Emergency Medicine Book

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Decontamination in Children

Aka: Decontamination in Children, Pediatric Decontamination, Contaminated Casualty Management in Children
  1. See Also
    1. Chemical Weapon
    2. Biological Weapon (Bioterrorism)
    3. Biological Neurotoxin
    4. Decontamination
  2. Indications
    1. Chemical Weapon Exposure
    2. Toxin Exposure
  3. Precautions
    1. Patients with critical injuries are decontaminated first
    2. Avoid separating families from their children unless otherwise dictated by critical medical priorities
    3. All children should have a unique identification number on wristband or similar
    4. Following Decontamination, patients should be triaged for further medical evaluation
  4. Protocol: Non-ambulatory children
    1. Child is undressed by caregiver/parent and "hot zone" staff
    2. Child is placed on stretcher or restraining device
    3. Child is moved through Decontamination shower, accompanied by caregiver/parent and "hot zone" staff
    4. Decontamination of child and caregiver/parent is directly supervised
    5. Airway monitoring is maintained throughout process
  5. Protocol: Ambulatory children ages 8 to 18 years old
    1. Child undresses without assistance, respecting modesty and privacy
    2. Child decontaminates self
    3. Child moves through Decontamination shower in succession with caregiver/parent or classmates
  6. Protocol: Ambulatory children ages 2 to 8 years old
    1. Child undresses with assistance from caregiver/parent and "hot zone" staff
    2. Child moves through Decontamination shower, accompanied by caregiver/parent or "hot zone" staff
    3. Decontamination of child is directly supervised
    4. Airway monitoring is maintained throughout process
  7. Protocol: Ambulatory children age under 2 years old (infants and toddlers)
    1. Child is undressed by caregiver/parent and "hot zone" staff
    2. Child is placed on stretcher or restraining device (not carried due to risk of falls)
    3. Child is moved through Decontamination shower, accompanied by caregiver/parent and "hot zone" staff
    4. Decontamination of child and caregiver/parent is directly supervised
    5. Airway monitoring is maintained throughout process
  8. References
    1. Seeyave and Bradin (2014) Crit Dec Emerg Med 28(12): 2-13
    2. Foltin (2009) Clin Pediatr Emerg 10(3): 186-94 [PubMed]

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