CMH – Emergency Operations Plan
Annex F: Hazardous Materials
F1: CODE ORANGE
PROCEDURE:
1. All persons involved in a hazardous materials incident are considered contaminated.
2. Safety of the decontamination team is the first priority. They will don Level C
personal protective equipment unless otherwise instructed by the Safety Officer or
the on-duty Medical Specialist.
3. A checkpoint staffed by a medical team will be set up at the entrance to the ER
driveway to assess and triage arriving contaminated patients.
4. If the number of arriving patients exceeds the capacity of the ER Decon Room, the
decontamination tents will be set up for field decontamination in the vicinity of the ER
entrance. Any staff working in the designated DIRTY area of the field
decontamination site must be in Level C personal protection equipment.
NOTE: Privacy is an important consideration in field decontamination procedures. In
order to obtain cooperation from patients, ensure their privacy with a tent or screen.
5. Once a patient has been triaged by the medical team, they will be sent to undress.
They will place their clothing in a provided bag. They will place their valuables in a
separate provided bag. Each bag will be labeled and the valuables will be placed in
a secure area. The clothing bags will be placed in a laundry cart.
NOTE: All clothing and valuables are considered to be criminal evidence unless
deemed otherwise by the police. No items will be returned to the patient until the
Incident Commander consults with police.
6. Use mild and non-abrasive soap for patient decontamination. If soap is not readily
available, use lots of water. Use soft sponges or soft scrub brushes to avoid skin
abrasions. Water spray should be gentle and at a suitable temperature.
7. Begin patient decontamination at the head and proceed downward. Care must be
taken not to flush contaminants into wounds. Wash wound area from center out.
Cover wounds with occlusive dressing or plastic wrap to prevent any further
contamination. Once all wound areas are clean, you should progress to other areas
of the body. Eyes and ear/nose cavities should be irrigated, hair washed and
fingernails cleaned. Special attention should be focused on opposing surface areas
such as the underarms and groin.
8. Initial stabilization should be carried out simultaneously with decontamination. All
personnel must wear proper PPE when providing patient treatment.
9. Ambulatory patients should be instructed in the proper ways to shower and allowed
to shower themselves. An observer will inform the patient of any areas they missed.
10. Have patient dress in a clean gown and proceed to the ER. Decontamination
personnel should give a brief overview of patient’s symptoms and injuries to the ER
nurse. If a patient must wait to be triaged, ensure that they have a clean triage tag
with the letter D noted on it as well as their presented condition and injuries. The
letter D indicates the patient has been decontaminated.
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CMH – Emergency Operations Plan
DECONTAMINATION PERSONNEL:
Medical Team
1. Made up of a provider, nurse, and nurse aide.
2. Provides for the triage and initial treatment of arriving patients.
3. Provides for the transfer of care to the hospital.
Decon Team
1. Responsible for patient decontamination.
2. Sets up and breaks down the field decontamination area.
3. Assists with transfer of patient to the hospital ER.
Plant Engineering
1. Provides technical assistance for handling of the incident.
2. Assists with the initial set-up/break down of the field decontamination area.
3. Responsible for the overall management of any non-medical needs in the field
decontamination area.
Security
1. Restricts access to field decontamination area.
2. Assists in the setup of the decontamination tents.
3. Directs non-ambulance traffic away from the field decontamination area.
4. Assists in securing all patient clothing, jewelry and valuables.
FIELD DECONTAMINATION SET-UP:
Unless otherwise instructed, decontamination tents will be set up outside of the ED.
Follow the manufacturer’s operational manual for setting up the decontamination tents.
Manuals are kept with each tent in the decontamination equipment storage area.
At the end of the incident, the decontamination tents will be cleaned and properly stored
away according to manufacturer’s recommendations. Staff will return tents and all
related equipment to the decontamination equipment storage area after it is cleaned.
Training will be conducted on a regular basis for staff responsible for decontamination
tent setup and operations.
Note: Decon tent setup will be upon instructions from the Incident Commander.
Decontamination Area Shutdown
1. At the conclusion of the decon process, the decon area must be decontaminated to
prevent the spread of any contaminated material.
2. The clean up must be done by the Decon Team while they are in PPE.
3. All contaminated solid waste is to be collected and placed in a contamination bag.
4. Hazardous material must be disposed of properly. The Fire/Police HazMat team will
give instructions on how this should be done – based upon the specific incident.
5. Waste water:
 if it is non-hazardous, it can be disposed of in the sewer system
 if it is hazardous, it must be placed in the holding tank or designated barrels.
The Facilities Director will make arrangements for the tank and/or barrels to
be emptied by the authorized vendor.
6. Tents must be cleaned and dried prior to being disassembled for storage.
7. Supplies and other equipment will be inventoried, restocked and returned to the
trailer and/or closet.
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