CSEPP.ORG

Department Health Services

I. Purpose

1. This guideline provides information and assistance in the proper selection, use and care of personal protective equipment (PPE). The purpose of this guideline is to ensure that PPE is properly used to provide adequate protection for emergency responders from chemical blister agents.

II. Scope

1. This guideline applies to all Department Health Services operations and all uses of PPE. This guideline will serve as the written PPE program for all fire, medical and law enforcement personnel.

III. References

1. Army and FEMA Personal Protective Equipment Instructors Guide, August 1994.

IV. Definitions

V. Program Requirements

1. Storage

   1. All PPE must be kept at the local department. PPE will consist of:
      
      1. Flight Bag for storage
      2. Respirator (MSA Ultraview face piece) or (3M hooded respirator)
      3. Respirator (Battery pack with Ni-cad battery attached)
      4. Respirator (Lithium battery back-up)
      5. Respirator (Chemical cartridges: for training and for an event)
      6. Suit-one package containing both the pants and the jacket
      7. One pair of cotton under-gloves
      8. One pair of butyl rubber chemical gloves
      9. One pair of rubber boots
      10. Training equipment - suit, gloves, liners, cartridges and boots
   2. The Oregon Department of Health Services (DHS) will keep extra PPE available in case it is damaged during drills or exercises. PPE will be issued to each person in a department only after they have completed all of the necessary training.
   3. PPE shall not be kept in personal or work vehicles due to the high heat extremes in the summer.
   4. If a PAPR is used for reasons other than CSEPP events, it is the responsibility of the person the PPE is issued to, to ensure that the face piece is functional for a CSEPP incident.
   5. Umatilla and Morrow Counties will also be outfitted with one bulk PPE trailer. The trailers store bulk inventories of suits, respirator supplies, gloves, boots, MRE's, water, blankets and other required equipment. (See Appendix 3)
      
      1. Heppner Fire Department will store the west end trailer and shall deploy it in the case of a CSEPP event.
      2. Umatilla Fire Departments will store the east end trailer and shall deploy it in the case of a CSEPP event.

2. Inventory

   1. The Department Health Services will keep a database to track PPE distribution by individual and department.
   2. All PPE will be inventoried monthly by the Department Health Services. A card located on the flight bag will indicate the date inspection and the person who inspected the equipment.
   3. If PPE is damaged after it has been issued, through unreasonable circumstances, the Department Health Services will work with the respective county and department to determine is reimbursement to the county is necessary.

3. Maintenance

   1. The Department Health Services will inspect all PPE for damage on a monthly basis. If any equipment is found to be faulty, it will be replaced with new or undamaged equipment.
   2. The Department Health Services will keep a record on file of all inspections replaced equipment.

4. Training

   1. Department Health Services
      
      1. The DHS shall create a training package for PPE utilization.
      2. The DHS shall train all first responders in the proper field use of the PPE yearly.
      3. The DHS maintain a set of training records for each individual/department trained.
   2. Individual Departments
      
      1. Each department shall ensure that all identified first responders receive the appropriate training from the DHS yearly.
      2. Each department shall keep records of PPE training for each individual in their department.

VI. PPE Specifications

1. MSA Ultraview or 3M Hooded Respirator PAPR

   Note: This is the only personal protective equipment allowed during a CSEPP event.
    

   1. The respirators and cartridges have been approved for use in areas where HD Mustard may be present. They ARE NOT approved for areas Immediately Danger to Life and Health (IDLH).
   2. The shelf life for the canisters is 4 years
   3. The respirator has been tested by Battelle and approved by the CDC/NCEH and NIOSH as a respirator the will work for the CSEPP program.

2. Mark IV BDO (COUGAR) Suit

   1. The suit is a permeable, expendable two-piece overgarment consisting of one coat and one pair of trousers.
   2. The outer layer is made of nylon cotton and the inner layer is a charcoal impregnated polyurethane foam. Some charcoal may be deposited on the skin or clothes while being worn, but will not detract from the protective qualities of the suit.
   3. Wear time for the suit begins when it is taken out of its protective bag. The suit will provide a minimum of 24 hours of protection against liquid and vapor chemical agents. When the suit was tested for breakthrough of vapor agents the suit lasted 10+ days without failing.
   4. The suit is considered unserviceable if ripped, torn, if fasteners are broken or missing, or if petroleum, oils, or lubricants are spilled or splashed on the garment.
   5. The shelf life for the suit is 12 years.

3. Butyl Rubber Chemical Gloves

   The 7 millimeter butyl glove will protect the wearer from chemical agents for Mustard (HD)---75 minutes with liquid deposition

   1. If the gloves become contaminated, replace within 60 minutes.
   2. The shelf life for the glove is 15 years

4. Cotton Under-Gloves

   1. This glove will not protect you from chemicals. It is to be used as an under-glove only and is designed to absorb moisture.

5. Rubber Boots

   1. The overshoes will provide up to 12 hours of protection against liquid and vapor depositions.
   2. The overshoe is designed to be worn over your existing shoes.
   3. If the overshoe shows signs of deterioration (cracks, tears, punctures, rubber become sticky), replace the overshoes. Also, replace the overshoe if it comes in contact with petroleum products.
   4. The shelf life for the overshoes is 15 years.

VII. Operations Guideline

1. General

   1. PPE is to be worn by any first responder who is working in an area that is contaminated or suspected to be contaminated with chemical blister agent.
   2. First responders should have PPE available to them at all times when working at decontamination/medical sites or while performing traffic duties within the IRZ/PAZ.
   3. All responders wearing PPE must abide by the work rules established by the DHS. The Wet Bulb Globe Thermometer (WBGT) chart, based upon real time WBGT readings, governs suit wear time.
   4. All responders must have their vital signs monitored prior to donning PPE. If the vitals do not fall within the range of acceptable limits, the responder shall not donn PPE (see Appendix 1 &2: Pre/Post Vitals Entry Criteria).
   5. Responders will not be sent into any area that is known or suspected to be contaminated with chemical agents.

2. Donning the Mark IV BDO (in order)

   1. Pants-Velcro at waste and tie suspenders
   2. Overshoes - Velcro pants on the outside of the boots.
   3. Jacket - Velcro at waist. Zip part way. Do not put the hood of the jacket on at this time.
   4. PAPR - Donn PAPR (turn it on before donning), then pull the jacket hood over head and then zip and fasten the Velcro at the neck.
   5. Gloves - Put on cotton gloves then butyl gloves. Tuck gloves into sleeves and fasten Velcro around wrists.

3. Doffing the Mark IV BDO if NOT contaminated

   1. Undo all Velcro straps (legs, wrists etc.)
   2. Remove respirator headpiece and blower
   3. Remove Jacket
   4. Remove Pants
   5. Remove boots without cutting

4. Doffing the Mark IV BDO (in order-for one person if contaminated) although one person decon is not recommended.

   1. Undo all Velcro straps (legs, wrists, and hood straps).
   2. Overshoes - Neutralize with decon spray and remain in boots.
   3. Battery Pack--Remove PAPR battery pack (leave unit powered and face piece on). You may have to set the battery pack on a table or bench to support the weight.
   4. Apron - Undo clips and remove (if applicable)
   5. Jacket - Undo Velcro, unzip, then remove jacket.
   6. Pants - Untie suspenders and throw over shoulder, undo Velcro, and then cut the pants down the outside of each leg. Pull pants off and discard.
   7. PAPR - Grab the face piece/hood and pull up and over head without loosening any of the straps.
   8. Discard of all contaminated clothing/respirator equipment in a hazardous waste container or vapor barrier bag marked as "Hazardous Waste".
   9. Gloves - Remove the butyl rubber gloves inside out making sure not to touch the outside portion and dispose of appropriately.

5. Doffing PPE with a Buddy (Buddy to perform doffing steps)

   1. Receive a spray down of .5% bleach solution from head to toe, including all equipment, if the respirator is going to be re-used for another mission. Allow the bleach to sit for 5 minutes. All sites are provided with a sprayer and bleach containers.
   2. The Buddy shall undo all Velcro straps (legs, wrists, and hood straps).
   3. Battery Pack - Remove PAPR battery pack (leave unit powered and face piece on). The person wearing the PPE shall hold the battery pack out and away from the buddy until the suit is removed.
   4. Apron - Undo clips and remove (if applicable)
   5. Jacket - Undo Velcro, unzip, remove jacket.
   6. Pants - Untie suspenders and throw over shoulder, cut pants down the outside of each leg. Pull pants off and discard.
   7. Overshoes - Overshoes shall be neutralized and remain on to be reused by the responder.
   8. PAPR - The person wearing the PPE will then grab the face piece and pull up and over head without loosening any of the straps. This should be done in one quick upward motion.
   9. Gloves - Remove the butyl rubber gloves inside out making sure not to touch the outside portion. Discard the gloves
   10. Discard of all contaminated clothing/respirator equipment in a hazardous waste container or vapor barrier bag marked as "Hazardous Waste". Note: If the respirator facepiece/hood, belt and blower unit have been sprayed with bleach, then they can be reused.

6. PPE Limited Stay Times

   1. Wet Bulb/ Dry Bulb Globe Thermometer (WBGT)
      
      1. The WBGT shall be used to determine the heat index and the work rest cycles before donning PPE for each mission.
   2. WBGT Setup
      
      1. Attach unit to tripod
      2. Insert probes
      3. Fill wet bulb with distilled water
      4. Turn dial to WBGT (out) for outside readings
      5. Place in direct sunlight or in working area "conditions" (shade…)
      6. Wait 5-10 minutes or until temperature stabilizes before taking a reading.
      7. Compare reading to chart for work/rest cycles.
   3. PPE - Work/Rest Cycles - See Appendix 1

VIII. Responsibilities

1. Department Health Services

   1. Create a written PPE program.
   2. Train all Umatilla and Morrow County responders and hospital staffs.
   3. Maintain all PPE equipment to ensure that it is completely functional and safe to operate at any time.

2. Fire, Law and Medical Departments

   1. Ensure all identified personnel are trained to all PPE procedures.
   2. Store all PPE in a safe and cool location that is easily accessible.
   3. Allow the DHS access to the PPE on a monthly basis for inspection.
   4. Conduct drills, at least yearly, to ensure responder proficiencies with PPE.