Untitled Document

Decontamination

Health care workers are at risk from exposure to hazardous materials when treating contaminated patients. The Occupational Safety and Health Act (OSHA) has recognized this fact and places the responsibility for ensuring a safe work environment upon the employer. This responsibility requires protection for workers, even in cases of emergencies, caused by the release (intentional or accidental) of hazardous materials.

OSHA considers hospital health care workers, who receive and treat patients contaminated by hazardous substances, to be "First Receivers." First receivers are a subset of "First Responders" and as such require "First Responder" training which will allow them to perform their duties safely.

MANDATORY TRAINING	FIRST RECEIVERS COVERED	REFERENCE
OPERATIONS LEVEL "First Receiver" Initial training (8 hrs.) & Annual refresher .	All employees with designated roles in the Hospital Decontamination Zone. This group includes, but is not limited to: 1. Decontamination staff, including decontamination victim inspectors; clinicians who will triage and/or stabilize victims prior to decontamination. 2. Security staff [e.g., crowd control and controlling access to the emergency department (ED)]; setup crew; and patient tracking clerks.	OSHA, 2003, 1992c, 1999
AWARENESS LEVEL "First Receiver" Initial training (8 hrs.) & Annual refresher	1. Security personnel, setup crew, and patient tracking clerks assigned only to patient receiving areas proximate to the Decontamination Zone, where they might encounter, but are not expected to have contact with, contaminated victims, their belongings, equipment, or waste. 2. ED clinicians, clerks, triage staff, and other employees associated with emergency departments, who might encounter self-referred contaminated victims (and their belongings, equipment, or waste) without receiving prior notification that such victims have been contaminated.	OSHA, 1991a, 1991b
UNANTICIPATED PARTICIPANTS Expedient Orientation * Nature of the hazard * Expected duties. * Appropriate use of PPE. * Other appropriate safety and health precautions (e.g., decontamination procedures).	Other employees whose role in the Hospital Decontamination Zone was not previously anticipated (i.e., who are called in incidentally). For example, a medical specialist or trade person, such as an electrician.	OSHA, 1997
POST-DECONTAMINATION Hazard Communication Standard: sufficient education to understand hazards and implement protective measures	Other personnel in the Hospital Post-Decontamination Zone who reasonably would not be expected to encounter or come in contact with unannounced contaminated victims, their belongings, equipment, or waste. For example, other ED staff, such as housekeepers.	29 CFR 1910.1200(h)

Following a mass contamination event, whether biological, chemical or radioactive, large numbers of wounded and/or contaminated victims will eventually enter the medical system. They will need:

Definition: Decontamination involves the reduction of infectious or hazardous agents to an acceptable level.
Three methods of decontamination include:

Effective decontamination, rapidly and safely reduces harm, while containing and controlling the hazardous agent in order to prevent secondary exposures.

The Federal Bureau of Investigation has released information indicating that hospitals and large shopping venues have been included in terrorist training schemes. This information adds more urgency to the need for all employees to be familiar with their facility's Emergency Management Plan. Your ability to anticipate and respond promptly can save lives in any emergency.