CSEPP.ORG

Department of Health Services

I) Purpose

1. This guideline provides information and assistance in the proper setup and use of CSEPP decontamination trailers. The purpose of this guideline is to ensure that systems are rapidly deployed and ready to provide adequate protection for civilians in any emergency.

II) Scope

1. This guideline applies to all CSEPP decontamination operations. This guideline will serve as the written decontamination program for all fire and medical personnel.

III) References

1. None cited.

IV) Definitions

V) Program Requirements

A) Storage

1. All trailer supplies should be kept at the local department. The decontamination setup consists of:
   1. A Self contained decontamination trailer complete with water heaters, sump pumps, water collection bladders, traffic cones, and any other equipment deemed necessary to conduct decontamination operations.
2. Each agency shall store the decontamination supplies on site ready for rapid deployment.

B) Inventory

1. The Oregon Department of Health Services (DHS) will inventory/test the decontamination supplies once a year to ensure that all equipment is functional. Each agency should also exercise or test the equipment on a yearly basis to ensure that it functions properly.
2. If decontamination supplies are found damaged due to natural wear and tear, the DHS and or respective county will replace the equipment.
3. If supplies are damaged after it has been issued, through unreasonable circumstances, the Department of Health Services will work with the respective county and department to determine if reimbursement to CSEPP is necessary.

C) Maintenance

1. Each agency is responsible to maintain the trailer in working order.
2. If there is a problem noted with the trailer, contact your DHS representative and they will help you fix the trailer. In most cases, DHS will pay to have the trailer repaired.
3. DHS employees will test the trailer after each yearly exercise and replace any expired or used equipment. DHS employees will organize the trailer in the most efficient manner possible. If any agency practices with the trailer during the year, that agency is responsible to ensure the trailer remains organized and functional.
4. The trailers are to remain plugged in year around to keep the batteries charged. The generators will not start if the batteries are dead.

D) Training

1. Department of Health Services
   1. The DHS shall create a training package for decontamination.
   2. The DHS shall train all personnel in the proper field use of the trailers.
   3. The DHS will 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.
   2. Each department shall keep records of decontamination training for each individual in their department.

VI) Operations Guideline

A) 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 agent (i.e., patient receiving, triage, traffic and shower stalls).
2. All personnel should have PPE available to them at all times when working at decontamination sites.
3. All responders wearing PPE must abide by the work rules established by the DHS. The WBGT chart, based upon real time WBGT readings, governs suit wear time (see the PPE Program for the Chart).
4. The trailer shall be setup in a pre-designated location to ensure electrical and water hook-ups are available (if applicable), otherwise tenders to supply water must be available.

B) Decontamination Site Assembly:

1. Hospitals--See Section IX
   
   1. The decontamination site should be set up and ready to receive patients in a timely manner. The average setup time for a complete setup of the trailer is approximately 45 minutes.
   2. If a quick setup is needed to expedite patient decontamination, then the trailer can be ready to receive patients in about 15 minutes if the peripheral equipment is not deployed. Note: Rapid setup is accomplished by emptying the trailer by cart, starting the generator, attaching the water bladder, and then supplying water.
2. Fire Departments - See Section VIII
   
   1. The decontamination site should be set up and ready to receive patients 30 minutes after arrival at the site. The average setup time for a complete setup of the trailer is approximately 30 minutes.
   2. If a quick setup is needed to expedite patient decontamination, then the trailer can be ready to receive patients in about 15 minutes if the peripheral equipment is not deployed. Note: Rapid setup is accomplished by emptying the trailer, starting the generator, attaching the water bladder, and then supplying water.

C) Staffing Locations/Duties:

1. Site Manager/Team Lead ( See Appendix I )
   1. Partial PPE required if outside near decontamination set-up.
   2. Assigns work for all team members
   3. Ensures trailer setup is complete and site is operational.
   4. Opens site for operations.
2. Site Safety Officer ( See Appendix II )
   1. Partial PPE required if outside near decontamination set-up.
   2. Establishes WBGT/heat index readings for PPE wear time.
   3. Ensures radio communications between team members.
   4. Establishes personnel staging area.
   5. Ensures proper PPE donning of all personnel.
   6. Tracks all personnel and suit, wear times.
3. Initial Screening/Traffic Control ( See Appendix III )
   1. Full PPE ensemble
   2. Number of people not defined - depends on resources available
   3. Control flow of traffic to the decontamination site (barricades etc.)
4. Triage ( See Appendix IV )
   1. Full PPE ensemble
   2. Process patients in order of severity using START triage. See the Medical Plan for complete START triage guidelines.
5. Entry Into the Trailer ( See Appendix V )
   1. Full PPE ensemble
   2. Controls patient flow into the trailer.
   3. Instructs patients on what to do with valuables and clothing upon entering the trailer.
6. De-gowning/Showers ( See Appendix V )
   
   1. Full PPE ensemble
   2. Monitors patients inside of the trailer
   3. If there are not enough resources to fill this position, then it can be filled by the Entry person or visa versa. Ideally there would be one person to fill each position.
   4. Ensures proper patient decontamination
7. Gowning ( See Appendix VI )
   1. Person should wear all PPE except for a respirator
   2. Ensures proper patient decontamination
   3. Visually sizes patient and gives towel and gown/slippers
   4. Ensures that patient moves to medical staging
   5. Applies Blue Decontamination Tag
8. Medical ( See Appendix VII )
   
   1. Partial PPE with gloves, respirator, coat and PAPR close by.
   2. Person shall be medically trained to perform triage.
   3. Scan patients as decon’d with scanner.
   4. Determine patient destination (medical or assistance center).
9. Maintenance ( See Appendix VIII )
   1. PPE not necessary for initial trailer setup.
   2. Preventive maintenance operations during a drill/event, the maintenance person should wear full PPE.
   3. Ensure that all equipment remains functional, and monitors all trash.
10. Personnel De-gowning ( See Appendix IX )
    
    1. Full PPE including an apron. Add an extra pair of butyl gloves over existing gloves.
    2. Helps responders doff their contaminated PPE.

D) Non-Ambulatory Decontamination:

1. This process requires at least 3-4 people in full PPE.
2. Place patient on a backboard with straps.
3. Move patient to the non-ambulatory area and strip all clothing and personal items (bag and label the items).
4. Place the patient and backboard onto the roller bed.
5. Wash the patient from top to bottom and head to feet. Log roll the patient to ensure that the entire body is washed.
6. Before transferring the patient and backboard to the awaiting gurney, wash the underside of the backboard to ensure all contaminants are washed away. Or transfer the patient to a clean backboard. Note: the transferring of patients to a clean backboard increased the potential for injury of the patient.
7. Pass the patient to the medical personnel on the clean side of the area for transport to the ER.

VII) Responsibilities

A) Department of Health Services

1. Create a written decontamination program.
2. Train all personnel on the proper use and setup of the tent/trailer.
3. Organize yearly tent /trailer and decontamination exercises/drills.

B) Fire and Medical Departments

1. Ensure all identified personnel are trained to all decontamination procedures.
2. Store all equipment in a safe and easily accessible location.
3. Conduct drills, at least yearly, to ensure personnel proficiencies with equipment.

VIII) Fire Department Co-location setup

IX) Hospital Decontamination Set-up

X) Decontamination Unit Preparation

AT STATION:

1. Ensure all compartment doors on trailer are unlocked.
2. Turn on Propane valve in front center compartment.
3. Enter clean room and start generators following this sequence:
   
   1. Turn on 12 volt toggle switch on upper left corner of control panel.
   2. Turn on Gas Detector switch, a slow "chirping" sound should be heard. This will continue for up to 2 minutes. (If a rapid chirping sound is heard, turn Gas Detector switch off then back on again)
   3. When the chirping stops and the green light comes on, depress the "Start" button on either generator control and hold it until the generator is running. If the generator has not started in 1 minute of cranking, attempt to start the other generator for up to 1 minute then re-attempt the first generator again. Repeat the sequence as needed.
   4. Once the generators are both running smoothly, switch the two main power controls from "shoreline" to "generators".
4. Exit the trailer, disconnect the shorelines from the power source and store them properly.
5. Ensure that potable water tank is full or being filled.
6. Confirm all trailer/tow unit hitch connectors are latched properly.
7. Start Tow unit and allow to build air pressure if needed.
8. Do one final walk around to make sure the unit may be moved safely.
9. Notify Site Manager that the unit is ready to roll.

AT DECON SITE:

1. Park as directed by the Site Manager and set tow unit parking brake. Turn off tow unit engine.
2. Obtain Wheel Chocks from Clean room of trailer and chock the rear wheels of the tow unit.
3. Deploy the steps and handrails at both the entrance and exit of the trailer.
4. Check trailer level by checking RV type levels mounted to the control panel in the clean room. Trailer may be as much as 1/2 bubble off level and will still function well. If trailer is MORE than 1/2 bubble off, then level trailer using the following procedure:
   
   1. On Control Panel, locate the hydraulic leveler controls, (Left side 1/2 down from top), activate Power switch.
   2. Utilize only the hydraulic jacks needed to properly level the decon trailer. (cribbing may be needed if the site has an excessive slope)
5. Move on to your assigned task for site set-up.