The Office of the Assistant Secretary for Preparedness and Response (ASPR) partnered with DHS and other agencies to develop two resources for managing exposure in mass chemical incidents.
The two science- and evidence-based guides are the Patient Decontamination in a Mass Chemical Exposure Incident: National Planning Guidance for Communities and Primary Response Incident Scene Management (PRISM) Guidance.
“(National Planning Guidance for Communities) draws on expertise in emergency response, emergency medicine, toxicology, risk communication, behavioral health, and other relevant fields and covers mass casualties, chemical release, external contamination, and decontamination of people (not animals, inanimate objects, or facilities),” said the Department of Health and Human Services.
The guidance is meant for primary personnel within the incident, such as commanders, emergency management personnel, and trainers of local response organizations and healthcare facilities.
First responders, researchers and others in response management can also use this guidance.
The National Planning Guidance for Communities emphasizes six key principles: determine decontamination needs of an individual, choose appropriate patient decontamination methods, prioritize patients for decontamination in a mass exposure incident, determine decontamination effectiveness, coordinate entire system-wide response, and communicate crisis and emergency risk messages to the community.
PRISM guidance tackles some knowledge gaps in National Planning Guidance for Communities. Evidence for PRISM was gathered in the United States and at the University of Hertfordshire in the United Kingdom, under research sponsored by Biomedical Advanced Research and Development Authority (BARDA).
“The aim of PRISM is to ensure that all patients exposed to potentially hazardous chemicals receive the most effective treatment possible during the initial stages of an incident,” said HHS. “Prompt decontamination is the best way to prevent the serious health consequences of exposure to toxic chemicals.”
The program did lab studies on effects of water temperature, flow rate, detergents and delayed decontamination. First responders in 35 municipalities across 21 states developed the guidance with their input on decontamination.
PRISM recommends three steps to reduce exposure and 99 percent of chemical contaminants: move quickly away from the hazardous area, carefully remove all clothes and wipe skin with paper towel or dry wipe.
ASPR and DHS plan to develop further guidance, specifically on decontaminating pediatric and pregnant patients in a mass chemical incident. BARDA and the University of Hertfordshire are currently updating PRISM guidance based on recent data.
“The primary objective is to generate appropriate evidence to allow focused revision of existing PRISM guidance to facilitate a fully optimized, generic, and standardized response by first responders to chemical incidents,” said HHS.
The revised PRISM will contain a user-friendly algorithm for first responders to rapidly assess the severity of the incident so that response is effective and proportionate.