Emergency Medicine Book

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Contaminated Casualty Management

Aka: Contaminated Casualty Management
  1. See Also
    1. Chemical Weapon
    2. Biological Weapon (Bioterrorism)
    3. Biological Neurotoxin
    4. Decontamination in Children
    5. Decontamination
  2. Indications
    1. Chemical Weapon
    2. Biological Weapon (Bioterrorism)
    3. Biological Neurotoxin
  3. Protocol: Dirty Side (Liquid Contaminated area)
    1. Emergent Management (ABCD)
      1. ABC Management
      2. Drug Antidotes
    2. Decontamination Areas
      1. Litter Decontamination (Requires person on each side)
        1. Decontaminate Mask and hood with Hypochlorite 5%
        2. Remove the hood (Leave mask in place)
        3. Remove field medical card
        4. Remove gross contamination from protective clothing
        5. Cut and remove protective garment jacket, trousers
        6. Remove outer gloves, over-boots, combat boots
        7. Remove inner clothing, underwear
      2. Ambulatory Decontamination
        1. Decontaminate and remove hood
        2. Decontaminate mask and surrounding skin
        3. Place field medical card into plastic bag
        4. Remove all gross contamination from outer clothing
        5. Remove the over-garment jacket
        6. Remove Rubber gloves, over-boots
        7. Remove over-garment trousers
        8. Remove cotton glove liners
        9. Check clothing and skin for contaminant
        10. Lift mask with eyes closed and breath holding
        11. Wipe face
        12. Replace, seal, and clear mask
    3. Physical Decontamination with shower and Hypochlorite
      1. See Decontamination
  4. Protocol: Hot Line
    1. Well marked line dividing clean from dirty side
      1. Divides area free of liquid contamination
      2. Another line might also indicate vapor/mask line
    2. Mark with engineer tape
    3. May require concertina wire fence and armed guard
  5. Protocol: Clean Side (Liquid contaminant free area)
    1. Arrival Point
      1. Entrance to casualty receiving area
      2. One road for incoming, one road for outgoing
    2. Triage Area (Senior Medic, Physician, NP, PA)
      1. Immediate
      2. Minimal
      3. Delayed
      4. Expectant
    3. Emergency Treatment Area
      1. Immediate Casualty Treatment
      2. Minimal Casualty Treatment
  6. Protocol: Evacuation
    1. Urgent: Transport in 2 hours
    2. Priority: Transport in 4 hours
    3. Routine: Transport in 24 hours

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