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Guidelines for Mass Casualty Decontamination During a Terrorist Chemical Agent Incident

NCJ Number
Victor J. Arca; Stephen M. Marshall; William A. Lake; Paul D. Fedele
Date Published
January 2000
56 pages
This document addresses issues involving chemical weapons of mass destruction (WMD) and how to decontaminate large numbers of people.
The U.S. Army Soldier and Biological Chemical Command (SBCCOM) under the Chemical Improved Response Program (IRP) formed a Mass Casualty Decontamination Research Team (MCDRT) in February 1998. This team was formed to address specific technical and operational issues associated with the performance of mass casualty decontamination after a terrorist incident involving chemical WMD. The MCDRT was assembled from affected emergency response and technical disciplines. The research team included a broad scientific and operational knowledge base, both with general experts and specialized staff, including medical doctors with direct knowledge of the physiology and toxicological effects of chemical agents, emergency responders drawn from government organizations at all levels, and from contract research organizations. Emphasis was placed on decontamination methods that could be performed with equipment and expertise readily available to most responder jurisdictions. The general principles identified to guide emergency responder policies, procedures, and actions after a chemical agent incident were: expect at least a 5:1 ratio of unaffected to affected casualties; decontaminate victims as soon as possible; disrobing is decontamination, head to toe, more removal is better; and water flushing generally is the best mass decontamination method. After a known exposure to liquid chemical agent, emergency responders should be decontaminated as soon as possible to avoid serious effects. A panel of experts from the chemical defense and emergency response communities studied each principle identified to ensure that they represented the best recommendations that provide the most benefit to the largest number of victims in the shortest possible time. 67 references and 3 appendices