Decontaminate a Casualty

 

INTRODUCTION

An important pre-step to treatment in a MTF is the decontamination of the casualty.  Casualty decontamination includes removal of gross contamination followed by careful removal of all garments.  When properly accomplished you will avoid further contamination of the casualty, yourself, or other soldiers.

Definition and Principles of Decontamination

Definition

(1)        Contamination - the deposition and/or absorption of biological or chemical agents, or radiological material on or by structures, areas, personnel, or equipment

(2)        Decontamination - removal or neutralization of hazardous levels of nuclear, biological, or chemical contamination from personnel and material

Reasons for Decontamination

(1)        Lethality - Some kinds of contamination are so lethal that they can kill or incapacitate if they contact exposed skin for only a few minutes

(2)        Performance degradation - Mission oriented protective posture (MOPP) gear provides protection but also reduces efficiency

(a)        Creates awkwardness

(b)        Tires and discourages soldiers

(c)        Reduces efficiency

(d)        Reduces field of view

(e)        Resting and sleeping are difficult

(f)         Soldiers cannot eat

(g)        Urinating and defecating are potentially dangerous

(h)        Reduces command, control, and communications (C3)

(3)        Equipment limitations - Although MOPP gear will provide protection from most chemical and biological agents, it cannot protect the soldier forever.

(a)        Contamination will eventually penetrate

(b)        Water, fuel, grease, and oil could defeat the protection qualities.

(c)        Provides little direct protection from radiological contamination

(d)        Equipment must be decontaminated in order to be used.

(4)        Spread - Unless decontamination is done early, contamination will spread and cause a more extensive hazard

(a)        Soldiers climbing in and out of vehicles

(b)        Contaminated equipment evacuated for repair

(c)        Contaminated supplies and ammunition flowing forward

Principles of Decontamination

(1)        Decontaminate as soon as possible

(a)        The most important principle

(b)        The sooner the contamination is removed, the sooner MOPP levels can be reduced and combat potential restored

(2)        Decontaminate only what is necessary - Consider the following factors:

(a)        Mission

(b)        Time available

(c)        Degree of contamination

(d)        Length of time the unit has been in MOPP 4

(e)        Decontamination assets available

(3)        Decontaminate as far forward as possible

(a)        Keep equipment on or near the operational area

(b)        Allows decontamination to begin earlier

(c)        Limits the spread of contamination to other areas

(4)        Decontaminate by priority

(a)        Mission essential first

(b)       Nonmission essential last

 

Decontaminants

Natural decontaminants - are readily available and frequently occurring in nature and are generally employed in field expedient methods of decontamination

(1)        Water - Flush contamination from surfaces with large quantities of water

(a)        Used for - nuclear, biological, and chemical

(b)        Cautions - effective in physically removing contamination but does not neutralize the contamination

(2)        Steam - accompanied by scrubbing is more effective than the use of steam alone.

(a)        Used for - nuclear, biological, and chemical

(b)        Cautions - effective in physically removing the contamination.  However, contamination may not be neutralized.

(3)        Absorbents - used to physically remove gross contamination from surfaces

(a)        Used for - chemical removal

(b)        Cautions - The absorbent becomes contaminated and must be disposed of accordingly

(c)        Examples - earth, sawdust, ashes, rags, and similar material

(4)        Sealants - used to physically seal in or shield contamination

(a)        Used for - nuclear, biological, and chemical

(b)        Cautions - break in the surface of the sealant will expose the contamination.  Contaminated areas covered with sealants must be marked with appropriate NBC warning signs.

(c)        Examples - concrete, asphalt, earth, paint, and similar materials

Standard decontaminants - are most often used and are available through the supply system and are stocked for contingency operations

(1)        STB (supertropical bleach) - a mixture of chlorinated lime and calcium oxide (white powder) with 30 percent available chlorine

(a)        Effective against

(i)         Nerve agents, both V and G series

(ii)        Blister agent, lewisite only

(iii)       Biological agents

(b)        Gives off toxic vapors on contact with G agents.

(c)        A 30-minute contact time is required.

(d)        Corrosive to most metals and injurious to most fabrics (thorough rinse required; metal surfaces must be oiled afterwards)

(2)        DS2 (decontaminating solution #2) - a mixture of 70% diethylenetriamine (DETA), 28% 2-methoxyethanol (methyl cellosolve), and 2% sodium hydroxide

(a)        Effective against

(i)         All known chemical agents

(ii)        Biological agents (except spores) with sufficient contact time

(b)        Available in 1 1/3 quart cans, 14 liter containers, or in 5-gallon drums

(c)        A protective mask and rubber gloves must be worn when using DS2 (extremely irritating to skin) (MOPP 4).

(d)        Ignites spontaneously on contact with STB and HTH (calcium hypochlorite)

(e)        Corrodes aluminum, cadmium, tin, and zinc; softens leather; may soften, remove, and discolor paints

(f)         Can be used in temperatures down to 25 Fahrenheit

(g)        Thirty minutes contact time for VX or 8-10 minutes for mustard and G agents

(3)        Other standard decontaminants include:

(a)        Mask the sanitation solution calcium hypochlorite (HTH); effective against chem/bio agents

(b)        Soaps and detergents - When they are mixed with (hot) water, they are effective against nuclear and chem/bio agents

Nonstandard - Decontaminants are not frequently used.  Some of these items can be found in the open market and available in the supply system but for other primary purposes.  They may be utilized for decontamination.

(1)        Caustic soda (sodium hydroxide)

(2)        HTH (calcium hypochlorite) or HTB (high-test bleach)

(3)        Bleach (sodium hypochloritehousehold bleach)

(4)        Washing soda (sodium carbonate)

(5)        Organic solvents (gasoline, kerosene, diesel, and alcohol)

(6)        Acids (sulfuric, hydrochloric, and acetic acids)

 

Decontaminate the casualty

Decontaminate the casualty's hood

Cut off the casualty's hood

Decontaminate the casualty's mask and exposed skin

Remove the casualty's Field Medical Card (FMC)

Remove gross contamination on the overgarment by wiping all visible contamination spots with a sponge soaked in 5% solution

Remove the casualty's protective overgarment jacket

Remove the casualty's protective overgarment trousers

Remove the casualty's butyl rubber gloves

Remove the casualty's protective overboots

Remove and secure the casualty's personal effects

Remove the combat boots following the same procedures as for removing the protective overboots

Cut off the casualty's battle dress uniform (BDU)

Cut off the casualty's undergarments

Remove the casualty's glove inner liners

Remove the casualty's socks

Decontaminate the casualty's ID tags

 

 

SUMMARY

Chemical agents pose a serious threat the casualty, combat medic, and other soldiers.  Proper care and equipment reduces the possibility of cross contamination which will result in ever escalating need for emergency care.  Familiarization with proper procedures will reduce the risk to you and your patient.