Post on 31-Mar-2015
Hazardous MaterialsHazardous Materials
HAZMAT Definition HAZMAT Definition (USDOT)(USDOT)
““Any substance which may pose an Any substance which may pose an unreasonable risk to health and unreasonable risk to health and safety of operating or emergency safety of operating or emergency personnel, the public, and/or the personnel, the public, and/or the environment if not properly environment if not properly controlled during handling, storage, controlled during handling, storage, manufacture, processing, manufacture, processing, packaging, use, disposal, or packaging, use, disposal, or transportation.”transportation.”
Requirements and Requirements and StandardsStandards
OSHA: CFR 1940.120OSHA: CFR 1940.120 EPA: 40 CFR 311EPA: 40 CFR 311 NFPA: Standard 473 NFPA: Standard 473
((Standard for Competencies of Standard for Competencies of EMS Personnel Responding to EMS Personnel Responding to Hazardous Materials IncidentsHazardous Materials Incidents))
EMS HAZMAT Training EMS HAZMAT Training LevelsLevels
AwarenessAwareness Level 1Level 1 Level 2Level 2
AwarenessAwareness
All responders who may arrive first All responders who may arrive first on scene and discover hazardous on scene and discover hazardous substancesubstance
EMS, Fire, Law enforcementEMS, Fire, Law enforcement FocusFocus
– Recognition of HAZMAT incidentsRecognition of HAZMAT incidents– Basic identification techniquesBasic identification techniques– Personal protectionPersonal protection
EMS Level IEMS Level I
Patient care in Patient care in cold zonecold zone with with NONO significant 2significant 2oo contamination risk contamination risk
FocusFocus– Hazard assessmentHazard assessment– Assessment, management of Assessment, management of
previouslypreviously contaminated patients contaminated patients
EMS Level IIEMS Level II
Patient care in Patient care in warm zonewarm zone with with significant risk of 2significant risk of 2oo contaminationcontamination
FocusFocus– Personal protectionPersonal protection– Decontamination proceduresDecontamination procedures– Assessment, management Assessment, management duringduring
decondecon
EMT RolesEMT Roles
Size up incidentSize up incident Establish commandEstablish command Activate IMSActivate IMS Isolate & identifyIsolate & identify Treat, transport patientsTreat, transport patients Support HAZMAT team members Support HAZMAT team members
(medical monitoring, rehab)(medical monitoring, rehab)
Incident Size UpIncident Size Up
Size-Up PrioritiesSize-Up Priorities
Safety: Self, crew first!Safety: Self, crew first! Incident stability (Stable vs. Incident stability (Stable vs.
Unstable)Unstable) Property conservationProperty conservation
– Exposures—people, propertyExposures—people, property– Run-offRun-off
Size-Up Special Size-Up Special ConsiderationsConsiderations
Personal risk of exposure, Personal risk of exposure, contaminationcontamination
Delayed product effectsDelayed product effects Scene topographyScene topography Wind directionWind direction Decontamination corridor(s)Decontamination corridor(s) Incident facility location contingency Incident facility location contingency
plansplans
HAZMAT IdentificationHAZMAT Identification
HAZMAT IdentificationHAZMAT Identification
Often most difficult part of Often most difficult part of incidentincident
ALWAYSALWAYS use at least use at least TWOTWO concurring sourcesconcurring sources
HAZMAT ReferencesHAZMAT References
Emergency Emergency Response Response GuidebookGuidebook
Container MarkingsContainer Markings Shipping PapersShipping Papers Material Safety Data Material Safety Data
SheetsSheets Monitors/Chemical Monitors/Chemical
TestsTests
Telephone HotlinesTelephone Hotlines Poison CentersPoison Centers ChemistsChemists ToxicologistsToxicologists Reference BooksReference Books Computer Computer
databasesdatabases
Emergency Response Emergency Response GuidebookGuidebook
U.S., Canada, MexicoU.S., Canada, Mexico Lists >1000 products with placards, Lists >1000 products with placards,
UN numbers, chemical names UN numbers, chemical names Cross references emergency, Cross references emergency,
evacuation proceduresevacuation procedures Medical information is limitedMedical information is limited Multiple chemicals carry the same Multiple chemicals carry the same
numbernumber
CluesClues
Occupancy, locationOccupancy, location Vehicle, container shapeVehicle, container shape Placards, other markingsPlacards, other markings LabelsLabels Scene appearanceScene appearance Other sensory informationOther sensory information
Occupancy/LocationOccupancy/Location
What do you know about the What do you know about the activities at this location?activities at this location?
Are hazardous materials likely to Are hazardous materials likely to be manufactured, stored, used be manufactured, stored, used there?there?
Highway incidents are by Highway incidents are by definition a high risk situation!definition a high risk situation!
Fixed FacilitiesFixed Facilities
ManufacturersManufacturers WarehousesWarehouses Hardware storesHardware stores Agricultural storesAgricultural stores Water treatment Water treatment
plantsplants
Loading docksLoading docks PipelinesPipelines SilosSilos BarnsBarns GreenhousesGreenhouses
Know Your Community!
Vehicle/Container ShapeVehicle/Container Shape
External ring stiffeners frequently are present on vehicles transporting corrosives or poisons.
Vehicle/Container ShapeVehicle/Container Shape
Rounded ends on highway transport vehicles suggest presence of pressurized contents.
Vehicle/Container ShapeVehicle/Container Shape
Dome covers on rail tank cars suggest that the contents are under pressure.
Tank cars with flat ends have been insulated to control product temperature changes.
PlacardsPlacards
DOT (transport vehicles)DOT (transport vehicles) NFPA 704 (fixed facilities)NFPA 704 (fixed facilities)
DOT LabelsDOT Labels
Placed on packages/containersPlaced on packages/containers
DOT Hazard ClassesDOT Hazard Classes
HAZARD CLASSHAZARD CLASS HAZARD TYPEHAZARD TYPE
11 ExplosivesExplosives
22 GasesGases
33 LiquidsLiquids
44 SolidsSolids
55 Oxidizers, organic Oxidizers, organic peroxidesperoxides
66 Poisons, etiologic agentsPoisons, etiologic agents
77 Radioactive materialsRadioactive materials
88 CorrosivesCorrosives
99 Miscellaneous (ORMs)Miscellaneous (ORMs)
UN NumbersUN Numbers
DOT Placard LimitationsDOT Placard Limitations
ALLALL product hazards product hazards NOTNOT indicatedindicated
Incorrect placardsIncorrect placards Absent placardsAbsent placards
DOT Placard LimitationsDOT Placard Limitations
Some products Some products NOTNOT placarded placarded– Rail and motor freight containing <1000 Rail and motor freight containing <1000
pounds of:pounds of:Nonflammable gasesChlorineFluorineLiquid oxygenFlammable gasesFlammable liquids
Combustible liquidsFlammable solidsOxidizers, organic peroxidesPoison BCorrosivesIrritating materials
NFPA 704NFPA 704
Used at fixed facilitiesUsed at fixed facilities
Health
Fire
Reactivity
SpecificHazard
NFPA 704NFPA 704
HEALTH
4 = Too dangerous to enter
3 = Extreme danger—Full protective clothing
2 = Hazardous—Breathing apparatus
1 = Slight hazard
0 = No hazard FIRE
4 = Extremely flammable
3 = Ignites at normal temperatures
2 = Ignites when moderately heated
1 = Must be preheated to burn
0 = Will not burn
NFPA 704NFPA 704
REACTIVITY
4 = May detonate—Evacuate area if fire present
3 = Shock, heat may detonate—Take cover
2 = Violent chemical change possible
1 = Unstable if heated
0 = Normally stable SPECIFIC HAZARD
OX = Oxidizer
ACID = Acid
ALK = Alkali (Base)
COR = Corrosive
W = Use NO Water
Shipping PapersShipping Papers
List specific substancesList specific substances Indicate quantities carriedIndicate quantities carried Operators may not take papers Operators may not take papers
with themwith them Scene may be too unstable to Scene may be too unstable to
retrieveretrieve Papers may be incomplete, Papers may be incomplete,
inaccurateinaccurate
Material Safety Data SheetsMaterial Safety Data Sheets
Present at fixed Present at fixed facilitiesfacilities
Available for Available for ALLALL hazards on sitehazards on site
Cover wide range Cover wide range of common, of common, simple productssimple products
Typically list:Typically list:– Material nameMaterial name– CharacteristicsCharacteristics– ManufacturerManufacturer– Health, fire, Health, fire,
reactivity dangersreactivity dangers– Safe handling Safe handling
considerationsconsiderations– Emergency Emergency
proceduresprocedures
Other Sensory InformationOther Sensory Information
What do you see? Hear? Smell?What do you see? Hear? Smell? Is there a vapor cloud?Is there a vapor cloud? Is there a fire?Is there a fire? Can you hear escape of a pressurized Can you hear escape of a pressurized
product?product? Any unusual odors?Any unusual odors? Are your eyes watering, burning?Are your eyes watering, burning? Are there dead animals, birds, fish Are there dead animals, birds, fish
observable?observable?
CHEMTREC HotlineCHEMTREC Hotline
Chemical Transportation Chemical Transportation Emergency Center (CHEMTREC)Emergency Center (CHEMTREC)
1-800-424-93001-800-424-9300
Sponsored by Chemical Sponsored by Chemical Manufacturer’s Association (CMA)Manufacturer’s Association (CMA)
CHEMTREC ServicesCHEMTREC Services
Emergency response informationEmergency response information Access to manufacturer’s Access to manufacturer’s
representativesrepresentatives Activation of specialized teams to Activation of specialized teams to
deal with chlorine, phosphorus, deal with chlorine, phosphorus, vinyl chloride, HCN, HF, and LPGvinyl chloride, HCN, HF, and LPG
Activation of CHEMNET response Activation of CHEMNET response teamsteams
CHEMTREC LimitationsCHEMTREC Limitations
Communicators Communicators NOTNOT technical technical personnelpersonnel
Will Will NOTNOT interpret data or go beyond interpret data or go beyond what information sheets saywhat information sheets say
Must have product trade or chemical Must have product trade or chemical name to provide assistancename to provide assistance
Cannot provide information on Cannot provide information on effects of mixing of several productseffects of mixing of several products
CHEMTREC Information CHEMTREC Information NeededNeeded
What has happened?What has happened? Where?Where? When?When? Chemical(s) involvedChemical(s) involved Container type Container type
conditioncondition Shipper/originShipper/origin CarrierCarrier
Consignee/destinationConsignee/destination Nature/extent casualtiesNature/extent casualties Nature/extent property Nature/extent property
damagedamage Prevailing weatherPrevailing weather Nature of incident areaNature of incident area Caller name/locationCaller name/location Call-back numberCall-back number
Federal, State, Local Federal, State, Local ResourcesResources
FederalFederal– US EPAUS EPA– Coast GuardCoast Guard
StateState– TNRCCTNRCC– TDHTDH– Railroad CommissionRailroad Commission– Parks & WildlifeParks & Wildlife– Agriculture Agriculture
DepartmentDepartment
LocalLocal– Poison ControlPoison Control– Health Health
DepartmentDepartment– Colleges, Colleges,
UniversitiesUniversities
Protective Equipment and Protective Equipment and Medical MonitoringMedical Monitoring
Protective Equipment Protective Equipment TypesTypes
Level ALevel A Level BLevel B Level CLevel C Level DLevel D
Level ALevel A
Highest level of respiratory/skin Highest level of respiratory/skin protectionprotection
Suit fully encapsulates rescuer, SCBASuit fully encapsulates rescuer, SCBA Used in hot zone with:Used in hot zone with:
– Unknown substancesUnknown substances– Substances with potential for respiratory Substances with potential for respiratory
and skin absorption hazardsand skin absorption hazards
Level ALevel A
Level BLevel B
Full respiratory Full respiratory protectionprotection
Lower skin protection Lower skin protection levellevel
Suit non-Suit non-encapsulating, but encapsulating, but chemically resistantchemically resistant
SCBA worn outside of SCBA worn outside of suitsuit
Typically worn in warm Typically worn in warm zone by decon teamzone by decon team
Level CLevel C
Non-permeable suit, Non-permeable suit, boots, hand, eye boots, hand, eye protectionprotection
Air-purifying Air-purifying respirator with respirator with cartridges for cartridges for specific substancesspecific substances
Worn during Worn during transport of patients transport of patients with 2with 2oo contamination riskcontamination risk
Level DLevel D
Firefighter turnout gearFirefighter turnout gear NOTNOT suitable for HAZMAT suitable for HAZMAT
incidentsincidents
Selection of PPESelection of PPE
Based on chemical involvedBased on chemical involved NONO single suit material is single suit material is
appropriate for all chemicalsappropriate for all chemicals Permeability charts should be Permeability charts should be
consulted to determine consulted to determine breakthrough times for suit breakthrough times for suit materialmaterial
Selection of PPESelection of PPE
Latex gloves are Latex gloves are NOTNOT chemically chemically resistantresistant
Nitrile gloves hive high resistance Nitrile gloves hive high resistance to most chemicalsto most chemicals
Leather boots will absorb Leather boots will absorb chemicals permanentlychemicals permanently
Medical Monitoring & Medical Monitoring & RehabRehab
A primary role of EMSA primary role of EMS Entry team personnel should have Entry team personnel should have
annual physicals with baseline annual physicals with baseline vitals on filevitals on file
Monitoring of crews prior to Monitoring of crews prior to entering and after working within entering and after working within the warm and hot zones.the warm and hot zones.
HAZMAT ZonesHAZMAT ZonesHot Zone
Contamination Present
Appropriate PPE
Limited number of personnel
Everything inside considered contaminatedWarm Zone
Contamination Control Zone
Appropriate PPE
Decon Corridor
Life-Saving Emergency Care
Cold Zone
CP Location
Treatment/Transport Areas
Staging
Medical Monitoring/Rehab
DecontaminationDecontamination
Decon Decision MakingDecon Decision Making
Fast BreakFast Break Long TermLong Term
Fast BreakFast Break
Quick decisions to prevent Quick decisions to prevent rescuer, equipment rescuer, equipment contaminationcontamination
Used on incidents with:Used on incidents with:– Patients who have self-rescuedPatients who have self-rescued– Critical patients out of hot zone Critical patients out of hot zone
needing immediate careneeding immediate care– Unknown materialsUnknown materials– Potentially life-threatening materialsPotentially life-threatening materials
Fast BreakFast Break
Do Do NOTNOT expose yourself expose yourself Contain, isolate patientsContain, isolate patients Remove clothing, if possible by Remove clothing, if possible by
having them undress themselveshaving them undress themselves Wash with large amounts of waterWash with large amounts of water Wrap completely in blankets Wrap completely in blankets
(human burrito)(human burrito)
Fast BreakFast Break
What are the What are the risksrisks associated associated with immediate care?with immediate care?
What are the What are the benefitsbenefits of the of the patient receiving immediate care?patient receiving immediate care?
Transport ConsiderationsTransport Considerations
Patients field decontaminated are only Patients field decontaminated are only semi-decontaminatedsemi-decontaminated
May harbor latent contaminants, may May harbor latent contaminants, may outgas contaminants in body fluidsoutgas contaminants in body fluids
Limit number of ambulances used in Limit number of ambulances used in transporttransport
Remove non-essential equipmentRemove non-essential equipment Wrap patient in plastic sheeting, Wrap patient in plastic sheeting,
blanketsblankets Cover floor with plastic sheetingCover floor with plastic sheeting
Transport ConsiderationsTransport Considerations
Better Dirty and Alive than Clean and Dead!
Transport ConsiderationsTransport Considerations
Do NOT assume your hospitals are equipped to
handle contaminated patients
Transport ConsiderationsTransport Considerations
Preplan transport of contaminated Preplan transport of contaminated patients to hospitalspatients to hospitals– Hospitals may want contaminated Hospitals may want contaminated
patients delivered to location other patients delivered to location other than usual ER entrancethan usual ER entrance
– Hospitals need adequate warning to Hospitals need adequate warning to prepare to receive these patients. prepare to receive these patients. Alert should come when Alert should come when firstfirst EMS unit EMS unit arrives at the scene.arrives at the scene.
WMD & TerrorismWMD & Terrorism
TerrorismTerrorism
A violent act or act dangerous to A violent act or act dangerous to human life, in violation of the human life, in violation of the criminal laws of the U.S. or any criminal laws of the U.S. or any segment to intimidate or coerce a segment to intimidate or coerce a government, the civilian government, the civilian population or any segment population or any segment thereof, in furtherance of political thereof, in furtherance of political or social objectives.or social objectives.
Terrorism TargetsTerrorism Targets
Potential TargetsPotential Targets– Public buildingsPublic buildings– Multinational HQsMultinational HQs– Shopping centersShopping centers– WorkplacesWorkplaces– Public assembly placesPublic assembly places– Places of worshipPlaces of worship– SchoolsSchools
Terrorism TargetsTerrorism Targets
Preplan potential targetsPreplan potential targets Multiple patients with similar signs, Multiple patients with similar signs,
symptoms = High index of suspicionsymptoms = High index of suspicion Consider secondary device, attack riskConsider secondary device, attack risk Think:Think:
– Occupancy or locationOccupancy or location– Type of eventType of event– Timing of eventTiming of event– On-scene warning signsOn-scene warning signs
WMDWMD
BBiologicaliological
NNuclearuclear
IIncendiaryncendiary
CChemicalhemical
EExplosivesxplosives
Protective MeasuresProtective Measures
All forms of protection can be All forms of protection can be defined in terms of:defined in terms of:
TimeTime
DistanceDistance
ShieldingShielding
ConsiderationsConsiderations
Acts of terrorism are criminal acts Acts of terrorism are criminal acts and will fall under the jurisdiction and will fall under the jurisdiction of the FBI.of the FBI.
ICS is pivotal in the successful ICS is pivotal in the successful mitigation of any terrorist act.mitigation of any terrorist act.
Self safety is foremost Self safety is foremost consideration at all times.consideration at all times.