CSEPP.ORG

Introduction

The Oregon CSEPP specifies that anyone exhibiting signs or symptoms of chemical agent exposure, passed through a potentially contaminated area, or demand decontamination, be decontaminated prior to transport via Emergency Medical Services or entry into an American Red Cross (ARC) mass care shelter. Persons are first screened at a Decontamination Site to determine if they show signs or are experiencing symptoms of possible exposure. If the persons are free from symptoms and do not require decontamination they are directed to a mass care center (where the ARC can assist them with registration, disaster welfare locator service, food, shelter, first aid, and disaster mental health services). If they are symptomatic, or passed through a potentially contaminated area, they will need to be decontaminated. The CSEPP has provided Decontamination Trailers and Tents to be set-up to decontaminate personnel quickly.

The County ECC/EOC may have some Pre-Planned Decontamination Sites; however, the Incident Commander will have the final decision on actual locations. The chosen location should provide space to park potentially contaminated vehicles, have sufficient space to set-up a Decontamination Trailer or Tent and should have ready access to designated evacuation routes.

This location must further allow emergency services personnel to direct evacuees off designated evacuation routes and quickly assess their circumstance (refer to Initial Screening Annex).  If they need assistance or have symptoms of exposure, refer them to decontamination or on to an Assistance Center.

Decontamination Trailers and Tents were designed and selected by Oregon CSEPP to be used to decontaminate civilian population and/or emergency workers. Persons will be checked or “screened” for possible exposure, given a "pass", or processed through decontamination as needed (or the person demands such care).

Processing Ambulatory Patients through the decontamination site involves screening, obtaining identifying information, undressing, a thorough shower, dressing in temporary clothing, and then transporting to an ARC  Assistance Center or, if a person's medical condition indicates, referred to a Medical Facility.

Non-Ambulatory Patients are placed on a litter, moved to the non-ambulatory decontamination area, clothing is cut off of the patient and they are washed with soap and water by staff from the site. The litter and patient are then turned over to the Medical Personnel.

SCREENING AND DECONTAMINATION STANDARD OPERATING PROCEDURE (SOP)

These decontamination procedures are designed for use by trained personnel.

Only personnel who have received the following CSEPP training will be allowed to fill positions at a decontamination site;

1. Medically screened and Fit Tested to wear a respirator
2. Trained in proper care and use of respirator
3. Trained to properly use the PPE Ensemble, (BDO, boots, gloves, glove liners, etc.)
4. Trained to recognize the signs and symptoms of Chemical Agent Exposure and to properly treat a victim of that exposure.
5. Trained to function in their assigned duty at the site.

Each County Emergency Operations Center will designate the agencies tasked with set-up and operation of the Decontamination Trailers or Tents. The training of the personnel in these agencies will be provided by the Oregon Health Division PPE Coordinator and/or their designee. This training will include procedures to set-up and operate the facility, how to screen people for necessity of decon, what steps are required for coordination among decontamination staff and the ECC-EOC/ARC, worker protection, and specific steps taken to prevent the spread of contamination.

HOW TO USE THIS PROCEDURE

The SOP is divided into sections. Each section describes a specific set of tasks that must be performed to set-up and operate the screening facility and Decontamination Trailer or Tent.

Each section is designed to be complete, so it can be "separated" from the entire SOP and used by the specific personnel assigned the stated function or duty. The sections and related ATTACHMENTS can also be "copied out of the document" for training purposes or ready reference.

To aid in training and operations, flow charts, pictures, signs or diagrams (with key items marked) are provided where practical. They can be used to familiarize staff with the preferred method of operations. Throughout the document, numerical "steps" allow for ease in recording activities; "boxes" allow information to be recorded; and underline or bold print reminds the user of possible issues for resolution by supervisors (or provides alternatives or suggestions to staff to make for operational efficiencies).

THE SCREENING AND DECONTAMINATION PROCESS

1. In the event of an incident involving a release of chemical agents from Umatilla Chemical Depot, County ECC/EOCs will order the commencement of agent exposure control operations (screening, processing, decontamination, medical treatment, etc.).
2. The Incident Commander sends Decontamination Trailers to pre-assigned locations, or newly identified locations to be set-up for operations. The incident commander may change these locations as needed. (generally along evacuation routes)
3. No screening or decontamination activities should begin until a site is fully functional.
4. The Decontamination Sites should be set-up as described in the Decontamination Site Set-up and Operations SOP.
5. The Incident Commander and County ECC/EOCs are to be advised when the Decontamination Sites are operational.
6. The Site Manager further contacts the Incident Command Post (ICP) regarding any unmet needs, equipment, transportation, medical problems, personnel, security, traffic control, crowd control, loss of facility or trailer power/lights, etc.
7. Screening staff will initially question and observe (screen) evacuees or emergency workers to determine if those individuals are exhibiting signs and symptoms of agent exposure. Any individual exhibiting signs or symptoms of exposure are assumed to be contaminated.
8. Screening staff will direct anyone assumed contaminated, or demanding decontamination, to the Contaminated Parking area, then on to the Processing Area.
9. For people who refuse decontamination: determine their location during the event and the likelihood of contamination. If contamination is likely they will be refused contact with the clean population until decontaminated or proven not contaminated. See the Patient Refusal Form Annex D: Attachment 1.
10. Anyone that shows moderate or severe symptoms, or presents with an illness or injury while waiting, should be moved to the front of the line for immediate processing.
11. All animals will be treated as if they may have been exposed/contaminated and shall be processed through the decontamination facility along with their respective owners. The animals are the owners responsibility at all times. Owners will facilitate the washing of the animal per decontamination instructions from the decon attendant. If an animal becomes combative it shall be removed from the decontamination site to prevent injury to others.

    The decontamination sites will furnish leashes which have the capability of being decontami-nated. If the leash cannot be decontaminated due to type of material, a new leash will be issued on the clean side of the decontamination process.

    Animals will not be allowed in to the hospital or assistance center setting; instead they will need to be sent to a collection facility which has the proper means of housing and caring for them until at which time they are cleared to be returned to their owners.

12. Emergency Medical Services should be contacted when anyone presents with severe illness or injury. Such persons should immediately be decontaminated and taken to the medical treatment tent.
13. Non-Ambulatory patients will be placed on a Litter and moved to the Non-Ambulatory Decon area. Once there, they will have their clothing removed, be washed with soap and water by decon site staff and then turned over to the medical personnel. In the case of a Decon Tent, the process is the same except that the actual decon process will be done over the containment pool on sawhorses.

SAMPLE SCREENING AND DECONTAMINATION FACILITY DIAGRAM