamination; • Dry decontamination • Wet decontamination 39 Contamination Contamination with fluids Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Dry decontamination: de contaminant is absorbt by tissues or high absorbing powders. • Advantages: • Large quantities can be held in stock • You can see which body parts already have been decontaminated • Wounded and injured can easily be helped on site. They do not have to be hospitalized. • Disadvantages: • Dust clouds caused by powders can harm machines and electrical equipment. 40 Contamination Contamination with fluids Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Wet decontamination: Wash of exposed skin and hair extensively with luke warm water. Use a mild soap for oily and highly absorbing chemicals. Wash eyes thoroughly with water or saline. Collect the waste water. 41 Chemical contamination Contamination Remove clothing Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External Perform life-saving actions Contamination with gas Contamination with fluids Contamination with solids radiation External contamination Internal contamination? Internal contamination Yes No Hospital Chemical contamination Remove clothing Perform life-saving actions Contamination with gas Contamination with fluids Contamination with solids Contact an advisor on hazardous materials (health officer). Clothing and personal belongings should be packed in airtight bags or shelters. Use a soft brush to brush of the dust and particles. Brush form head to toe. Collect the dust and store in a suitable shelter. Beware of open wounds. Decontaminate according to the directions of the advisor. Provide emergency clothing. Internal contamination? Yes No Hospital 42 Chemical contamination Contamination Remove clothing Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External Perform life-saving actions Contamination with gas Contamination with fluids Contamination with solids radiation External contamination Internal contamination? Internal contamination Yes No Hospital Chemical contamination Remove clothing Perform life-saving actions Contamination with gas Contamination with fluids Contamination with solids If a casualty is (suspected) internally contaminated, he or she is to be transferred to a hospital for examination. Internal contamination is to be treated there. One van be internally contaminated by inhalation, ingestion and through the skin. Internal contamination? Yes No Hospital 43 Chemical contamination Contamination Remove clothing Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External Perform life-saving actions Contamination with gas Contamination with fluids Contamination with solids radiation External contamination Internal contamination? Internal contamination Yes No Hospital Chemical contamination Remove clothing Perform life-saving actions Contamination with gas Contamination with fluids If there is no internal contamination, the person is decontaminated and clean. The person can be transferred to the cold zone. Contamination with solids Internal contamination? Yes No Hospital 44 Chemical decontamination injured people Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination • Emergency rescue collects the victims from the hot zone • Stabilize and decontaminate victims • Hospital 45 Chemical decontamination injured people Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Emergency rescue collects victims from the hot zone Non ambulant victims will be carried out on stretchers. Near de line between the hot zone and the warm zone clothing will be removed from the casualty. Clothing will be stored in airtight bags or shelters. Casualties will be transferred to the warm zone on a clean stretcher. Casualties who can walk by themselves will be handed over to the medical personnel. They also will have there clothing removed and packed. 46 Chemical decontamination injured people Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Stabilize and decontaminate victims In the warm zone casualties will be stabilized and partially decontaminated whereafter they will be transferred to a hospital. 47 Chemical decontamination injured people Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Hospital: In hospital casualties will be decontaminated completely and there injuries and wounds will be attended to. 48 Chemical decontamination non injured people Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination • Emergency rescue collects the victims from the hot zone • Decontaminate victims • Hospital or cold zone 49 Chemical decontamination non injured people Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Emergency rescue collects the victims from the hot zone After collecting the victims from the hot zone, emergency rescue lead them to the decon area. The victims will be received and assisted by the decon personnel. 50 Chemical decontamination non injured people Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Victims will be decontaminated. First clothing will be removed and packed in airtight bags or shelters. The victims will be showered and provided with emergency clothing. They will be examined. If not fully decontaminated they will be showered again; three times maximum. More will make no difference. In due time decontamination will the disappear as the skin renews itself. Internal contaminated victims will be sent to hospital. 51 Chemical decontamination non injured people Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination To hospital or cold zone: Internal contaminated victims will be sent to hospital. If the victim is clean he or she can proceed to the cold zone. 52 Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External radiation External External External contamination Internal contamination 53 Contamination Biological contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Emergency personnel has to wear protective clothing, eye protection and breathing protection when there is risk of inhalation. Emergency personnel is to vaccinated at first, before coming into action. 54 Contamination Biological contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination De sequence of decontamination is the same as with chemical decontamination. Same system is used as is the setup of the area. Injured and non injured are treated the same way as in chemical decontamination. 55 Contamination Biological contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination In some cases it may be needed to vaccinate or use of antivirals and antibiotics is required. A medical expert on infectuous diseases can provide decisive answers. Always contact the medical expert when there is biological contamination. 56 Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External radiation External External External contamination Internal contamination 57 Contamination Radioactive decontamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination When a victim only is exposed to radiation it’s called external radiation. The victim can not be decontaminated. 58 Contamination Radioactive decontamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination If there is a radioactive substance on the body of the victim, there is external contamination. Decontamination is essential. 59 Contamination Radioactive decontamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination If there is a radioactive substance inside the body of the victim, there is internal contamination. Decontamination is essential. 60 Radioactive contamination External contamination Wounded Not wounded Contamination External contamination Inhalation Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External Ingestion radiation External contamination Internal contamination Radioactive contamination External contamination Wounded Not wounded External contamination Inhalation Ingestion 61 External radioactive contamination injured people Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination At first clothing is to be removed. Remove clothing away from the face. Keep away from body parts whish are not contaminated. Store clothing in an airtight (double) bag or suitable shelter. 62 External radioactive contamination injured people Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination First the most contaminated wounds are to be treated. Wash the wounds with saline or oxidized water. Have the wounds bleed out (under venous occlusion if needed). 63 External radioactive contamination injured people Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination If the wounds are contaminated with solvent radionuclides, use of correct medicine or treatment has to be started as soon as possible. 64 External radioactive contamination injured people Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination When needed the victim will be transferred to a hospital. If there is severe decontamination of the wound, contaminated tissue may be surgically removed. Amputation will only be performed in a few occurences. 65 External radioactive contamination injured people Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination After decontaminating the wounds, commence decontaminating the body as if it where a non injured person. Treatment of radioactive contaminated burns is to be done in a specialized facility (burns centre). 66 External radioactive contamination non-injured people Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination At first use luke warm water and soap (neutral pH) in combination with soft brushes and sponges. If the result is not sufficient you can use a more powerful (freely obtainable) product. 67 External radioactive contamination non-injured people Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination If the contamination is more than skindeep. You could use peeling cremes, but avoid scrubbing. 68 External radioactive contamination non-injured people Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Skin which is not contaminated can be covered with adhesive plastic foil, Vaseline or spray bandages. The possibility of contamination of these parts will me minimized. 69 External radioactive contamination non-injured people Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Washing and showering to a maximum of 3 times. More is not effective. Remaining contamination will dissapear as the skin renews itself. 70 Internal radioactive contamination inhalation Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Internal contamination only can be treated in a hospital. 71 Internal radioactive contamination inhalation Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination After live saving actions performed by the emergency rescue personnel, the victim is to be transferred to a hospital. 72 Internal radioactive contamination inhalation Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination In hospital the casualty will be decontaminated internally and externally. The casualties wounds will be treated. 73 Internal radioactive contamination inhalation Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination On inhalation the method of decontaminating is a lung lavage. 74 Internal radioactive contamination ingestion Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination If the contamination of the intestines occurred recently, intubations or the use of emetics can be administered. 75 Internal radioactive contamination ingestion Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Less recent contaminations may be treated with laxatives. In some cases this even may reduce the absorption of isotopes. Also medicines which can improve the excretion of water by the kidneys may be used. 76 Contamination The Area Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination cold zone The decontamination area is divided in three zones; hot zone •The hot zone •The warm zone hot zone Wind •The cold zone Source The area is set up in opposite direction of the wind direction! Decon 77 Contamination The Area Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination cold zone hot zone: This is the area directly around the source of the contamination. Only rescue personnel wearing protective clothing may enter this area. hot zone Wind hot zone Source Emergency personnel determines the protective provisions applicable for and the outline of the area. Decon 78 Contamination The Area Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination cold zone hot zone Wind hot zone Source Decon Warm zone: the area around the hot zone. Emergency rescue determines size and distance. Live saving activities and decontamination are performed in this area. Medical personnel is active in this area. All emergency and mdical personnel is wearing protective clothing. Decontaminated victims are going to the cold zone or directly to a hospital. 79 Contamination The Area Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination cold zone Cold zone: hazard free area. Heavily injured victims are transferred to hospital. hot zone Wind hot zone Source Decon 80 External radioactive decontamination Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination • Emergency rescue collects victims from the hot zone • Decontamination • Cold zone 81 External radioactive decontamination Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination • Emergency rescue brings wounded non amabulant victims to the medical personnel in the warm zone • Ambulant victims are directed to the medical personnel by the emergency rescue personnel • Victims are treated on the wounds en will be decontaminated. • Casualties will be transferred to hospital 82 External radioactive decontamination Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Non injured victims will be direct to the decon area where they will be decontaminated. The will be inspected. If still contaminated they will be decontaminated again. 83 External radioactive decontamination Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Decontaminated persons will enter the cold zone. They are clean. 84 Internal radioactive decontamination Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination • Emergency rescue collects victims form the hot zone • Hospital 85 Internal radioactive decontamination Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Emergency rescue collects victims form the hot zone. They will bring victims with (suspected) internal contamination to the medical personnel. Non ambulant victims will be carried on a stretcher, ambulant victims will be directed. 86 Internal radioactive decontamination Contamination Viral Chemical Biological Radioactive contamination contamination contamination contamination Internal Internal External External External radiation External contamination Internal contamination Victims will receive live saving treatment if needed. They will be transferred to hospital. In hospital the will be internally en extarnally decontaminated. After this their wounds and injuries will be attended to. 87 Decontamination procedures 88
