(MCD) Guidelines

GUIDELINES FOR MILITARY 

MASS CASUALTY DECONTAMINATION OPERATIONS 

DURING A DOMESTIC HAZMAT/WEAPONS OF MASS 

DESTRUCTION INCIDENT

Guidelines for Military Mass Casualty Decontamination Operations 

During a Domestic HAZMAT/Weapon of Mass Destruction Incident 

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Table of Contents 

1.0 Introduction and Background .............................................................................1 

2.0 Objective and Scope ..........................................................................................2 

3.0 Support to Civilian Authorities ............................................................................4 

4.0 Communication and Coordination with Civilian Incident Command ...................6 

5.0 All-Hazard Threats .............................................................................................7 

5.1 Toxic Industrial Materials............................................................................8 

5.2 Chemical Warfare Agents ..........................................................................9 

5.3 Biological Agents......................................................................................10 

5.4 Radiological Agents .................................................................................10 

6.0 Comparison Between Military and Civilian MCD Equipment............................12 

6.1 MCD Equipment.......................................................................................13 

6.2 Detection Equipment................................................................................13 

6.3 Individual and Personal Protective Equipment .........................................16 

7.0 Decontamination Overview ..............................................................................19 

7.1 Purpose, Definitions, and Types of Decontamination...............................19 

7.2 Principles of Decontamination..................................................................25 

7.3 Methods of Decontamination....................................................................28 

8.0 MCD Operations ..............................................................................................31 

8.1 Considerations for MCD Set Up and Response .......................................31 

8.2 MCD Decontamination Line Set Up and Operation..................................46 

8.3 Modified MCD Operations........................................................................64 

8.4 MCD Operations for Chemical, Biological, and Radiological Hazards .....72 

8.5 Mass Fatality Decontamination ................................................................74 

8.6 Post-MCD Operations ..............................................................................77 

9.0 Summary..........................................................................................................79 

Appendix A – References........................................................................................83 

Appendix B – Acronym List .....................................................................................91 

Appendix C – Glossary............................................................................................95 

Appendix D – Cross-Reference Guide with Civilian Equipment Specifications .....111 

Appendix E – Properties and Symptoms of Chemical, Biological and Radiological 

Agents.................................................................................................125 

Appendix F – MCD Decision Tree Matrices and Easy Reference Checklists.........133 

Appendix G – USARNORTH MCD Operational Requirements and External 

Evaluation Standards..........................................................................143 

Original iii 

Table of 

Contents 

Introduction MCD Equipment 

Comparison 

Decontamination 

Overview 

MCD 

Operations 

Summary Appendix A 

References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 

MCD Cross- 

Reference Guide 

Appendix E 

CBR Guide 

Appendix F 

MCD Decision 

Trees 

Appendix G 

ARNORTH 

Guidance



List of Figures 

Figure 1: Incident Command System Showing Unity of Command..........................6 

Figure 2: Interrelationships between Military and Civilian 

Decontamination Processes and Systems..............................................23 

Figure 3: MCD Site with Gross, Mass, and Technical Decontamination 

Elements. ................................................................................................24 

Figure 4: Planning for MCD Operations Using Standards and Best 

Practices. ................................................................................................27 

Figure 5: Liquid and Vapor Control Lines within a Decontamination Line. .............46 

Figure 6: Decision Tree Matrix of the Overall MCD Process, including 

Gross, Mass, Technical, and Fatality Decontamination Lines.................47 

Figure 7: Example LPS System in a Gross Decontamination Line.........................48 

Figure 8: Example EDCS System in a Gross Decontamination Line. ....................49 

Figure 9: Decision Tree Matrix for Gross Decontamination Operations. ................52 

Figure 10: Ambulatory Decontamination Line Set Up and Operation......................54 

Figure 11: Decision Tree Matrix for Ambulatory and Nonambulatory Mass 

Decontamination Operations...................................................................55 

Figure 12: Nonambulatory Decontamination Station Using a Roller 

System. ...................................................................................................57 

Figure 13: Nonambulatory Decontamination Station Using Sawhorses. ..................57 

Figure 14: Sample Technical Decontamination Line with 10 Stations......................60 

Figure 15: Decision Tree Matrix for Technical Decontamination 

Operations. .............................................................................................62 

Figure 16: Top View of Airflow Eddies Forming Urban Canyons Around 

Buildings. ................................................................................................67 

Figure 17: Side View of Airflow Eddies Forming Urban Canyons Around 

and Between Buildings............................................................................67 

Figure 18: Cold Weather Decontamination Guidelines. ...........................................68 

List of Tables 

Table 1: Factors for the Selection of Monitoring Equipment..................................14 

Table 2: Capabilities and Limitations of Common Monitoring 

Equipment...............................................................................................15 

Table 3: Components for OSHA PPE Levels. .......................................................17 

Table 4: Comparison of Decontamination Terminology from These 

Guidelines; Field Manuals 3-11.5, 3-11.21, 4-02.7; NFPA 472; 

and OSHA 3249-08N. .............................................................................20 

Table 5: Comparison of the Decontamination Fundamentals Between 

FM 3-11.5, DHS TCL/UTL, and the USACBRNS/ECBC 

Guidelines, Volumes I & II.......................................................................26 

Table 6: Principals of Mass Casualty Decontamination. .......................................28 

Table 7: Common Decontamination Solutions. .....................................................29 

iv Original



Table 8: Medical Care Versus Decontamination Priorities. ...................................43 

Table 9: Probability Matrix for Liquid and Vapor Contamination through 

a Decontamination Line. .........................................................................45 

Table 10: Sample Scheme to Color Code the Decontamination Line. ....................70 

Table 11: Meteorological Effects on the Aerosol Release of Chemical 

Agents.....................................................................................................72 

Table 12: Best Practices and Lessons Learned Techniques for MCD 

Operations. .............................................................................................80 

Table 13: Cross-Reference Guide Comparing Military and Civilian MCD 

Equipment.............................................................................................111 

Table 14: Capabilities, and Limitations of Chemical Detection Equipment............120 

Table 15: Capabilities, and Limitations of Biological Detection 

Equipment.............................................................................................123 

Table 16: Capabilities, and Limitations of Radiological Detection 

Equipment.............................................................................................123 

Table 17: Chemical Agent Symptom Matrix..........................................................125 

Table 18: Chemical Agent Properties. ..................................................................127 

Table 19: Biological Agent Properties. ..................................................................129 

Table 20: Radiological Exposure and Symptomology Chart. ................................131 

Table 21: Medical Care Versus Decontamination for Radiation Exposure............132 

Original v 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



PREFACE 

About these Mass Casualty 

Decontamination (MCD) Guidelines 

These Guidelines provide key information to military personnel who support civil 

authorities in a domestic incident involving hazardous materials (HAZMAT) and/or 

weapons of mass destruction (WMD). They address concepts, principles, and 

fundamentals for support to domestic agencies during HAZMAT/WMD incidents 

using common language. These Guidelines were developed using the most current 

policy, guidance, and tactics, techniques, and procedures, and accepted best 

practices and lessons learned from key military, federal, state, and civilian 

authorities. 

This document is designed to assist in bridging the gap between military and civilian 

personnel. It provides a direct comparison between the MCD principles, 

decontamination equipment, and language used by military and civilian personnel. 

Special features to these guidelines include: 

• Best practices and lessons learned from MCD exercises and responses. 

• Detailed steps and techniques for conducting MCD operations under various 

conditions, including variations in the hazard, time, number of casualties, 

environment, and available equipment, supplies, and human resources. 

• Text boxes identifying common military and civilian MCD tasks in key doctrine. 

• A cross-reference guide showing similarities and differences between military and 

civilian MCD equipment. 

• Clarification of military and civilian terminology regarding MCD operations. 

These Guidelines are formatted to allow the user to tab between the 15 different 

sections. Sections 1.0 – 9.0 focus on MCD operations and appendices A – G contain 

supporting information. Appendix A contains the references that are cited in these 

Guidelines, including each appendix. Appendix B and Appendix C contain the 

acronym list and glossary, respectively. Appendix D contains the cross-reference 

guide that compares military and civilian MCD equipment. Appendix E contains 

information related to chemical, biological, and radiological agents and detection 

equipment. Appendix F contains decision tree matrices and checklists. Appendix G 

contains U.S. Army North MCD operational requirements and associated external 

evaluation standards. 

These Guidelines use the term “casualty” instead of “victim” or “patient.” However, 

cited references may use the terms “victim” and/or “patient.” These terms will not be 

changed to “casualty” when quotes are taken from the cited references. Generally, 

“casualty,” “victim,” and “patient” can be used interchangeably. The term “mass 

decontamination” is referring to a type of decontamination conducted within the 

overall MCD process itself. 

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Guidelines for Military Mass Casualty Decontamination 

Operations During a Domestic HAZMAT/Weapons of Mass 

Destruction Incident 

1.0 Introduction and Background 

The information provided within these Guidelines is designed to supplement U.S. 

Army Chemical, Biological, Radiological and Nuclear School (USACBRNS) mass 

casualty decontamination standards and complement first responder best practices 

as provided in the Guidelines for Mass Casualty Decontamination during a 

HAZMAT/Weapon of Mass Destruction Incident Volumes I and II. 1 The USACBRNS 

Mass Casualty Decontamination Collective Tasks, also incorporated into these 

Guidelines, 2 will continue to reflect a unit’s mission essential tasks and training 

standards for conducting mass casualty decontamination (MCD) operations. 

However, Commanders and planners need to understand that there is no one 

perfect solution for every real world MCD event. 

These Guidelines provide key information to military personnel who are tasked to 

support civil authorities in a domestic incident involving hazardous materials 

(HAZMAT) and/or weapons of mass destruction (WMD). The Guidelines assist 

military personnel in planning for, responding to, recovering from, and mitigating the 

effects of HAZMAT/WMD incidents. Military personnel can use these Guidelines to 

plan and execute a variety of domestic decontamination missions. These Guidelines 

can also be used by personnel from local, state, and federal civilian response 

agencies, including: 

• Emergency Management Agencies 

• Public Health Agencies 

• Hospital, Clinic, and Physician Offices 

• Coroner’s Office and Mortuaries 

• Law Enforcement 

• Fire Service 

• Emergency Medical Service 

• Environmental Agencies 

• Public Works Offices 

• Jurisdictional Administrators 

This document was developed using the most current policy, guidance, and tactics, 

techniques, and procedures, and accepted best practices and lessons learned from 

the following military and local, state, and federal civilian authorities: 

• USACBRNS, U.S. Army, U.S. Army North (USARNORTH), U.S. Department of 

Defense (DoD) 

• National Fire Protection Association (NFPA) 

• U.S. Occupational Safety and Health Administration (OSHA) 

• U.S. Environmental Protection Agency (EPA) 

• U.S. Federal Emergency Management Agency (FEMA) 

• U.S. Department of Homeland Security (DHS) 

Original 1 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



HAZMAT, whether chemical, biological, or radiological, are present in all aspects of 

everyday life. HAZMAT incidents, either accidental or intentional, have increased in 

recent years. The following examples show the increasingly effective use of 

HAZMAT/WMDs by terrorists, both on American and foreign soil: 

• 1984 Salmonella release in a salad bar in Oregon (0 killed, 715 sickened) 3 

• 1995 sarin attack in the Tokyo subway (12 killed, 3800 injured), which was 

preceded by a test run in 1994 (7 killed, 500 injured) 4 

• 2001 anthrax-laden letters in the U.S. mail (5 killed, 17 sickened) 5 

• 2006 assassination of Alexander Litvinenko by polonium-210-induced acute 

radiation syndrome 

• Regularly occurring use of chlorine-laden bombs in Iraq 6 

Incidents in England, France, and Germany, and countless attacks contributed to Al 

Qaeda show that this problem does not just affect American soil. HAZMAT is 

available and transported in large quantities, which makes them easier to access by 

terrorists. Hundreds of casualties may be produced a large-scale HAZMAT or WMD 

incident, whether accidental or intentional. MCD is one of the key elements in 

consequence management planning, response operations, and recovery. 

MCD can take many forms and use many different techniques. Each technique can 

be just as effective as another in removing contamination from casualties. These 

Guidelines present baseline and alternate MCD operations that are based on military 

and civilian guidance and doctrine. However, actual MCD operations are based on 

available equipment, hazard, time, number of casualties, environmental conditions, 

and resources at the scene. MCD operations must be adaptable, innovative, and, 

when necessary, improvisational. 7 This document describes MCD operations that 

imply a combination of a large number of casualties and incident conditions that 

challenges or exceeds a jurisdiction’s ability to provide basic life saving services. 

2.0 Objective and Scope 

This document is designed to provide military personnel with a supplemental tool to 

plan and train mass decontamination operations. Specifically, these Guidelines 

address the decontamination of an overwhelming number of people resulting from a 

HAZMAT/WMD incident in a populated area. 

Mass casualty decontamination is NOT an exact science. The diversity of chemical, 

biological, and radiological agents that have the capability to produce casualties that 

need decontamination prior to medical care is overwhelming. The lack of empirical 

evidence from large-scale MCD incidents requires that planning involve an 

appropriate MCD process that causes the least harm and does the most good for 

the majority of casualties. Military and civilian responders conduct MCD operations 

after a HAZMAT/WMD incident to save lives, minimize suffering, and prepare 

casualties for follow-on medical care. These Guidelines explain the theory behind 

suggested baseline operational techniques, but the listed and implied steps are not 

definitive. The actual incident and associated conditions itself dictates what specific 

2 Original



and modified techniques are necessary to effectively conduct MCD operations. The 

foundation of these Guidelines includes best practices and lessons learned from 

responders around the nation as well as military doctrine and training standards. 

To assist in bridging the gap between military and civilian personnel, these 

Guidelines directly compare MCD principles, decontamination equipment, and 

language used by both personnel. The differences and similarities in MCD principles 

are highlighted by text boxes that identify common military and civilian techniques 

and procedures. Civilians follow the guidance mandated by DHS and FEMA, which 

includes the National Response Framework (NRF), National Incident Management 

System (NIMS), and the Target Capabilities List (TCL). 8-11 

The TCL describes capabilities that civilian responders need to have to prevent, 

protect, respond to, and recover from incidents, including MCD operations. 11 The 

TCL also provides a performance standard that is based on the Universal Task List 

(UTL), 12 against which emergency preparedness activities can be evaluated and 

assessed. Throughout these Guidelines, critical MCD tasks identified in the UTL are 

compared to the MCD tasks presented in the USACBRNS Mass Casualty 

Decontamination Collective Tasks. 2 

An equipment cross-reference guide compares military decontamination equipment 

to that commonly used by civilian responders. The guide in Appendix D gives 

military personnel an idea of the types of equipment they might encounter when 

assisting civilians during a mass casualty incident. While language is not the focus of 

these Guidelines, it is important to know differences between military and civilian 

decontamination terminology. These Guidelines are consistent with NIMS, which is a 

core set of doctrines, concepts, principles, terminology, and organizational 

processes related to emergency management. NIMS guidance enables effective, 

efficient, and collaborative incident management. 

The scope of this best practices document does not include a definitive or 

universally agreed upon metric for determining that “safe” decontamination has been 

performed. Currently, how clean-is-clean is not operationally defined for the full 

spectrum of chemical and biological hazards. For the purposes of this document, 

clean is defined as undetectable or as low as reasonably achievable (ALARA) on the 

casualty’s body by field chemical, biological, and radiological detection equipment as 

determined by the Incident Commander. In addition, it is not meant to include 

infectious outbreaks for which casualty decontamination is not necessary. 13,14 Postdecontamination 

levels for radioactive hazards should be determined by the Incident 

Commander, but they are typically less than twice natural background levels. 15,16 

Original 3 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



3.0 Support to Civilian Authorities 

INTENT: Provide support to civilian authorities during HAZMAT/WMD response 

operations using military support elements already in place. 

The DoD maintains readiness to provide defense support 

of civil authorities via a network of command and 

response elements under the command and control of 

U.S. Northern Command (USNORTHCOM). Such 

elements in the continental U.S. are responsible for 

supporting and assisting civil authorities as directed by 

and in coordination with the NRF. Missions may include 

response, mitigation, and recovery assistance for natural 

and man-made disasters, including CBRN-related 

incidents. 13 The military’s role in support of domestic 

emergencies is well defined, but is limited in scope and 

duration. 17 Military resources temporarily support and 

augment, but do not replace, local, state, and federal civilian agencies. 

MCD Principles for 

Supporting Civilian 

Authorities 

DHS UTL Tasks 

• ComA 2.6 

• ResB1d 7.2.4 

USACBRNS Tasks 

• 03-1-6592 

• 03-2-6591 

There are numerous military command and response elements that can be tasked to 

assist in civilian response operations using guidance from appropriate 

doctrine. 13,15,18,19,20 The nature, scope, size, location, and complexity of the incident 

determines which group would be assigned to assist local, state, and federal 

agencies, particularly related to MCD operations. 

• USARNORTH 

• U.S. Army CBRNE Consequence Management Response Force (CCMRF) 

• U.S. Army 20th Support Command 

• U.S. Army Radiological Advisory Medical Team (RAMT) 

• National Guard Civil Support Team (CST) 

• National Guard CBRNE Enhanced Response Force Package (CERFP) 

• U.S. Army Reserve Units and Reserve Component (RC) CBRN Units 

• U.S. Coast Guard National Strike Force 

• U.S. Navy Forward Deployable Preventive Medicine Units (FDPMUs) 

• U.S. Marine Corps Chemical and Biological Incident Response Force (CBIRF) 

• U.S. Air Force Medical CBRN Defense Team 

• U.S. Air Force Home Station Medical Response Capabilities 

USARNORTH works with the Department of the Army, USNORTHCOM, the 

National Guard, FEMA, and DHS to develop, organize, and unify the military 

capability in the land domain for CBRN response. Appendix G contains U.S. Army 

North MCD operational requirements and associated external evaluation standards 

that are consistent with the USACBRNS Mass Casualty Decontamination Collective 

Tasks. 2,21 

4 Original



MCD operations conducted in support of civilian organizations shall comply with 29 

Code of Federal Regulations (CFR) 1910.120 within the U.S., its territories, and 

possessions. 22 Compliance with military and civilian policies, procedures, training, 

regulations, and guidelines must also be achieved. 13,15,18,19,23 Military augmentation 

to support defense support of civil authorities generally follows the planning, 

preparation, response, and recovery process, as described below: 15,23 

• Preparation Phase. Military forces conduct or support decontamination 

operations based on the mission and strategic need. Military personnel tasked to 

assist local, state, and/or federal responders must be familiar with the NRF and 

NIMS. Military personnel should also coordinate, train, and exercise with civilian 

response agencies using an all-hazards approach. This ensures that protocols 

and procedures are coordinated, understood, and practiced before an actual 

incident occurs. 8-10,24 Exercises, training, memorandums of understanding, and 

memorandums of agreement assist the military and civilian sides in identifying 

operational and equipment capabilities and limitations. Military personnel 

expected to perform MCD operations in support of civilian organizations must be 

trained and certified to the first responder operations level as defined in 29 CFR 

1910.120. 22 

• Response Phase. In the event of a HAZMAT/WMD incident, military resources 

with decontamination capabilities may be called upon to respond and assist 

civilian organizations. The scope and magnitude of the military response focuses 

on providing capabilities that are beyond the resources of civil authorities as part 

of a flexible tiered response. 23 A tier I response would be sufficient for a smallscale, 

localized CBRN incident. Significantly greater support would be required by 

the military to implement tier II and III responses. The individual requirements of 

each scene require the Incident Commander and the Commander to customize 

the response procedures. Gross, immediate, emergency, mass, technical, 

thorough, and detailed decontamination processes are generally conducted in the 

response phase. They consider factors such as inclement weather, special needs 

of casualties, and remote locations in the overall response plan. 

• Recovery Phase. For civil support missions, mass decontamination requirements 

will likely end following the response phase. Military personnel may be requested 

to assist with the decontamination of equipment, infrastructure, and terrain in the 

recovery phase. This could involve technical, clearance, and definitive 

decontamination processes. A transition plan is implemented, and tasks are 

transferred from the Commander to the appropriate civil authorities. 

• Restoration Phase. Restoration includes the actions necessary to return the 

decontamination assets to their full operational capability. Restoration actions may 

include replacing ill/injured personnel, reordering supplies, repairing equipment, 

documenting expenditures, and concluding outstanding agreements with civil 

authorities. Restoration activities are generally performed at the home station. 

Imminently serious conditions resulting from any civil emergency or attack may 

require immediate action by military Commanders, or by responsible officials of other 

DoD Agencies, to save lives, prevent human suffering, or mitigate great property 

Original 5 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



damage. When such conditions exist and time does not permit prior approval from 

higher headquarters, local military Commanders and responsible officials of other 

DoD Components are authorized by DoD Directives, subject to any supplemental 

direction that may be provided by their DoD Component, to take necessary action to 

respond to requests of civil authorities. All such necessary action is referred to in this 

Directive as "Immediate Response." 19,20 Implementing this support must be 

consistent with the Posse Comitatus Act. 25 

Any Commander or official acting under the Immediate Response authority of DoD 

Directives shall advise the DoD Executive Agent through command channels, by the 

most expeditious means available, and shall seek approval or additional 

authorizations, as needed. 19 

4.0 Communication and Coordination with Civilian 

Incident Command 

INTENT: Establish communication with local Incident Command and determine 

situational needs and conditions. 

Effective response and recovery actions depend on 

effective communications among all participating people, 

agencies, and jurisdictions. NIMS are designed to assist 

in this communication using a standardized approach to 

incident management. Under NIMS, civilian response 

agencies use the Incident Command System to establish 

and maintain order and control of the scene. 8,26 

The Command and General Staff positions, shown in 

Figure 1, implement the Incident Command System 

principle of unity of command. Command Staff positions 

are shown in black and General Staff positions are shown 

in white. Only the Incident Commander position is 

required for each response. The other positions are filled 

depending on the nature and severity of the incident. 

Figure 1: Incident Command System Showing Unity of 

Command. 

Public Information Officer 

Liaison Officer 

Incident Commander 

Safety Officer 

Operations Section Planning Logistics Finance/Administration 

Branch 

Divisions 

Groups 

Strike Team 

Task Force 

Single Resource 

Resources 

Situation Unit 

Documentation Unit 

Demobilization 

Support Branch 

Supply Unit 

Facilities Unit 

Ground Support Unit 

Service Branch 

Communications Unit 

Medical Unit 

Food Unit 

Time Unit 

Procurement Unit 

Compensation Claims Unit 

Cost Unit 


Civilian Contact and 

Coordination 

DHS UTL Tasks 

• ResA1a 3.1 

• ResB1a 3.2.1 and 3.3.3 

• ResB2b 3.2.3 and 

3.2.6.1 

• Res.B2b 3.2.5.4 


• 03-1-6592 Steps 1, 2, 3, 

9, 10, 11 12 

• 03-2-6594 Steps 1a, 1f, 

2c, 3a, 4a, 6, 7, 8 

• 03-3-5130 Steps 1, 2, 3, 

11g, and 12 

6 Original



This command structure is effective during a multi-agency, multi-jurisdictional 

response, particularly one that requires MCD. It can expand into a Unified Command 

that enables agencies with different legal, geographic, and functional responsibilities 

to coordinate, plan, and interact effectively within a common response framework. In 

a Unified Command structure, individuals designated by their jurisdictional 

authorities jointly determine objectives, plans, and priorities. They work together to 

execute the plans instead of relying on one Incident Command to do this. This is 

accomplished without losing agency authority, responsibility, or accountability. 26 

It is vital to plan and coordinate with civilian authorities before an incident occurs. 

This helps military personnel integrate with civilians more easily when a situation 

occurs that requires MCD. Providing decontamination assistance to civilian response 

agencies requires detailed coordination in areas such as communications, logistics, 

and planning. Civilian and military operations should be constantly coordinated to 

achieve the incident objectives of saving lives, preventing human suffering, 

mitigating property damage, and/or limiting the spread of contamination. 

The civilian Incident Commander will request military assistance through their 

emergency management chain to the Governor’s office. Once deployment orders 

are issued, the Commander establishes an Advance Echelon that represents all key 

unit components and deploys to the civilian Incident Command’s location. The 

Advance Echelon then establishes liaison and communications with Incident 

Command, 2,23 and determines local needs, available resources, and capabilities. 

The military should provide the civilian Incident Commander with a list of available 

personnel and equipment. The military Commander and civilian Incident 

Commander should prepare a joint Site Safety Plan to adequately address potential 

hazards. 

5.0 All-Hazard Threats 

INTENT: Understand the all-hazards threats that could lead to a mass casualty 

incident that requires MCD during emergency response. 

The all-hazards approach to emergency management 

provides a basic framework for responding to a variety of 

disasters. Understanding threats that could require MCD 

is essential to preparation and response. Regardless of 

the cause, the tactics, techniques, and procedures remain 

generally the same for any situation where mass 

casualties require immediate decontamination—flush 

them with a large quantity of water as quickly as possible. 


All-Hazard Threats 

DHS UTL Tasks 

• None identified. 


• 03-2-0018 

• 03-3-5127 

• 03-5-6595 

The need for MCD is not unique to terrorist or industrial 

disaster responses. Natural disasters, such as 

earthquakes, hurricanes, or floods, can also result in release of contaminants. A 

natural disaster can impact a community by affecting a facility that produces or 

Original 7 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



stores hazardous materials. Should a release occur from such a facility, MCD could 

certainly be required during the response phase. 

The risks from CBRN weapons and commercial, industrial, and medical hazards 

have increased over the years. Agent contamination can occur as a result of a direct 

attack or an accidental release. Chemical, biological, and radiological materials can 

be released in the following forms, which impacts how MCD operations are 

performed: 15,23 

• Vapors are substances that exist in gaseous form at atmospheric pressure. They 

can be dispersed by generators or bursting munitions. They generally disperse 

rapidly in an open or outdoor area, and cause widespread contamination indoors. 

• Aerosols are liquid or solid agents divided into small particles suspended in a 

gaseous medium. They behave much like vapors. Examples include mist, fog, or 

smoke. 

• Liquids can range from thick and sticky to the consistency of water. 

• Solids range from radioactive material, biological spores, and powder agents. 

5.1 Toxic Industrial Materials 

A toxic industrial material (TIM) is a generic term for toxic or radioactive substances 

in solid, liquid, aerosol, or gaseous form. These may be used or stored for industrial, 

commercial, medical, military, or domestic purposes. They are described as a toxic 

industrial chemical (TIC), toxic industrial biological (TIB), or toxic industrial 

radiological (TIR). 27 

TICs are used throughout the country from households to industry. Production of 

most chemicals keeps rising, according to statistics from various government 

agencies and trade associations. 28,29 TICs, such as ammonia, sulfuric acid, chlorine, 

and pesticides, are transported by highway, railway, waterway, and airway. TICs are 

also widespread throughout the world. U.S. forces use area studies, intelligence 

estimates, and/or economic studies to indicate TICs available and potential hazards 

in an area of operation. 

A TIB is any biological material made, used, transported, or stored for any processes 

in industry, medicine, or commerce. These materials are used in clinical research, 

medical industry, and pharmaceutical manufacturing. These substances damage 

vegetation and can be toxic to humans and animals. 15,30 A TIR is any radiological 

material made, used, transported, or stored for any processes in industry, medicine, 

or commerce. These materials are used in research, generation of electricity, and 

medical tests and treatments. Such materials include pharmaceuticals, medical 

sources, and even spent fuel rods. TIRs damage vegetation and can be toxic to 

humans and animals. 15,30 

The threat of a purposeful or accidental release of a TIC onto a population is more 

likely than a threat from a release of a TIB or TIR because TICs are readily used in 

industry. Accordingly, these Guidelines largely focus on an MCD incident resulting 

8 Original



from a TIC release rather than from a TIB or TIR. Further information on chemical-, 

biological-, and radiological-specific decontamination guidelines is Section 8.4. 

Specific properties of selected TIMs are in Appendix E. 

5.2 Chemical Warfare Agents 

Chemical warfare agents (CWA) are a group of chemicals that have been 

engineered for, or used in, warfare. These agents are classified by either the body 

system that they affect or the symptoms they cause. Sample CWAs include the 

following: 31-33 (Military abbreviations are used here. Acronyms are defined in 

Appendix B) 

• Nerve agents (GA, GB, GD, GF, VX) 

• Blister agents (H, HD, HT, HN-1, HN-2, HN-3, L) 

• Blood agents (CK, AC) 

• Choking agent (CG, PS) 

• Incapacitating agents (BZ) 

• Riot control agents (CS) 

• Respiratory irritants, formerly known as vomiting agents (DA, DM, DC, chlorine) 

NOTE: The Centers for Disease Control and Prevention (CDC) classifies chlorine 

and phosgene as pulmonary agents, adamsite as a vomiting agent, and tear gas 

(CS) as a riot control agent. 34 

There are several ways to obtain chemical agents. One way is to steal it from a 

national stockpile of existing munitions or the support network within it. This is limited 

in the U.S. because of the extensive security measures in place. However, with the 

fall of the former Soviet bloc countries and the growth of rogue nations such as Iraq 

and North Korea, chemical weapon caches are more easily obtained by well-funded 

terrorist organizations. 

A more likely way to obtain chemical agents is by synthesizing the material. A high 

school-level chemistry course could give most anyone the knowledge needed to 

synthesize a chemical agent. The Aum Shinrikyo cult synthesized the nerve agent 

sarin in 1995 and exposed thousands of civilians in the Tokyo subways. 4 The sarin 

used in this effective attack was made in a basement laboratory at the cult’s 

compound. They used equipment considered crude by industrial standards, but the 

sarin-laced bombs still injured thousands. 

Information and how-to guides on synthesis of CWAs are available from many 

sources. However, incidents involving TICs being used as a weapon are more likely 

to occur than CWAs because of their availability in bulk quantities. 

Section 8.4.1 gives more information on chemical-specific decontamination 

guidelines. Appendix E lists specific properties of selected CWAs. 

Original 9 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



5.3 Biological Agents 

Biological agents are commonly classified into three categories: bacteria, viruses, 

and toxins. 34 However, the military classifies them as pathogens, toxins, 

bioregulators, and prions. 31 Commonly known examples of biological agents are 

anthrax, plague, smallpox, ricin toxin, and botulinum toxin. Biological agents can be 

produced easily in a short time. 35 When used as a weapon, these agents can be 

delivered by modified conventional munitions or by ground-based or aerial-borne 

spray devices. 

Certain biological agents are communicable, but cause illness after a long incubation 

period. This means that casualties spread the pathogen before outwardly showing 

symptoms or becoming ill. The Japanese used biological agents before and during 

World War II. They discovered that the effects of biological weapons are difficult to 

anticipate and control. They found that biological weapons can cause considerable 

casualties to unvaccinated friendly forces and populations. 36 In 1972, President 

Nixon ended the United States’ offensive biological weapons program. Several 

nations still continue to develop and produce biological weapons using commercially 

available equipment and established microbiological techniques. 

In 2008, a man was hospitalized after staying in a Las Vegas hotel room that was 

contaminated with the powerful toxin ricin. Ricin was also found in 2004 in the 

mailroom of the Dirksen Senate Office Building in Washington. Anthrax, a bacterial 

agent, was used in the 2001 attacks that killed 5 and sickened 17. The ensuing 

investigation by the FBI and its partners—code-named Amerithrax—has been one of 

the largest and most complex in the history of law enforcement. 37 

Section 8.4.2 provides move information on biological-specific decontamination 

guidelines. Appendix E lists specific properties of selected biological species and 

agents. 

5.4 Radiological Agents 

Radiological threats exist in many different forms. The most easily recognized 

applications of a radiological threat are a radiological dispersal device, radiation 

emitting devices, or an improvised nuclear device. A radiological dispersal device is 

also known as a “dirty bomb.” An improvised nuclear device is “an illicit nuclear 

weapon bought, stolen, or otherwise originating from a nuclear state, or a weapon 

fabricated by a terrorist group from illegally obtained fissile nuclear weapons material 

that produces a nuclear explosion.” 38 

The threat of terrorist groups using these types of devices continues, but other 

threats are much more prevalent. Industrial and medical uses for radiation have 

created an ongoing potential for concern. Medical facilities are required to follow 

stringent storage, use, and accountability guidelines governing radioactive materials. 

However, there are frequent reports of loss of accountability for these materials. 

There are also documented cases of industrial radiological instruments, such as 

radiography devices used for examining the integrity of welded seams, being 

10 Original



improperly accounted for, used, or maintained. These cases resulted in the 

unintended loss or theft of the radioactive material. In some cases, unsuspecting 

civilians have discovered this material and picked it up purely out of curiosity. These 

actions resulted in accidental exposures and fatalities to themselves and others. 39 

Finally, the threat of radiation exposure exists due to an atmospheric release at any 

of the nuclear power generators operating throughout the U.S. This release may be 

the result of potential accidents at a given location. The release could also result 

from a coordinated act of terror through an intentional compromise of a generator’s 

safety and containment systems. Another source of exposure comes from the everpresent 

threat of waste materials generated by any of the industrial uses of 

radioactive materials. Any compromise of containment systems for these materials 

could result in a mass contamination scenario. Examples of these types of exposure 

incidents include the accidents at Three Mile Island and the Chernobyl Power 

Facility. 

Once potential exposure incidents occur, responding agencies are expected to 

perform emergency response actions including decontamination. Established 

procedures, recommendations, and guidelines are used to determine the actions to 

take during such an incident. The most familiar procedures are the EPA’s Protective 

Action Guides (PAG). They were developed in order to “help state and local 

authorities make radiation protection decisions during emergencies. The EPA 

developed the PAG Manual to provide guidance on actions to protect the public. 

Responders can use the PAG Manual in any radiation emergency, including nuclear 

power plant incident, foreign reactor incident, contaminated materials at steel mills or 

scrap metal recycling facilities, transportation accidents involving radioactive 

materials, or a radiological dispersal device/improvised nuclear device research 

facility incident.” 16 

In many cases, civilian response organizations may only provide a limited response 

to radiation incidents. This limitation could be due to an absence of equipment or a 

lack of familiarity and experience with operating it. The limited response could also 

be the result of procedural requirements and restrictions when dealing with these 

types of incidents. In these cases, military response organizations are critically 

important—their procedural and response capabilities and experience provide them 

with exceptional knowledge and increased flexibility in conducting operations. 

The U.S. military has an extensive capability for radiological surveying and 

monitoring in all Services. A majority of the military is trained to deal with a nuclear 

attack and to monitor and conduct surveys to lessen the exposure of their personnel. 

This information and training are useful in case of a well planned and executed 

radiological dispersal device or improvised nuclear device. Most branches also send 

many of their personnel to advanced training on radiological incidents. Proper 

monitoring and detection is required before any responders can make entry into 

hazardous areas to perform emergency response functions. As a result, there are 

numerous military command and response elements that can be tasked to assist in 

Original 11 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



civilian response operations, such as surveillance/monitoring and decontamination, 

as described in Section 3.0. 

U.S. Army and U.S. Marine Corps (USMC) tactical units, at battalion level and 

above, have an organic radiological detection capability, and monitoring and survey 

capability. Radiological survey and monitoring has been a mission since these 

organizations were established. These organizations have the equipment, training, 

and experience necessary for alpha, beta, and gamma detection, particularly within 

the USMC CBIRF. The U.S. Air Force (USAF) has personnel trained to operate 

radiation, detection, indication, and computation (RADIAC) detection equipment and 

to perform radiological monitoring and surveys. 

Most Navy ships have organic radiological monitoring and survey capability. U.S. 

Navy afloat surface forces and larger naval shipyards are outfitted with an array of 

radiological detection and monitoring equipment. Through land-based radiation 

technicians and ship-based laboratory technicians, afloat forces, and all nuclearpowered 

vessels, Navy personnel can rapidly detect airborne, waterborne, and solid 

mass radioactive sources or inadvertent releases. Navy personnel also respond 

accordingly to warn and protect people in the immediate vicinity until relieved by 

civilian responders. If the attack occurs while the vessel is transiting open waters, 

the ship’s crew assumes a defensive posture. The crew decontaminates exposed 

exterior surfaces and personnel to the maximum extent possible before entering any 

civilian ports or restricted waters. Section 8.3.9 provides specific details on such 

decontamination. 

Section 8.4.3 provides more information on radiological-specific decontamination 

guidelines. Appendix E lists dose rates and symptoms of radiation exposure. 

6.0 Comparison Between Military and Civilian MCD 

Equipment 

INTENT: Provide a cross-reference guide that compares MCD, detection, and 

protective equipment for military and civilian responders. 

The Cross-Reference Guide, presented in Appendix D, compares military 

decontamination equipment to that available to civilian responders. Military 

personnel will have an idea of the types of equipment they might encounter when 

providing assistance to civilians during a mass casualty incident. Types of 

equipment compared include MCD, detection, and individual protective equipment 

(IPE) and personal protective equipment (PPE). Appendix D provides information on 

capabilities, limitations, and operational specifications of some common equipment 

civilian responders’ use. 

The military equipment list provides an example of a well-supplied Army element 

with significant MCD capabilities. Actual elements could have more or less of the 

MCD equipment listed. The civilian responder equipment listed in Appendix D was 

compiled from sources such as Lessons Learned Information Sharing (LLIS), 

12 Original



Responder Knowledge Base, and Department of Justice guides. Equipment 

available to fire, emergency medical service, and law enforcement personnel is 

included. However, the appendix focuses on the specific equipment available to 

jurisdictionally-based fire departments because they are typically responsible for 

conducting MCD operations. 

6.1 MCD Equipment 

Considerable detection, protection, and decontamination equipment and systems 

have been designed to conduct MCD operations. Equipment has advanced from 

basic hoses and showerheads to complex MCD tent structures and self contained 

trainer systems. 

The basic MCD configuration uses equipment that civilian responders already have 

in stock. This system uses fire hoses and nozzles, ladders, salvage covers and their 

fire apparatus to create a system to decontaminate large numbers of casualties with 

water in the first response. Specialized equipment is not required to conduct this 

type of MCD. 

Advanced MCD systems have been made specifically to deal with mass casualty 

incidents that produce overwhelming casualties. These systems typically consist of a 

trailer or tent, a multi-head shower system for ambulatory casualties, and a roller or 

litter system for non-ambulatory casualties. These systems also may include water 

heaters, decontamination solution pumps, generators, lights, heaters, cooling fans, 

multiple hoses, containment pits, sump pumps, and ancillary support equipment. 

The ancillary support equipment required varies by location and agency and is 

dependent on the exact type of equipment being used. Over the years, local 

communities and hospitals have been purchasing these advanced systems to 

complement the equipment they already have on hand. Common equipment and 

systems manufacturers include Reeves Manufacturing, Drash, TVI, Nor E, and 

Zumro (no product endorsement is implied). 

Over the past 10 years, the military has been leveraging commercially-available 

civilian equipment that would benefit them in the urban environment. The military 

has been evaluating methods to quickly and adequately outfit specialized response 

teams (see Section 3.0). These specialized teams are now available to support the 

civilian agencies. Other military decon equipment could be used and adapted to a 

MCD event, such as the M17 lightweight decontamination system, M12, M100 

sorbent decontamination system, and the Joint Service Transportable 

Decontamination System – Small Scale. Some of this equipment is equally designed 

for military operations and/or decontamination of equipment and casualties. 

6.2 Detection Equipment 

Identifying the contaminant is an important step early in the emergency response 

process. Civilian response organizations may need assistance with identifying the 

contaminant because 1) they have limited detection equipment and/or 2) the 

equipment they have does not effectively identify or quantify the threat. Identifying 

Original 13 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



the contaminant determines what protective equipment is worn, how casualties are 

extracted, and most importantly, which MCD techniques are used to decontaminate 

casualties. 

Conducting a preliminary hazard assessment aids in the selection of the most 

appropriate detection device for positively identify the contaminant. Symptomology 

reports, the speed by which symptoms begin to appear, casualty interviews, and 

scene assessments provide information that can help include or exclude possible 

contaminants. 

This equipment is also used to ensure decontamination is as complete as possible 

throughout the MCD process. There are various points when monitoring equipment 

is used within the decontamination corridor to determine the thoroughness of 

decontamination, as described in Section 8.1.11. 

Detection devices that are generally available to military and civilian responders 

detect chemical, biological, and radiological agents. 40 There are many different types 

of detectors that identify and/or measure the amount of a chemical present. 

Biological agents are most commonly analyzed in the field using enzyme 

immunoassay tests. Radiation is naturally occurring and is everywhere. Radiation 

detectors detect and measure the presence of radiation. Some detectors operate by 

simply turning the instrument on to detect radiation, while others use probes to 

detect and measure radiation. 2,15 

Some detection devices can differentiate between compounds but not quantify the 

amount. Others can report a quantity of agent but not determine what or how many 

agents are present. 41 Some detectors are best designed for vapors, but others 

require a solid or liquid sample. Some respond almost immediately, but others can 

take more than 20 minutes. 

Consider all of these factors when selecting the combination of equipment to use in 

a response operation. Additional factors for the selection of monitoring equipment 

are listed in Table 1. 41 

Table 1: Factors for the Selection of Monitoring Equipment. 

Selection Factors for Monitoring Equipment 

Features Description 

Agents Detected This describes the chemical, biological, or radiological material the device 

can detect. 

Sensitivity This describes the minimum detection limit of the device. 

Response Time This is defined as the amount of time required for the instrument to collect, 

analyze, and provide feedback on a sample. 

Resistance to Sometimes, a compound can cause a detector to alarm when it should not, 

Interferents 

which is a false positive. Or, a compound can prevent a detector from 

alarming when it should, which is a false negative. Such a compound is 

considered to be an interferent. This describes how well a device can 

differentiate an interferent from a true agent of interest. 

14 Original



Selection Factors for Monitoring Equipment 

Detection states This indicates if the device can detect a sample in a vapor, aerosol, liquid, or 

solid state. 

Alarm Capability This is determined by an audible, visual, or combination alarm. 

Environmental Limits The describes the environment required by the equipment to operate 

optimally, and could include humidity, temperature extremes, rain, snow, 

fog, etc. 

Durability This indicates how rugged a device is. 

Power/Battery 

Requirements 

Operator Skill and 

Training Requirements 

This indicates if a device requires AC electrical power or can function off of a 

battery, and the available battery life. 

This refers to the general skill level and amount of initial and sustainment 

training required for optimum operation of the equipment. 

In the best case scenario, multiple detectors are available to responders to increase 

the likelihood of accurate and rapid identification of the agent. A good example 

would be to combine a photoionization device (PID) with a colorimetric device. The 

PID can measure a vapor concentration but not identify the agent. The colorimetric 

device can identify the agent but cannot accurately measure a vapor concentration. 

Table 2 provides basic information on detection equipment that is commonly 

available to civilian responders to monitor for chemical, biological, and radiological 

contaminants. 40 This listing is not inclusive since there are many different types of 

detection equipment on the market. Appendix D provides a more comprehensive 

listing of detection equipment, along with their capabilities and limitations. 

Table 2: Capabilities and Limitations of Common Monitoring Equipment. 

Technology Capabilities 

Chemical Detectors 

Limitations 

Photoionization • Rapidly detects broad range of TIC • Does not positively identify agent. 

Detector vapors, such as ammonia and • High humidity affects accuracy of the 

benzene. 

• Provides quantitative results. 

results. 

Colorimetric • Individual detector chips can detect a • Agent detection depends on the chip 

Detector wide range of TICs, such as ammonia being used. 

and chlorine. 

• Chips require specific storage 

conditions to optimize shelf-life. 

Biological Detectors 

Enzyme • Identifies presence of biological • Test strips require specific storage 

Immunoassay materials, such as anthrax and ricin. conditions to optimize shelf-life. 

• Field rugged. 

• Results must be confirmed. 

Enzyme • Individual test strips can detect • Agent detection depends on the test 

Immunoassay biological agents, such as anthrax and strip being used. 

ricin. 

• Does not alarm positive if agent count 

• Screens granular, powder, liquid, and is below threshold value. 

aerosol samples. 

• Results must be confirmed. 

Original 15 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



Technology Capabilities Limitations 

Radiological Detectors 

Geiger-Mueller • Detects alpha, beta, and gamma 

radiation depending on probe being 

used. 

• Measures dose and dose rate. 

Ion Chamber • Primarily detects gamma and highenergy 

beta radiation. 

• Measures dose and dose rate. 

• Becomes saturated in high radiation 

environments. 

• Uses high voltages to operate, so it is 

not intrinsically safe. 

• Does not detect alpha radiation. 

• Requires annual calibration at offsite 

facility. 

There is considerable reference material available to responders that can be used in 

the interpretation of data, including (but not limited to): 

• U.S. Department of Transportation (DOT) Emergency Response Guidebook 

(ERG) 42 

• National Institute of Occupational Safety and Health (NIOSH) Pocket Guide to 

Chemical Hazards 43 

• U.S. Coast Guard (USCG) Chemical Hazards Response Information System 

(CHRIS) Manual and Hazard Assessment Computer System 

• Various suites of free HAZMAT software. Example software includes Areal 

Location of Hazardous Atmospheres model (ALOHA); Computer-Aided 

Management of Emergency Operations (CAMEO); and Mapping Application for 

Response, Planning and Local Operational Tasks (MARPLOT) 

• Various suites of commercially available HAZMAT software, such as CoBRA 

• Consequence Assessment Tool Set with Joint Assessment of Catastrophic 

Events (CATS-JACE) from the Defense Threat Reduction Agency, U.S. Army 

• Joint Warning and Reporting Network (JWARN) from the Joint Program Executive 

Office for Chemical and Biological Defense, U.S. Army 

• Wireless Information System for Emergency Responders (WISER) from the U.S. 

National Library of Medicine, National Institutes of Health and the Department of 

Health and Human Services 

• Manufacturer-provided material safety data sheets (MSDSs) 

• Shipping papers, bills of lading, and/or manifests 

Additional tools and information on detection and surveillance methods to identify 

agents are provided in Appendix D and Appendix E. 

6.3 Individual and Personal Protective Equipment 

The Incident Commander establishes the appropriate protective posture based on 

information gained during survey and monitoring reconnaissance operations. PPE 

guidance can be found in the product or agent’s MSDS, DOT ERG, 42 and/or NIOSH 

Pocket Guide. 43 All personnel who may be directly or indirectly exposed must don 

appropriate PPE. Or, they should follow at least the minimum level of protective 

measures required. Mission-oriented protective posture (MOPP) gear available to 

military personnel is IPE and is categorized into four ensembles: 13,44 

16 Original



• MOPP Level 1 level of protection is established when the general warning is 

given and the threat of CBRN exists. Level 1 ensemble consists of the overgarment 

being worn open or closed. The over-boots, mask, and gloves are 

carried. 

• MOPP Level 2 level of protection should be established during a tactical situation 

that requires units to cross-terrain where the previous use of CBRN agents is 

unknown. Level 2 ensemble consists of the over-garment worn open or closed. 

The over-boots are worn, and the mask and gloves are carried. 

• MOPP Level 3 level of protection should be established when units are on the 

move and a CBRN attack is possible. Level 3 ensemble consists of the overgarment 

worn closed. The over-boots are worn, and the mask is worn. The hood 

is open or closed, based on temperature, and the gloves are carried. 

• MOPP Level 4 level of protection should be established when a unit is operating 

within a contaminated environment or if there is an imminent threat of an attack. 

The Level 4 ensemble consists of the over-garment worn closed and the overboots 

are worn. The mask and hood are worn with hood closed, and the gloves 

are worn. This level is the closest equivalent to an OSHA Level C ensemble. 

Toxicological agent protective aprons maybe added to MOPP4 to provide 

additional protection. This is important when working with liquid contaminants. 

• NOTE: MOPP gear does not provide adequate protection for many TIMs. 15 

The levels of civilian PPE as defined by OSHA are Level A, Level B, Level C, and 

Level D. The components of each are in Table 3. 45 Civilian PPE may be available to 

military personnel during response operations. 

Table 3: Components for OSHA PPE Levels. 

PPE Component Level A Level B Level C Level D 

Self-contained breathing apparatus (SCBA) or 

supplied air respirator with escape SCBA bottle 

Required Required 

Air purifying respirator Required 

Escape mask Optional Optional 

Totally encapsulating chemical protective suit Required 

Hooded chemical resistant splash protective 

clothing 

Required Required 

Coveralls Optional Optional Optional Required 

Long underwear Optional 

Gloves, outer, chemical resistant Required Required Required Optional 

Gloves, inner, chemical resistant Required Required Required Optional 

Boots, chemical resistant, steel toe and shank Required Required Optional Required 

Boot covers Optional Optional Optional 

Hard hat Optional Optional Optional Optional 

Face shield Optional Optional Optional 

Safety glasses or chemical splash goggles Optional 

Secondary protective suit, worn over totally 

encapsulating suit 

Optional 

Original 17 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



Level A protection should be used when: 

• The hazardous substance has been identified and requires the highest level of 

protection for skin, eyes, and the respiratory system. Use of Level A is based on 

the measured (or potential for) high concentration of atmospheric vapors, gases, 

or particulates. Level A is also used if the site operations and work functions 

involve a high potential for splash, immersion, or exposure to unexpected vapors, 

gases, or particulates of materials. These substances are harmful to skin or 

capable of being absorbed through the skin. 

• Substances with a high degree of hazard to the skin are known or suspected to be 

present. Skin contact is possible. 

• Operations must be conducted in confined, poorly ventilated areas. Also, the 

conditions requiring Level A have not yet been determined. 

• Casualties indicate a harmful substance of some type. The level of hazard is 

unknown. 

Level B protection should be used when: 

• The type and atmospheric concentration of substances have been identified. The 

substances require a high level of respiratory protection but less skin protection. 

• The atmosphere contains less than 19.5% oxygen. 

• A direct-reading organic vapor detection instrument indicates incompletely 

identified vapors or gases are present. However, vapors and gases are not 

suspected of containing high levels of chemicals harmful to skin or capable of 

being absorbed through the skin. 

• An unknown environment is encountered. Level B is the minimum required level 

of protection. 15,45,46 

• NOTE: Level B is used with atmospheres with immediately dangerous to life and 

health (IDLH) concentrations of specific substances that present severe inhalation 

hazards. The substances do not represent a severe skin hazard or do not meet 

the criteria for using air-purifying respirators. Among other references, the IDLH 

level can be found in the NIOSH Pocket Guide 43 or in the MSDS for the product, if 

available. 

Level C protection should be used when: 

• The atmospheric contaminants, liquid splashes, or other direct contact will not 

adversely affect or be absorbed through any exposed skin. 

• The types of air contaminants have been identified, concentrations measured, and 

an air-purifying respirator is available that can remove the contaminants. 

• All criteria for the use of air-purifying respirators are met. 

• NOTE: MOPP Level 4 is the closest equivalent to an OSHA Level C ensemble. 

However, it does not meet OSHA Level C requirements because the suit is not 

splash-protective. 

Level D protection should be used when: 

• The atmosphere contains no known hazard. 

• Work functions preclude splashes, immersion, or the potential for unexpected 

inhalation of or contact with hazardous levels of any chemicals. 

18 Original



Combinations of PPE other than those described for Levels A, B, C, and D 

protection may be more appropriate and may be used to provide the proper level of 

protection. 45 The utility of military protective gear for certain operations, such as 

MOPP Level 4 with or without splash protection, may be appropriate for some mass 

decontamination positions depending on the identified hazard. 

7.0 Decontamination Overview 

7.1 Purpose, Definitions, and Types of Decontamination 

INTENT: Understand MCD terminology, principles, processes, and systems by 

comparing military and civilian standard practices, guidance, and doctrine. 

The purpose of decontamination is to limit and/or prevent the spread of 

contamination, to remove the contaminant from the casualties, and to protect the 

responders from secondary transfer or “cross-contamination.” Decontamination is 

the process of making any person, object, or area safe by absorbing, destroying, 

neutralizing, making harmless, or removing chemical or biological agents, or by 

removing radioactive material clinging to or around it. 13 

For both military and civilian responders, there are three generally accepted levels of 

decontamination operations. They include the primary, secondary, and tertiary levels 

of decontamination. Each level repeats the decontamination process, but each level 

is progressively more thorough so that the casualty, responder, and/or piece of 

equipment becomes less contaminated than at the conclusion of the previous level. 

Military and civilian responders use very similar processes and techniques when 

conducting primary, secondary, and tertiary levels of decontamination. Sometimes, 

the same decontamination process just goes by a different name. These differences 

are highlighted in the remainder of this section. 

The primary decontamination level involves the rapid removal of bulk contamination 

from casualties, responders, and equipment. Gross, immediate, and emergency 

decontamination processes are associated with this level. Civilians generally use the 

terms gross and emergency decontamination. Military guidance and doctrine use all 

three terms, but immediate is the term most generally used to describe primary 

decontamination. Immediate decontamination is typically used in a tactical 

environment by military personnel on themselves and their equipment. The term 

immediate decontamination is not usually associated with MCD operations in a 

domestic environment. 

The secondary level of decontamination involves the thorough and systematic 

removal of contaminants. Mass, technical, thorough, operational, detailed, and 

definitive decontamination are associated with this level. Military guidance and 

doctrine use all the terms, but of the terms that are listed, civilians generally use 

mass and technical decontamination. 

Original 19 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



The tertiary level of decontamination is less defined and compartmentalized than the 

primary and secondary levels. Essentially, the tertiary level measures the amount of 

contaminant remaining, and should there be any contaminant detected, the casualty, 

responder or piece of equipment goes through the secondary decontamination 

process again. The tertiary level allows for the unrestricted use of resources and 

verifies that the decontamination of a casualty, responder, or piece of equipment is 

as complete as possible. Thus, the casualty and responder may be released and the 

equipment may be returned to operational use. 

Military terms associated with the tertiary decontamination phase are definitive and 

clearance decontamination. Sometimes clearance decontamination is included in the 

fourth level if operational decontamination is included between immediate and 

thorough decontamination (thus, immediate, operational, through, and clearance). 47 

Civilian guidance does not readily address tertiary decontamination, although it is 

followed in practice at the conclusion of mass and technical decontamination. 

Table 4 compares the military and civilian definitions of predominant 

decontamination terms from military and civilian guidance and doctrine. 13,15,23,46,47 

The table also identifies which decontamination terms are used in these Guidelines. 

In the context of this document, mass casualty decontamination is the overarching 

process with mass decontamination being a subordinate process. 

Table 4: Comparison of Decontamination Terminology from These Guidelines; Field Manuals 

3-11.5, 3-11.21, 4-02.7; NFPA 472; and OSHA 3249-08N. 

Decontamination Terminology from Key References 

Gross Emergency Mass 

These Guidelines 

Technical Clearance 

a 

Initial decontamina- Required when a Often established after Designed to remove Designed to elimi-nate 

tion to begin removing contingency incident gross decontamina- contaminants from or reduce to a harm- 

contaminants from the occurs and may be tion, will optimally use responders in PPE, less level any remain- 

casualties, and is needed at any time, a soap and water their equipment, and ing hazard on the 

usually performed by when immediate action solution and allow for evidence. A step-by- casualty, equipment, 

emergency responders is necessary. the casualties to be step process to and facilities. This fine 

through handlines, an 

completely disrobed perform a thorough level of decontamina- 

emergency decontami- 

and decontaminated. decontamination tion usually requires a 

nation corridor system 

before being allowed large amount of 

(EDCS), or a ladder 

to enter the cold zone. logistical support and 

pipe system (LPS). 

Can be used for time, and returns the 

casualties in an casualty, equipment, 

emergency situation. and facilities to 

acceptable or precontamination 

levels. 

Not defined. 

Field Manual 3-11.5 

Can occur at any point Rapid reduction of 

during a decontamina- agent from the skin of 

tion operation. many contaminated 

Commonly refers to victims. Performed as 

procedures taken for quickly as possible 

the rapid reduction of while also practicing 

agent from the skin. contamination 

avoidance. b 

Deliberate decontamination 

of responders, 

equipment, and 

evidence. Can also be 

performed on a mass 

contaminated 

populous if conditions 

allow. Emphasis on 

neutralization of the 

agent. Speed is not a 

factor. c 

Decontamination of 

equipment and 

personnel to levels 

that allow unrestricted 

transportation, 

maintenance, employment, 

and disposal. 

May be required 

as part of restoration 

operations. 

20 Original



Decontamination Terminology from Key References 

Gross Emergency Mass Technical Clearance 

Not defined. Removes contamination 

from personnel in 

order to save lives, 

minimizes casualties, 

and limits the spread 

of the contamination. 

Facilitates rapid medical 

attention without 

transferring the contamination 

to other 

personnel or 

equipment. 


Not defined. Deliberate decontamination 

of responders, 

response equipment, 

and evidence. 

Conducted during a 

CBRN CM response 

where trained responders 

conduct decontamination 

operations. 

The focus is 

neutralization of the 

agent. 

Provides decontamination 

to a level that 

allows unrestricted 

transportation, 

maintenance, 

employment, and 

disposal of equipment. 

Carried out by indivi- Not defined. 


Not defined. Deliberate deconta- Equipment and 

duals immediately 

mination of respon- technical decontami- 

upon becoming conders 

and patient nation where a fourth 

taminated to save 

decontamination site level of decontamina- 

lives, minimize cas- 

personnel and their tion is conducted for 

ualties, and limit the 

equipment. Conduc- verification that all 

spread of contaminated 

with the emphasis residual hazard has 

tion. May include de- 

on deactivation and been mitigated to 

contamination of so- 

neutralization of the levels acceptable for 

me personal clothing 

agent with speed not unprotected 

and/or equipment. 

being a factor. personnel. d 

NFPA 472 

Significantly reduce 

the amount of 

additional exposure. 

Accomplished by 

mechanical removal of 

the contaminant or 

initial rinsing from 

handheld hose lines, 

emergency showers, 

or other nearby 

sources of water. e 

Quickly separates as A gross decontami- Subsequent to gross Not defined. 

much of the 

nation process using decontamination des- 

contaminant as large volumes of lowigned to remove con- 

possible from the pressure water to taminants from respo- 

individual to minimize reduce contamination. nders, their equipment, 

exposure and injury. Soap-and-water or and victims. In non- 

other appropriate life-threateningcon- solution is best. tamination incidents, 

technical decontamination 

can also be 

OSHA 3249-08N 

used on victims of the 

initial release. 

Patient will do head-to- Not defined. Should commence in Hospital personnel will Not defined. 

toe gross decontami- 

the event that the undergo a technical 

nation wash using mild 

chemical exposure decontamination wash 

soap and water. 

incident involves more from head-to-toe 

than 3 people requiring involving the outer 

decontamination simu- garments, gloves, and 

ltaneously, or incident 

information suggests 

the arrival of large 

numbers of patients 

requiring decontamination 

as a result of a 

mass exposure. 

boots. 

a. These Guidelines use the term “casualty” instead of “victim” or “patient.” However, cited references may use the terms 

“victim” and/or “patient.” These terms will not be changed to “casualty” when quotes are taken from the cited references. 

b. Other terms associated with the mass decontamination process are emergency, gross, and immediate decontamination. 

c. Other terms commonly associated with technical decontamination are detailed, thorough, deliberate, definitive, and 

responder decontamination. 

d. Clearance decontamination is included in the fourth decontamination level if operational decontamination is included 

between immediate and thorough decontamination (thus, immediate, operational, through, and clearance). 47 

e. Per NFPA 472, emergency decontamination is performed on 1) entry team members before technical decontamination; 2) 

victims during emergency decontamination; and 3) persons requiring mass decontamination. 

Original 21 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



The primary, secondary, and tertiary decontamination levels are conducted in 

sequential order—the casualty, responder, and/or equipment will be cleaner at the 

completion of each subsequent decontamination level. However, processes such as 

gross, mass, and technical decontamination are often conducted simultaneously to 

increase the effectiveness of resource utilization. Time, sequence of events, 

resource availability, and desired outcome are the key drivers of the type of 

decontamination process applied. 

The combination of processes that are used to complete the primary, secondary, 

and tertiary decontamination cycle create a decontamination system. For example, 

using gross, mass, and technical decontamination for mass casualties creates a 

version of mass casualty decontamination. There are numerous decontamination 

systems in place, and they are used by both military and civilian personnel. 

Additional systems include patient decontamination, hospital decontamination, and 

mass fatality decontamination, just to name a few. Each system can be standalone 

or multiple systems can be used—the incident dictates how MCD operations are 

conducted. 

Figure 2 below shows the following interrelationships related to decontamination 

operations as a function of time, resources, and cleanliness: 13,15,23,46,47 

• The relationship between decontamination levels (primary, secondary, and 

tertiary) and processes (gross, immediate, emergency, technical, definitive, 

thorough, detailed, definitive, and clearance). 

• The correlation between military (immediate, technical, thorough, detailed, 

definitive, and clearance) and civilian (gross, mass, and technical) processes. 

Shared processes are also identified. 

• The relationship between the different decontamination systems, such as mass 

casualty, patient, and hospital decontamination systems. 

• NOTE: The exact terminology used by any military or civilian responder is defined 

by the emergency plans and procedures of the responding agencies. 

• NOTE: The nature and complexity of the incident, conditions, and resource 

availability determines the decontamination system and processes that are 

chosen by the Incident Commander or Commander. 

The top portion of Figure 2 shows the transition from the primary to the tertiary 

decontamination level, including the subordinate processes. The primary level 

provides fast decontamination and requires fewer resources, but it also removes the 

least amount of decontamination. Conversely, the secondary level takes more time 

and resources, but results in little to no contamination. The tertiary level confirms the 

results of secondary decontamination and routes a casualty, responder, or piece of 

equipment back through secondary decontamination process if any contaminants 

are detected. 

22 Original



Figure 2: Interrelationships between Military and Civilian Decontamination Processes and 

Systems. 

Figure 2 also compares the decontamination systems that are used by military and 

civilian response personnel. This figure shows how all the different systems overlap 

in relation to the levels of decontamination, processing speed, resources required, 

and resulting removal of contamination after decontamination: 

• Mass Casualty Decontamination System. The MCD system is used by military 

and civilian response personnel during the first phase of a mass casualty incident. 

The system consists of gross/immediate/emergency decontamination, mass 

decontamination, and technical decontamination processes, as illustrated in 

Figure 3. 

o Gross/Immediate/Emergency Decontamination. Speed is of the utmost 

importance. Military responders generally use M291 skin decontamination 

kits or remove clothing and use water to rapidly remove contaminants. 

Civilian responders use fire hoses with nozzles, LPS, and/or EDCS. Soap 

is generally not used. Ambulatory casualties generally remove the 

outermost clothing and process through a large volume, low pressure water 

shower. It is not recommended that nonambulatory casualties be 

processed through the LPS or EDCS. Depending on the assets and 

personnel available, gross decontamination maybe the only method 

available to decontaminate casualties before they are allowed to leave. 

Original 23 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



o Mass Decontamination. Both military and civilian responders use shower 

systems for ambulatory casualties, and litter system and/or roller system to 

process nonambulatory casualties. This system can potentially be used on 

a standalone basis, depending on equipment and personnel assets 

available at the scene. Compared to gross decontamination, mass 

decontamination provides a more through decontamination before 

casualties are allowed to enter the cold zone, be moved to a holding area 

for observation, or be transported to a medical treatment facility for 

observation and/or treatment. 

o Technical Decontamination. Both military and civilian responders use 

technical decontamination to transition from the warm zone to the cold 

zone. This process is conducted upon responders and equipment, and 

under special circumstances, casualties can also go through technical 

decontamination. It is conducted with the emphasis on deactivation or 

neutralization of the agent with speed not being a factor because of the use 

of IPE/PPE. This line is located away from the mass decontamination line 

to avoid confusion and cross contamination. Civilians use “technical 

decontamination” to describe both responder and equipment 

decontamination. Military guidance uses detailed troop decontamination 

(DTD) and detailed equipment decontamination (DED) to describe the 

technical decontamination process. These military terms are not usually 

associated with MCD operations in a domestic environment. 

Figure 3: MCD Site with Gross, Mass, and Technical Decontamination Elements. 

24 Original



• Hospital Decontamination System. This system is used at the medical 

treatment facility where casualties are transported after being decontaminated 

and assessed at the incident site. Generally, all casualties go through mass 

decontamination upon arrival at the medical treatment facility. This is true for 

casualties that self-present and those that have already been decontaminated by 

responders at the incident site. A majority of civilian hospitals have purchased 

equipment that is able to decontaminate both ambulatory and nonambulatory 

casualties. Technical decontamination at hospitals is generally the same as 

previously described. 

• Patient Decontamination System. This is primarily a system used by the military 

to decontaminate personnel before they enter a medical treatment facility. 13,15,23 

This system functions more between the secondary and tertiary levels of 

decontamination because military personnel usually don IPE, and have received 

immediate and operational decontamination prior to arrival. This system has the 

ability to decontaminate ambulatory and nonambulatory casualties. DTD and DED 

follow as appropriate to decontaminate responders and equipment. These are 

military terms not usually associated with MCD operations in a domestic 

environment. 

• Mass Fatality Decontamination System. The system for decontaminating 

fatalities mirrors that used for nonambulatory casualties, regardless of the exact 

decontamination process used. Technical decontamination at hospitals is 

generally the same as previously described. 

7.2 Principles of Decontamination 

INTENT: Describe common approaches to mass casualty decontamination for 

military and civilian responders. 

Mass casualty decontamination is both a medical and crowd management operation. 

Speed and efficiency are critical elements of MCD operations. A key factor in the 

speed and effectiveness of MCD operations rests with how the crowds are 

managed. The military’s experience on how to organize and manage 

decontamination efforts primarily addresses how to handle young healthy soldiers 

already wearing protective clothing and respiratory protection. 

This model is not directly applicable to a diversified, unprotected, and undisciplined 

population that has not had the benefit of a program to familiarize them with their 

expected role in an event requiring MCD. The psychological impact of being 

exposed to a contaminant is not well studied. How crowds will listen to instructions, 

what they need to be told and how that message should be given must be 

considered. Some people may hesitate to take off their clothes in the absence of an 

obvious immediate danger, or shower with persons they have never met before. 

Managing crowds, especially crowds who may believe they are in danger is a critical 

planning factor that needs to considered and addressed. 

Additional planning factors include managing crowds that are 1) waiting to be 

decontaminated, 2) currently undergoing decontamination, and 3) those that have 

Original 25 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



completed decontamination and are seeking medical care. Every effort should be 

made to ensure that health care professionals and officials are intimately involved 

with and part of MCD planning, training and operations. In addition, an MCD 

approach that only considers decontamination from the incident site alone will not be 

effective in the face of casualties self-presenting to health care facilities rapidly and 

in high numbers. 

The principles of decontamination should guide all processes and priorities when 

planning and performing decontamination. 15 Table 5 compares the fundamentals 

and priorities listed in Field Manual 3-11.5 for military operations to those listed in 

the DHS TCL/UTL and USACBRNS/ECBC guidelines for civilian operations. 1,11,15 

Note that the three lists complement each other. The DHS’ TCL/UTL and 

USACBRNS/ECBC recommendations are more operational. The FM 3-11.5 

recommendations are more academic. Table 6consolidates these basic principles 

and associates them to specific USACBRNS collective tasks. 

Table 5: Comparison of the Decontamination Fundamentals Between FM 3-11.5, DHS 

TCL/UTL, and the USACBRNS/ECBC Guidelines, Volumes I & II. 

FM 3-11.5 DHS TCL/UTL* USACBRNS/ECBC* 

1. Speed. Personnel should 

conduct decontamination 

operations as quickly as 

possible. Direct exposure to 

CBRN agents or toxic industrial 

materials will create casualties 

and could be fatal within 

minutes. The sooner equipment 

is decontaminated, the less likely 

it is to absorb the agent or 

spread to other surfaces. 

2. Need. Decontaminate only what 

is necessary. Personnel have a 

limited amount of resources 

available and should expend 

resources only where they are 

needed. 

3. Priority. Decontaminate the 

most essential items first; 

foremost will be the skin if 

contact occurs. Once wearing 

protective equipment, personnel 

should begin decontamination 

operations on clothing, 

equipment, and vehicles. 

4. Limited Area. Personnel should 

perform decontamination near 

the area where the 

contamination occurs. This limits 

the spread of contamination to 

other areas and reduces the 

time spent traveling. 

1. Test and identify all likely 

hazardous substances onsite. 

2. Establish decontamination 

site for victims. 

3. Implement emergency 

decontamination operations. 

4. Screen affected persons. 

5. Decontaminate victims 

exposed to CBRNE materials. 

6. Implement plans, procedures, 

and protocols to ensure on-site 

individual gross 

decontamination of persons 

and household pets affected by 

the incident. 

7. Readily identify people who 

have received gross 


8. Implement technical 

decontamination for injured, 

contaminated victims. 

9. Monitor exit points for 

contaminant movement outside 

the isolation zone. 

10. Monitor clean areas within 

the contamination control line. 

1. Disrobing is the most critical 

step and removes up to 90% of 

physical contamination. 

2. Neither should disrobing nor set 

up of a high-volume, lowpressure 

water shower be 

delayed to introduce a soap 

water solution or to set up 

tents. 

3. Triage victims for 

decontamination before the 

water shower. 

4. Victims should be washed 

between 30 seconds and 3 

minutes. 

5. Decontamination of chemical 

vapors, biological material or 

radiological substances can be 

aided by rubbing hands or 

cleans cloths across the skin. 

6. Rubbing should start with the 

head and proceed down the 

body to the feet. 

7. Use victim observation areas to 

watch for delayed symptom 

onset. 

8. Perform additional secondary 

decontamination as 

necessary. 

* These Guidelines use the term “casualty” instead of “victim” or “patient.” However, cited references may use 

the terms “victim” and/or “patient.” These terms will not be changed to “casualty” when quotes are taken from 

the cited references. 

26 Original



The MCD principals presented in these Guidelines are derived from the DHS 

TCL/UTL, USACBRNS/ECBC Guidelines, Field Manuals 3-11.5, 3-11.21, 4-02.7, 

and other sources. They are designed to impart a sense of order to an ill-defined 

and complex operation. A large scale intentional or unintentional release of a 

chemical, biological, or radiological hazard is likely to lead to scores of casualties 

and fatalities. The rapid implementation of effective MCD process will be vital to 

optimizing casualty survivability and responder safety. Exactly how this process 

should be conducted is neither well known nor extensively studied. 

USACBRNS and USARNORTH have invested significant resources and time to 

develop MCD training standards and a process that reflects a worst case scenario. 

These standards are largely anecdotal and developed around 1) young healthy 

soldiers and 2) traditional HAZMAT/CBRN response techniques. The standards 

alone are not appropriate for all situations and may need to be adjusted to improve 

the unified military and civilian MCD response capability. The key is to know the 

standards and incorporate best practices and lessons learned into the planning 

process to be able to conduct optimum MCD operations that are adaptable to 

evolving conditions. 

Figure 4: Planning for MCD Operations Using Standards and Best Practices. 

Evolving 

Conditions 

Know the 

Standards 

Plan for the 

MCD Mission 

Tactics, Technique, 

and Procedures 


Operations 

Incorporate Best 

Practices 

The MCD principles presented in Table 6 should be considered and appropriately 

integrated from initial planning to the actual conduct of MCD operations. MCD is 

both a medical procedure and crowd management operation. Speed and efficiency 

are critical elements of MCD operations. Section numbers are provided in 

parentheses where these principals are explained in greater detail in this document. 

Original 27 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



Table 6: Principals of Mass Casualty Decontamination. 

Identify and understand the 

hazard(s) and operating 

conditions of the incident. 

Conduct and coordinate 

both decontamination and 

medical triage. 

Disrobing may be a critical 

step and can remove the 

majority of physical contamination 

(depends on 

casualty state of dress). 

Use high-volume, low 

pressure lukewarm water 

showers, with liquid soap if 

available, for up to 5 

minutes or as indicated by 

post-decontamination 

monitoring. 

Monitor decontamination 

effectiveness; use random 

sampling of casualties 

before transportation to 

medical treatment facility. 

Principals of Mass Casualty Decontamination 

Knowing what agent that contaminated the casualties can 1) change the 

level of IPE/PPE to be worn by responders during response operations, 

2) determine MCD decontamination processes to be used, and 3) 

modify the MCD processes as appropriate as the incident response 

progresses. Knowing hazards such as slip, trip, falls, overhead hazards, 

and heat/cold hazards ensures that responding personnel and 

casualties are safe. Safety is a large concern. (Sections 8.1.2 and 8.1.5) 

Triage is a prioritization system to allow responders to provide the 

necessary care to as many people as possible. Decontamination triage 

should not be confused with medical triage. Decontamination triage is 

performed to determine who should be washed off first, while medical 

triage is performed to determine who should receive medical treatment 

first. (Section 8.1.9) 

Disrobing is a fast and easy decontamination process that can remove 

most of the external contaminant, during most times of the year. 

Summer months in warmer climates will result in a lower removal 

percentage by disrobing, due to a greater percentage of exposed skin. 

(Section 7.3.1) 

High volume and low pressure water aids in the removal of any 

contamination. High volume ensures there is enough water to 

completely douse the casualty. Low pressure flow minimizes potential 

damage to the skin that could allow the contaminant to penetrate the 

skin faster. Water should be lukewarm so that the skin’s pores are less 

likely to open. Soap or other decontamination solutions can be added 

into a decontamination process to ensure more thorough removal of the 

contaminant. (Sections 8.2.1 – 8.2.5) 

Verify casualties have been decontaminated with appropriate detectors 

to verify that contaminants were successfully removed. If an appropriate 

detector is not available, visually observe the casualty for indicators that 

contamination removal was unsuccessful or wait for appropriate 

detector. (Section 8.1.11) 

During decontamination operations, also consider the containment, environmental 

run-off and monitoring, contamination and recontamination avoidance, and site 

cross-contamination prevention. However, the key MCD principles described in 

Table 6 apply regardless of the size and complexity of the incident. 

7.3 Methods of Decontamination 

Mass casualty decontamination can be accomplished predominately by physical 

removal and neutralization. 15,23 Preventive methods, such as the use of disposable 

protective clothing and equipment, reduce the risk of cross-contamination. 23 

Consider the agent’s solubility and reactivity with water when selecting the best 

method to decontaminate casualties. 23 Decontamination methods are described in 

detail in Field Manuals 3-11.5 and 4-02.7. 13,15 

28 Original



7.3.1. Physical Removal of Contaminants 

Physical removal is the preferred technique when decontaminating mass casualties, 

particularly for the gross/immediate/emergency decontamination process. Disrobing, 

absorption, adsorption, flushing, brushing and scraping, isolation and disposal, 

vacuuming, and washing are common techniques to physically remove 

contaminants. Using water showers is the most practical method for performing 

gross decontamination. Disrobing, followed by flushing, is a fast and easy process 

that can remove most of the external contaminant, during most times of the year. 1 In 

warmer climates, summer months will result in a lower removal percentage by 

disrobing, due to a greater percentage of exposed skin. 

When water is limited or not available, dry materials, such as dirt, flour, baking 

powder, Fuller’s earth, activated charcoal, leaves, and/or sawdust, may be used to 

remove contaminants. 13 However, it is important that the dry material is not abrasive, 

like sand is to skin. Abrasiveness causes the skin’s pores to open, which could allow 

greater absorption of the contaminant through the skin. 13 Another consideration is 

the temperature of the water used to flush contaminants from the skin. The warmer 

the water is, the more the pores of the skin are opened. As such, it is recommended 

that lukewarm water is used in the decontamination process. 13 

Physical methods simply reduce the amount of contaminant on the casualty. 

Physical removal of the contaminant could be sufficient on its own to decontaminate 

casualties, depending on the nature of the contaminant. This method does not 

change or reduce the toxicity of the agent. Therefore, subsequent neutralization of 

the contaminant on casualties may be required during the 

mass/thorough/operational/detailed/definitive decontamination process. 

7.3.2. Cleansing and Neutralization of Contaminants 

Adding a cleansing or neutralizing compound to the water spray during the mass 

decontamination process makes decontaminating casualties more efficient and 

thorough. Cleansing compounds do not change or reduce the toxicity of the agent. 

The chemical nature of the cleansing compounds aid in disrupting the bond between 

the skin and the contaminant, so that the contaminant can be washed away by 

water. Neutralization is a reaction of the contaminating agent with other chemicals to 

render the agent less toxic, but its use on skin is discouraged because of possible 

irritation. Table 7 describes decontamination solutions. 

Table 7: Common Decontamination Solutions. 


Description 

Solution 

Soap Is a cleansing compound. A fat-based soap can be added into a decontamination 

process to ensure more thorough removal of the contaminant. Soap 

removes chemical, biological, and radiological contaminants, but it does not 

kill biological agents or neutralize radiological agents. 13 Soap removes oily 

contaminants that stick to skin, such as VX and mustard. Do not delay 

decontamination to incorporate the soap, but introduce it as soon as practical. 

An effective solution can be made by mixing 16 ounces of baby shampoo with 

5 gallons of water. 48 

Original 29 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance




Solution 

M291 Skin 

Decontamination Kit 

Description 

Contains a finger-sized pad that is saturated with a carbon-based adsorbent 

and ion exchange resins. This powder is highly effective for skin decontamination, 

is non-toxic and non-irritating, and can be applied directly to the face 

and around wounds. The black powder also shows the areas that have and 

have not been decontaminated because of the resulting color contrast. The 

military typically uses this kit in the immediate/emergency decontamination 

process, but water has been shown to be more effective for some 

contamination. 13,15 

Aqueous Film Do not use this product in any casualty decontamination situation because it 

Forming Foam is known to be a skin and eye irritant. 49 

Sanitizing and/or Can be used to begin to remove liquid or solid contamination from a 

Baby Wipes casualty’s skin. This applies particularly during cold weather conditions and 

after gross decontamination while waiting for the mass decontamination line 

to be established. The sanitizing wipe could be effective against biological 

agents. 

Reactive Skin A commercially available product that can be used to aid in decontamination 

Decontamination operations. Reactive skin decontamination lotion is highly effective against 

Lotion 

chemical agents, and can neutralize the effects of many agents. 13 However, it 

is more expensive than soap and can be difficult to distribute to a large number 

of casualties. To use, open the individually-wrapped packet and blot the 

lotion onto visible spot contamination to begin neutralization. The reactive 

skin decontamination lotion can be used for the decontamination of intact skin 

around wounds, but is not approved for the decontamination of wounds. 13 

Bleach Can irritate the skin and open pores, so it is generally not recommended for 

use as a casualty decontaminant. If necessary, only a 0.5% solution should 

be used. 15 It is effective for the removal of chemical and biological agents, but 

not for radioactive agents. 13 Bleach reacts with a riot control agent to form a 

strong irritant, 50 so do not decontaminate riot control agents with any form of 

bleach. 51 The nerve agent Tabun (GA) may react to form cyanogen chloride 

(CK) in a bleach slurry. 52 A bleach and water solution may be used in the 

technical decontamination line for cleaning equipment and PPE. Full strength 

(5%) bleach can be used to decontaminate equipment such as litters or 

shears, but the equipment should always be rinsed thoroughly before it is 

reused. Bleach requires sufficient contact time with agent for complete 

neutralization, which depends on the agent, ambient temperature, and 

concentration of the bleach. Ensure time has elapsed so that complete 

neutralization occurs. 13 

Peroxides Are strong oxidizers and are highly reactive. While they may be effective at 

neutralizing contaminants, the break-down reaction can be violent and 

produce heat. The use of peroxide-containing solutions for casualty decontamination 

is not recommended, but it is recommended for the decontamination 

of equipment, facilities (furniture, walls, and doors, etc), and terrain. 13 

Caution is recommended if peroxide-based solutions are used during the 

technical decontamination process. 

30 Original



8.0 MCD Operations 

Civilian responders may ask military personnel to perform all or selected MCD 

operations. These Guidelines present the full scope of MCD operations to orient 

military personnel with general civilian MCD techniques, best practices, and lessons 

learned. Full scope includes planning, set up, conduct, resupply, closeout, 

demobilization, restoration, and MCD operations under varying environmental 

conditions and terrain. However, it is important to know that civilian responders may 

request military assistance with only pieces of the MCD operations. The following 

presents example situations that the military may face when support is requested: 

• Military may be pre-staged at a large-gathering event, such as inaugurations, G8 

conferences, Olympics, or speeches. Military may be asked to provide fullspectrum 

support if MCD operations are required. 

• If not pre-staged, the military could be asked to: 

o Identify the agent/contaminant. 

o Augment the civilian responders on the LPS and/or EDCS. 

o Support current MCD lines under continuing operations. 

o Set up a new MCD corridor or a technical decontamination line at the 

incident location. 

o Set up or support technical decontamination line at the incident without 

MCD. 

o Establish and/or assist with MCD at sites outside the incident location, such 

as secondary sites or hospital sites. 

o Decontaminate the deceased. 

o Conduct other decontamination functions not related to casualties. 

Examples include decontaminating the area, facilities, and equipment, or 

performing resupply and logistics. (Both examples are outside the scope of 

these Guidelines). 

The exact support required by civilian response agencies is based on the nature and 

complexity of the incident. Required support may also depend on whether the 

civilian agencies can respond with the staffing, supplies, and equipment already in 

place. 

8.1 Considerations for MCD Set Up and Response 

Responders may be required to control, triage, 

decontaminate, and track a large number of casualties 

at the mass casualty incident site. Scene control may 

involve a large area, a mass casualty incident with 

numerous responders, and the press seeking 

information about the incident. A response of this 

magnitude requires more personnel and 

supplies/materials than may be available. Therefore, 

detailed contingency planning, training, and exercising 

are required in advance. 2 Planning and coordination 

with civilian authorities before an incident are crucial. 


Pre-Planning Activities 

DHS UTL Tasks 

• ComA 2.2.1, 2.2.2, 2.2.3, 

2.3, 2.3.3, 2.9.1.3, 2.9.1.5, 

3.1, and 3.2 


• 03-2-6594 Steps 1a, 1f, 

and 2c 

• 03-3-5130 Steps 3a, 3c, 

3b, 3h, 3k, 5b, 11g, and 12 

Original 31 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



With preplanning, leadership and personnel can more easily integrate with civilian 

resources and response procedures when a situation occurs that requires MCD. 

WMD incidents may include secondary devices meant to kill or incapacitate 

responders, and the scene should be searched as soon as practical for such 

devices. However, lifesaving operations should not be delayed. Instead, personnel 

should remain aware for the possibility of such devices. 48 Complex mass casualty 

incidents may result in a large number of deceased casualties that expire 

immediately or within a short timeframe after the incident occurs. Mass fatality 

management assistance results in the coordinated efforts of medical examiners, 

coroners, Disaster Mortuary Assistance Teams, and Mortuary Affairs personnel at a 

level appropriate to the scale and complexity of the incident. 

8.1.1. Establish Zones 

INTENT: Determine and mark off hot, warm, and cold contamination control zones. 

Contamination control zones define areas of high, low, 

and no contamination. 47 Contamination control zones are 

where certain functions occur, such as response and 

MCD operations, and they help provide contamination 

control discipline. All MCD operations should be located 

uphill and upwind from the location of the release or 

detonation, at a distance safe enough for responders not 

wearing IPE/PPE to be exposed to the contaminant. The 

DOT ERG and other HAZMAT references identified in 

Section 6.2 can help you plan appropriate contamination 

control zones as well as the topography and site 

conditions at the incident location. Contamination control 

zones should not be confused with stand-off distances, 

no-go zones, or other terminology used by various civilian 

HAZMAT documents and guides. 


Establishing Zones 

DHS UTL Tasks 

• ResB1b 3.1 and 3.2.1 

• ResB2b 3.2.6.1, 3.3, 

3.3.1, 3.3.2, 5.3, 5.3.1, 

5.5, 5.5.2, 5.5.3, 5.5.4, 

5.6, 5.6.1, 5.6.2, and 5.3 


• 03-2-5124 Steps 2, 3, 4, 

and 18b 

• 03-2-6594 Steps 5 and 

5c 

• 03-3-5130 Steps 8 and 

8c 

We will discuss contamination control zones in terms of a 

chemical/biological release, a radiological release, and a nuclear detonation. 

Regardless of the type of hazard, early warning detection devices or monitoring 

equipment can help determine these zones. Meteorological monitoring assists in 

plume prediction to estimate the spread of the contaminant. Once determined, mark 

these zones with safety cones and/or safety tape. 2 This measure is essential to 

prevent cross-contamination and ensure safe movement between hazardous 

areas. 53 These appropriate zones should also have supplies needed to support MCD 

operations. Example supplies include water, wastewater control, and electrical 

capability. NOTE: The zones must adapt to the specific incident and can/will change 

over time as a function of 1) reduction or increase in the level of contamination, 2) 

weather and/or environmental conditions, 3) safety-related conditions, and 4) site 

response activities, among others. 

32 Original



For chemical and biological releases, hot, warm, and cold contamination zones 

define areas of high, low, and no contamination. 47 The hot zone includes high 

hazard areas where responders operate, including the incident site itself. The hot 

zone also includes the areas in which casualties have gathered. Initial triage occurs 

in this zone once responders are able to enter safely. The spray from a fire hose is 

directed into this zone to begin decontamination. The warm zone contains all 

remaining decontamination operations. 47 Gross or mass decontamination lines 

should be physically separated from technical decontamination lines. A technical 

decontamination line should be established as soon as possible to clean personnel 

wearing IPE/PPE. The cold zone contains command and control efforts, medical 

evaluation, medical triage, treatment, transport, staging, security, and other such 

response elements. 54 Sections 8.4.1 and 8.4.2 contains specific information 

regarding chemical and biological decontamination techniques. 

For a radiological release, hazard zones are identified by the level of radiation 

present in the environment. 55 There are five zones associated with a radiological 

release are identified in the following list. Section 8.4.3 contains specific information 

regarding radiological decontamination techniques. 

• Extreme Caution Radiation Zone. This area, located within the high radiation 

zone, is restricted to the most critical activities, such as lifesaving. Personal 

dosimetry required, although one monitor for several responders is acceptable if 

they remain near the person with the monitor. Limit time spent in this area to avoid 

acute radiation syndrome. People within this zone at the time of the explosion 

must be surveyed for contamination before being released. 

• High-Radiation Zone. Restrict access to authorized personnel with specific 

critical tasks such as firefighting, medical assistance, rescue, extrication, and 

other time- sensitive activities. Personal dosimetry should be worn. People within 

this zone at the time of the explosion should be surveyed for contamination before 

being released. 

• Medium-Radiation Zone. Restrict access to only authorized personnel. Personal 

dosimetry should be worn. Serves as a buffer zone/transition area between the 

high and low radiation zones. People within this zone at the time of the explosion 

should be surveyed for contamination before being released. 

• Low-Radiation Zone. Restrict access to essential response individuals. Initial 

decontamination of first responders should occur near the outer boundary of this 

zone. Uninjured people within this zone at the time of the release can be directed 

to proceed directly home to shower if resources do not permit contamination 

surveying at the scene. 

• Uncontrolled Radiation Zone. The best location for Incident Command and 

decontamination activities. 

For a nuclear detonation, hazard zones are identified by the level of damage to the 

infrastructure surrounding the detonation site, as described in the following list. 56 

Responding personnel must bear in mind that these zones will not be evenly 

distributed or symmetrical around the axis of detonation. Depending on the size of 

Original 33 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



the nuclear detonation, height of burst and other factors, these zones can measure 

several miles in distance. Depending on terrain and structures, there will typically not 

be distinct boundaries between the damage zones. 

• No-Go Zone. Has the most damage to infrastructure, which will most likely be 

completely destroyed. The radiation level is very high and it is unlikely that any 

casualties will survive in this zone. However, people in substructures such as 

subterranean parking garages or subway tunnels may survive the initial blast. 

• Moderate Damage Zone. Has significant building damage and rubble, downed 

utility poles, overturned vehicles, and fires. Radiation levels in this zone are 

expected to be elevated and may be very high in some areas, but this is the zone 

has the greatest lifesaving potential. Casualties will come from this zone and will 

have thermal, blast, and radiation injuries. Most of the injured will require help 

and/or extraction to receive decontamination and treatment. 

• Light Damage Zone. Buildings typically will have broken windows with light 

damage to other infrastructure. A majority of the casualties will be ambulatory and 

can self-evacuate for decontamination and treatment. Radiation levels in this zone 

maybe slightly elevated from normal background levels. 

• Dangerous Fallout Zone. The area covered by fallout that impacts responder 

life-saving operations and/or has acute radiation injury potential to the population. 

This area is not identified by structural or other damage—it is based on fallout 

radiation levels. Typically this zone will consist of radiation levels of 10 Roentgen 

per hour or higher. Depending on various parameters (wind, atmosphere, and/or 

geographic terrain), this zone could extend 20 plus miles from the point of 

detonation and can include parts of the no-go, moderate damage and light 

damage zones. Existence of radiation beyond this zone may still require some 

sort of protective action. 

Regarding a nuclear detonation, the most effective life-saving opportunities for 

response officials in the fist 60 minutes will be the decision to safely shelter or 

evacuate people in expected fallout areas. 56 

8.1.2. Identify and Rule Out 

Contaminants 

INTENT: Determine the contaminant to the best 

extent possible. Determine appropriate levels of 

PPE based upon the type of hazard identified. 

Knowing what agent that contaminated the 

casualties allows the Incident Commander to 

establish 1) the level of IPE/PPE to be worn by 

responders during response operations, 2) to 

determine MCD decontamination processes to 

be used, and 3) modify the MCD processes as 

appropriate as the incident response progresses. 

For example, in the case of oily agents like VX or 


Identifying Contaminants 

DHS UTL Tasks 

• ResB1b 7.4.3, 7.5.1, and 7.5.2 

• ResB2b 5.5, 5.5.1.1, 5.5.1.3, 5.5.2, 

5.5.3, and 5.5.4 


• 03-1-6592 Step 7 

• 03-2-6591 Steps 2a, 3c, 3f, 6, 8d 

• 03-2-6594 Step 3c 

• 03-3-0038 

• 03-3-5127 Steps 1f, 4d, and 15 

• 03-3-5128 Steps 4d and 6 

• 03-3-5130 Step 7f 

34 Original



HD, casualties should not rub their skin with their hands without the use of soap. 

Doing so only causes further spread of contamination across the skin since the 

agent is not rinsed away by plain water. 

A plan for the initial entry and exit of qualified and medically screened personnel 

includes the use of detection equipment specific to the possible agents. 47 Use 

multiple detectors that use different detection technologies to increase the likelihood 

of accurate and rapid identification of the agent. After equipment is checked for 

functionality and a team briefing has occurred, the entry team begins the survey 

procedures. Continuous hazard monitoring must be conducted to detect hazards 

present in the area. Surveying for the presence of such agents must always be 

performed by personnel wearing appropriate PPE. 15 

Regardless of the type of hazard, document the location and types of hazards 

present, the area layout, and the position and condition of any casualties. These 

observations may be recorded by still photograph or video means. Upon exiting the 

area, entry team members should go immediately through the technical 

decontamination line. Then they should be medically monitored and debriefed for 

any pertinent observations. Document these findings in a situation map sketch and 

report to higher and adjacent commands using the CBRN Warning and Reporting 

System. 2 The type PPE that is worn by responders while extracting casualties is 

selected based on the outcome of the survey and monitoring report (CBRN4). 15,57 

Types and functionality of PPE are discussed in Section 6.3. 

A list of reference materials and tools that can be used in the interpretation of 

surveillance data is provided in Section 6.2, Appendix D, and Appendix E. 

8.1.3. MCD Corridor Site Selection 

INTENT: Determine the location where decontamination operations will take place. 

Typically, the MCD corridor is established at the start of 

the hot zone and goes through the warm zone. It 

terminates at the start of the cold zone. This corridor 

contains all decontamination operations in response to a 

mass casualty incident. The purpose for a 

decontamination corridor is to limit cross-contamination 

and increase the throughput of casualties through 

decontamination. Generally, there is no contamination in 

the decontamination corridor until causalities and/or 

responders enter it. The decontamination corridor should 

slope towards the hot zone and with the equipment being 

set up on a non-porous surface. The width of the corridor 

depends on what type of decontamination equipment is 

being used. This corridor may expand and contract as 

response operations move forward. 


Site Selection and 

Corridor Set Up 

DHS UTL Tasks 

• ResB2b 8.1, 8.2, 8.2.1, 

8.2.2, 8.3, 8.3.1, 8.3.2, 

8.3.3, 8.4, 8.4.1, 8.4.2, 

8.4.3, 8.4.4, 8.4.5, 8.4.6, 

8.5, and 8.5.1 


• 03-2-5124 Steps 2 and 

2a 

Original 35 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



8.1.4. Runoff Control 

INTENT: Control contaminated water to limit the spread of contamination and limit 

the impact on the environment. 

Runoff control is required to reduce the spread of the 

hazard. Accordingly, make all efforts to establish and 

maintain decontamination operations uphill of the hot 

zone. The Operations Center determines if runoff water 

will be collected or be allowed to drain. Because it could 

be toxic, keep decontamination runoff away from storm 

drains, groundwater, streams, and other bodies of water. 

When time and circumstances permit, contaminated 

runoff should be minimized. 


Runoff Control 

DHS UTL Tasks 

• ResB3c 1.7.2, 1.7.2.1.1, 

1.7.2.1.2, and 1.7.4.1, 

• ResB1d 8.3.1 

• RecB1a 1, 3, and 3.1 


• 03-2-5124 Steps 2c, 2g, 

and 2h 

Any MCD operation requires the collection of runoff to 

reduce the spread of the hazard. Berms can be 

constructed by placing 4x4 wooden beams along the edges of protective sheeting 

and wrapping the sheeting around the beams, creating a reservoir pool. Ensure the 

berm’s plug is in place to prevent unwanted berm drainage. 58 Evacuate the retention 

area as it fills to prevent the release of contaminated runoff. Sump pumps can 

remove the wastewater and transfer it into storage containers for later disposal. 

These storage containers could be barrels, water buffaloes, or even hollow plastic 

crowd barriers. If runoff is authorized, determine the route of drainage and construct 

dikes or dams to divert runoff from sensitive locations. Avoid allowing runoff to flow 

through areas that requires personnel to step over the contaminated liquid. 59 

Life safety should not be delayed to address environmental concerns. NEVER try to 

control runoff at the cost of providing emergency assistance to casualties. In July 

2000, the EPA addressed the issue of responders and the release of contaminated 

runoff. The concern was whether responders should be held responsible for the 

environmental liability of the release of contaminated runoff while performing 

necessary emergency actions in order to save lives. 59 

Their response was based on the Comprehensive Environmental Response, 

Compensation, and Liability Act (CERCLA), Section §107(d)(1). This “Good 

Samaritan” provision states, “No person shall be liable… for costs or damages as a 

result of actions taken or omitted in the course of rendering care, assistance, or 

advice in accordance with the National Contingency Plan, or at the direction of an 

on-scene coordinator appointed under such plan, with respect to an incident creating 

a danger to public health or welfare or the environment as a result of any releases of 

a hazardous substance or the threat thereof.” 60 

Furthermore, states are not liable under CERCLA “as a result of actions taken in 

response to an emergency created by the release or threatened release of a 

hazardous substance generated by or from a facility owned by another person.” 

However, the provision does not apply to costs or damages caused by “gross 

36 Original



negligence or intentional misconduct by the state or local government.” These 

clauses are for the life-critical actions taken in the short term of the initial response 

actions. Once any imminent threats to human health and life are addressed, 

first responders should immediately take all reasonable efforts to contain the 

contamination and avoid or mitigate environmental consequences. 

8.1.5. Slip, Trip, and Fall Hazards 

INTENT: Prevent people from slipping, tripping, and falling during MCD operations. 

Regardless of the type of decontamination being performed, always set up the lines 

to reduce tripping hazards. Casualties may not be able to see due to contamination 

in their eyes or broken eyeglasses. Responders may have reduced visibility because 

of the PPE they are wearing. Hoses should be lifted off the ground whenever 

possible. One action to take is to support the hoses by ladders overhead between 

fire trucks in an EDCS. Another way to reduce trip hazards is to cover the hoses. 

When required to step up-and-over a lip, such as a retaining berm or collection pool, 

provide balance support with a walker, chair, or sawhorse. 

Materials on the ground, such as soapy runoff, oil substances, or ice may also 

present slipping hazards. Eliminate these hazards by redirecting runoff or traffic flow 

to keep the two separated. If ice is present, apply a deicer or gritty material to 

increase traction. 

8.1.6. Crowd Control 

INTENT: Keep the casualties in a controlled area until they are decontaminated, and 

keep others from becoming injured or contaminated. 

During a large-scale release, casualties may attempt to 

flee the area. Curious onlookers or members of the media 

may attempt to access the site. Controlling the entry and 

exit to the area is vital to control the scene. Local law 

enforcement agencies, trained and equipped with PPE, 

should establish a perimeter as soon as possible. 

Establish one entry point to maintain accountability of 

personnel/casualties entering the MCD corridor and one 

exit point and to document the condition of 

personnel/casualties exiting the corridor. 

Casualties who are on scene may become aggressive in 

their attempts to be helped. Accordingly, use the public 

address system on one of the first arriving emergency 

vehicles to give reassurance and direction. Make simple 


Crowd Control 

DHS UTL Tasks 

• ResB3d 5.1, 5.1.1, 6.1, 

6.1.1, 6.1.2, 6.1.3, 6.2, 

6.2.1, 6.2.2, 6.2.4, 6.3, 

6.3.1, 6.3.2, 7.3, 7.3.1, 

7.4, 7.4.1, 7.4.2, 7.5, 

and 7.5.1 


• 03-2-5124 Step 20 

• 03-2-6593 Step 3d 

• 03-3-5130 Step 11g 

and direct statements, such as “Do not approach the fire truck,” “If you need help, 

stand near the oak tree,” or “We are going to wash you off. Walk towards the water 

spray.” If force is needed to control unruly casualties, use the standing Use of Force 

Original 37 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



guidance established by Incident Command. One example would be using fire 

service pike poles or the water spray of a handline to hold people at bay. 

The media may also attempt to access the area, seeking to report information. 

Establish an area close enough to the site to meet the media’s needs for information 

but far enough away to keep them safe and from interfering with operations. Media 

personnel should be able to operate their equipment self-sufficiently. Power, lighting, 

sound, and other such equipment are not the responsibility of the responding 

agencies. The Public Information Officer should regularly report to this location to 

provide situational updates. This action can help place the responding agencies and 

the circumstances around the response in a more positive light. 

8.1.7. Casualty Collection Point 

INTENT: Begin to evacuate casualties from the hot zone in an organized and 

systematic manner. 

Taking control of the situation as soon as possible after 

arriving on the scene is a high priority for responders. 

First, separate those who can walk from those who 

cannot to begin triage, decontamination, and treatment 

prioritization. 

A public address system on most emergency vehicles is 

sufficient to direct those who can walk to go to a location 

away from the immediate release. An example statement 

includes, “If you can walk, go stand by the light pole, so 

the fire department can wash you off.” Among these 

casualties, separate those who are displaying symptoms 

and those who are not. Decontamination can then occur 

based on the priority system established by the Incident 

Commander. 15 


Casualty Collection 

DHS UTL Tasks 

• ResB2b 6.1 and 6.2 

• ResC1a 6.1, 6.2, 6.2.1, 

6.2.2, 6.2.3, and 6.3 

• Res.C4a 4.3.1 and 4.3.2 


• 03-2-5124 Step 6b, 7a, 

and 7b 

• 03-2-6591 Step 9f 

• 03-2-6593 Steps 1b, 1d, 

1e, 2c, and 3b 

• 03-3-5128 Step 5b 

The initial triage, sometimes called decontamination triage, separates the 

ambulatory casualties from the nonambulatory casualties who cannot walk 

unassisted. From the nonambulatory casualties, find those who can follow simple 

directions from those who cannot. 2 Use a statement such as, “If you cannot walk 

and can hear my voice, raise a hand.” 

Because not all casualties will be able to walk, operational priorities may change 

based on the number of these casualties. Nonambulatory casualties require 

coordinated transport by litter through the decontamination processes. This 

demands a large number of personnel and resources. 

To control the casualty collection point, use engineer tape, “caution” tape, or existing 

obstacles to maintain entry-and-exit routes. This ensures casualties do not bypass 

38 Original



the decontamination corridor. This process also assists in maintaining casualty 

accountability. 

Tracking casualties begins at the casualty collection point. For casualties that are 

responsive, collect information on the incident and their identity. Ask for name, date 

of birth, home address, phone number, location at the moment of release, and next 

of kin. If the casualty is unresponsive, perform an inspection of his/her personal 

effects to attempt to identify him/her, and assign him/her a number. The information 

gathered on all casualties is documented at the log-in and log-out station. This 

station is located at the rear of the decontamination area. 

At all points during casualty collection and decontamination, basic medical care and 

triage are provided to ensure that the casualty is/remains stable to enhance 

survivability during decontamination. 15 

8.1.8. Collection of Casualty Personal Effects 

INTENT: Collect and track personal effects from a casualty through the MCD 

process. 

As casualties go through the decontamination processes, 

they will remove clothing, watches, wallets, purses, 

shoes, and belts. Do not collect personal effects into one 

large pile, as reuniting owners with their personal effects 

will then be virtually impossible. Such personal effects 

should be bagged and definitively marked with the 

casualty’s name, a barcode, a unique serial number, or 

another method to indicate from whom the personal 

effects were collected. This helps later when claiming 

personal effects or for evidence accountability purposes if 

required by further investigation. 54 


Runoff Control 

DHS UTL Tasks 

• ResC4a 1.6.4, 1.6.5, 

6.5.8, 6.6.1, 6.6.2, 6.6.5 


• 03-2-5124 Steps 14f 

and 14i 

Bags, such as onion bags, 58 empty sand bags, or large plastic bags, may be 

provided to casualties. Also, homemade “Trash Bag Decon” kits can be made ahead 

of time and could be constructed using trash bags and zip-top-style bags. Each item 

within a kit should be pre-numbered with a number unique to that kit for tracking 

purposes. The Connecticut Capitol Region Metropolitan Medical Response System 

recommends the following items for Trash Bag Decon: 48 

• Pre-numbered casualty armband taped to the outside of the bag or near the inside 

top. 

• Pre-numbered gallon-size, medium zip-lock bag for valuables (for example, 

watch, keys, jewelry, and/or wallet). 

• Pre-numbered large zip-lock bag (at least 24” x 24”) for clothing. 

• Pre-numbered large zip-lock bag (24” x 30”) to store these items. 

o This bag is used to double-bag the clothes and valuables. 

• Black lawn-type trash bag (at least 59 gallon, 2.0 mil thickness). 

Original 39 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



o Cut a hole in the top, big enough for a head, and arm holes on the side. 

o This bag can be used as covering if no other shelter is available. 

o A Tyvek-type covering could be used as a gown instead of a trash bag. 

Bags of personal effects, once identified, closed, and secured, can be placed into 

large trash cans, large plastic-lined cardboard boxes, 58 or barrels to keep them all 

together. 

Some personal effects, such as eyeglasses, hearing aids, walkers, or prosthetic 

limbs, may be critical for the casualty to be able to function independently. However, 

such personal effects may be made of porous materials or have numerous crevices 

that could easily trap contamination. Try to decontaminate the item while the 

casualty is assisted through the mass decontamination line. Submerse the item into 

a proper decontaminant if it will not be damaged or destroyed in the process. Have 

proper monitoring equipment available to verify that the item is thoroughly 

decontaminated before it is released back to the casualty. The return of such items 

should be made on a case-by-case basis and done with the approval of a higher 

authority. Any contact lenses should be removed, discarded, and not reinserted. 

8.1.9. Triage 

INTENT: Sort casualties into groups for decontamination and treatment based on 

their presenting conditions. 

Triage is a prioritization system to allow responders to 

provide the necessary care to as many people as 

possible. Do not confuse decontamination triage with 

medical triage. Decontamination triage is performed to 

determine who should be washed off first. Medical triage 

is performed to determine who should receive medical 

treatment first. 

Triage should be conducted repeatedly throughout the 

MCD process because a casualty’s status could change. 

Some response agencies may perform gross 

decontamination on all casualties as rapidly as possible 

without performing any triage. However, if 

decontamination triage is performed, casualties should 

be separated into these categories: 

1. Ambulatory and symptomatic 

2. Nonambulatory 

3. Ambulatory, non-symptomatic, exposed to contaminant 

4. Ambulatory, non-symptomatic, no obvious exposure to contaminant 

MCD Principles 

for Triage 

DHS UTL Tasks 

• ResB2b 6.1 and 6.2 

• ResC1a 5.1, 6.1, 6.2, 

6.2.1, 6.2.2, 6.2.3, and 

6.3 


• 03-2-5124 Step 3 

• 03-2-5126 Step 5 

• 03-2-6593 Step 2 

The highest priority for decontamination is ambulatory casualties who are 

symptomatic yet can follow simple directions. They are easiest to decontaminate 

40 Original



because they can walk themselves through the decontamination system. The next 

highest priority is those casualties who are nonambulatory. 1 Remember that some 

nonambulatory casualties will be extracted once responders can safely access the 

hot zone wearing appropriate PPE. Based on operational conditions, 

decontaminating ambulatory casualties may continue in decreasing order of priority 

until nonambulatory casualties can be physically moved. 

The next priority is casualties are those that are ambulatory, non-symptomatic, but 

have been exposed to the contaminant because of their location in relation to the 

release. The health of these casualties could rapidly deteriorate due to their 

exposure to the contaminant. Depending upon the degree of exposure, the onset of 

symptoms could occur at any time during the decontamination process. 

Decontaminate these casualties as soon as possible after higher priority casualties. 

The last priority includes those casualties who are ambulatory, non-symptomatic, 

and who likely were not exposed to the hazard. The Mass Casualty Decontamination 

Research Team from ECBC states that commanders should, “expect at least a 5:1 

ratio of unaffected to affected casualties.” 61 This group of unaffected casualties may 

also be referred to as “worried well.” Because they are usually the largest group 

presenting for help, they result in a large logistical hurdle. It is possible that these 

casualties may not require decontamination. They may instead be sent to another 

area for observation of delayed onset of symptoms. If the situation and resources 

allow, the Incident Commander may choose to decontaminate these casualties to 

provide an additional degree of safety. 

Casualties who are deemed deceased in the hot zone should be left in place as part 

of the crime scene as evidence. Place those who die after entering the 

decontamination process or those who are deemed “expectant” into a morgue away 

from operations. This gives the decedents appropriate respect while removing visual 

cues from the remaining casualties as to the severity of the incident. The morgue 

structure could be a tent or tarps suspended from wires or ropes, or a portable 

system, such as a trailer. Section 8.5 gives additional Guidelines on mass fatality 

decontamination operations. 

Medical triage should be conducted on casualties after gross and mass 

decontamination to determine the order in which they receive medical care. Many 

medical triage systems are in routine practice. 62 The most commonly used system in 

the United States is the Simple Triage and Rapid Treatment (START) system. 

START was developed in 1983 by Hoag Hospital and the Newport Beach 

(California) Fire and Marine Department. It is a system by which casualties are 

triaged as Immediate, Delayed, Minor, or Deceased based on the severity of illness 

and/or injury. A special medical triage algorithm has been developed for children 

called JumpSTART. 63 Using the JumpSTART algorithm, all children that did not walk 

under their own power are evaluated first. Both START and JumpSTART use the 

same color-coding system, as described below: 

Original 41 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



• Deceased (Black Triage Tag). Casualty unlikely to survive given severity of 

injuries, level of available care, or both. Palliative care and pain relief should be 

provided. 

• Immediate (Red Triage Tag). Casualty can be helped by immediate intervention 

and transport. Requires medical attention within minutes for survival (up to 60). 

Casualty’s airway, breathing, and circulation have been compromised. 

• Delayed (Yellow Triage Tag). Casualty’s transport can be delayed. Has serious 

and potentially life-threatening injuries, but status not expected to deteriorate 

significantly over several hours. 

• Minor (Green Triage Tag). Casualty has relatively minor injuries. Status unlikely 

to deteriorate over days. May be able to assist in own care. Also known as 

walking wounded. 

To identify casualties in the different triage categories, affix a commercially available 

triage tag to each casualty. The commercially available tags are perforated for easy 

ripping. The bottom-most color of the tag indicates the triage category of the 

casualty. Some tags may also have barcoded strips that can be detached and 

included in a bag of personal effects or retained by the Triage Officer. The barcodes 

make tracking, documentation, and accountability processes easier for casualty 

management. 

To separate the Triage Staging Area within the MCD corridor, lay colored tarps on 

the ground or place small colored flags in an area. Direct or place the casualties 

accordingly. The colors of the tarps and/or flags should correlate to the triage 

categories of Red, Yellow, Green, and Black. 2 

8.1.10. Treatment Versus Decontamination 

INTENT: Determine which casualties should receive treatment before they receive 


Most medical treatment is delivered in the cold zone, after 

decontamination has occurred and been verified. 

However, in some cases, advanced-level skills are 

needed in the warm or hot zone before or during 

decontamination activities. In such a situation, the need 

for life-saving care should be weighed against the need to 

remove the contaminant. 

Before giving medical care, consider the nature and 

severity of the incident, the medical resources available, 

the resource requirements of providing such treatment, 

and the need to perform decontamination. 54 A casualty’s 


Treatment Vs. Decon 

DHS UTL Tasks 

• ResB2b 6.1 and 6.2 

• ResC1a 5.1, 6.1, 6.2, 

6.2.1, 6.2.2, 6.2.3, and 

6.3 


• 03-2-5124 Step 19 

• 03-2-6593 Step 2a 

chance of survival increases exponentially if he/she reaches medical care within the 

first 60 minutes after the injury, sometimes referred to as the “golden hour.” 

42 Original



The medical treatment of those who have been exposed to a radioactive material, in 

the absence of any other contamination, should take priority over all other activities, 

including decontamination. 55 Life safety of the responder is the most important 

aspect of MCD. Any emergency medical service (EMS) personnel operating in such 

situations should be trained under NFPA 473 and meet PPE requirements under 

NFPA 472 and 29 CFR 1910.120. 45,47,54 

Casualties with open wounds may need special attention because bandages could 

trap the contaminant against the wound. Only properly trained medical personnel 

should remove contaminated bandages and splints. If the casualty arrives for 

decontamination with a bandage, remove the bandage and decontaminate the 

wound. Examine the wound and remove any visible foreign objects, if they can be 

removed without aggravating the wound. If bleeding persists, place a fresh bandage 

over the cleaned wound. 15 

The priorities for treatment compared to decontamination in a situation in which 

other significant injuries exist should be based on the information listed in Table 8: 54 

Table 8: Medical Care Versus Decontamination Priorities. 

Contamination Level Priority Based on Condition 

Critical (A) Unstable (B) Stable (C) 

Heavily contaminated with highly toxic substance II III III 

Heavily contaminated with low-toxicity substance I II II 

Low-level contamination with highly toxic substance II III III 

Low-level contamination with low-toxicity substance I I II 

Chemical in eyes: decontaminate eyes immediately and thoroughly 

A casualty’s condition can be determined by the following criteria: 54 

(A) – Critical condition. Airway compromised, serious signs or symptoms of shock, 

life-threatening trauma, or burns. 

(B) – Unstable condition. Shortness of breath, unstable vital signs, altered level of 

consciousness, significant trauma, or burns. 

(C) – Stable condition. Stable vital signs, no altered level of consciousness, and no 

significant trauma or burns. 

A casualty’s priority can be determined by the following criteria: 54 

Priority I – Medical Care First. For these casualties, medical care is more 

important than thorough decontamination. They should be processed through 

emergency decontamination before treatment and/or transport. If serious or critical 

medical conditions are present, start life-saving measures while gross 

decontamination is being performed. 

Original 43 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



Priority II – Combined Priorities. Medical care needs and decontamination needs 

are equal. These casualties’ injuries are usually unrelated to the agent. However, 

they are still contaminated, and responders must wear appropriate PPE. Focus on 

maintaining the casualty’s airway, breathing, and circulation processes while 

decontamination is performed. 

Priority III – Decontaminate First. Medical care is less important than 


8.1.11. Casualty Monitoring to Ensure Decontamination through 

the MCD Corridor 

INTENT: Use detection equipment throughout the MCD corridor to ensure 

decontamination is as complete as possible. 

The detection equipment introduced in Section 6.2 can be 

used 1) to ensure casualty decontamination is as 

complete as possible throughout the MCD process and 2) 

as an early warning system for responders working in the 

decontamination corridor. 

There are various points when detection equipment is 

used using both passive and active monitoring. Be 

cautious when installing some detectors in tents and other 

confined spaces. The build-up of humidity from water 

spray may suppress the detection capability of a detector, 

thus making it difficult to monitor for the contaminant. 

Additionally, vapors from any decontamination solutions 

that are used may cause a detector to alarm a false positive. 


Casualty Monitoring to 

Ensure Decontamination 

DHS UTL Tasks 

• Res3B2b 8.4.5, 9.2.2, 

and 9.2.3 


• 03-2-5124 Steps 3, 12, 

and 13 

• 03-2-5125 Step 3 

• 03-2-5126 Steps 4 and 9 

Passive monitoring allows one or more detectors to be set up and operated at 

various locations within the MCD corridor and around the MCD site in general. 

These monitoring locations can act as an early warning system to notify responders 

and Incident Command that an agent has been detected in the immediate 

environment. The detectors can be operated by a responder or operated remotely. 

They could also be equipped with a loud audible alarm to notify responders. 

Active monitoring usually takes place within the decontamination lines to determine 

the thoroughness of the decontamination process. When going through a 

decontamination line, a casualty, responder, or piece of equipment enters the line 

more contaminated that he/she/it will exit the line. This is true whether the line is a 

gross, ambulatory mass, nonambulatory mass, technical, or emergency 

decontamination line. 

Each decontamination line has three distinct zones going from the entry 

(contamination) to the exit (less or no decontamination). These three zones are 

referred to as primary, secondary, and tertiary contamination zones. The primary 

44 Original



and secondary zones are embedded within the warm zone, while the tertiary zone is 

equivalent to the cold zone. 

The primary zone is an area with a high probability for the presence of liquid and/or 

vapor contamination. The secondary zone is an area where there is a low probability 

for liquid presence and a high probability of vapor contamination. The tertiary zone is 

an area that has a low probability for the presence of liquid and/or vapor. Table 9 

summarizes the probability of liquid and vapor contamination through a 

decontamination line. This matrix is relevant for the gross, mass, and technical 

decontamination lines presented in this document. 

Table 9: Probability Matrix for Liquid and Vapor Contamination through a Decontamination 

Line. 

Zone 

Probability of Liquid 

Contamination Presence 

Probability of Vapor 

Contamination Presence 

Primary High High 

Secondary Low High 

Tertiary Low Low 

The establishment of “boundaries” between zones is at the discretion of the Incident 

Commander or his/her designee. The Incident Commander bases this decision on 

surveys, situation reports, environmental conditions, and visual indications. The 

boundaries are referred to as control lines. These two control lines represent 

different hazard levels in the systems. 

The boundary between the primary and secondary zones is called the liquid control 

line. In Figure 5, liquid contamination is expected to be present to the left of the 

liquid control line in the primary zone. None is expected on the right side of the 

boundary in the secondary zone. If liquid contamination is found on a casualty, 

responder, or piece of equipment at the liquid control line, he/she/it must be 

immediately decontaminated again to prevent further spread of contamination. 

The boundary between the secondary and tertiary zones is the vapor control line. In 

Figure 5, no liquid contamination is expected on the left side of the vapor control 

line, but vapor contamination is expected. On the right side of the vapor control line, 

neither liquid or vapor contamination is expected in the tertiary zone. If liquid or 

vapor contamination is found on a casualty, responder, or piece of equipment at the 

vapor control line, he/she/it must be immediately decontaminated again to prevent 

further spread of contamination. 

All decontamination lines have a common liquid control line and vapor control line. 

The liquid control line boundary is located after the decontamination stations (spray, 

showers and/or rollers, rinse). A casualty is allowed to leave the primary zone by 

crossing the liquid control line upon inspection that confirms no liquid contamination 

is present. 

Original 45 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



The casualty is now within the secondary zone where the drying and monitoring 

stations are typically positioned within the decontamination line. If sufficient 

personnel and equipment assets are available, monitoring points may be staffed as 

indicated in Figure 5. If not available, continuous passive monitoring can be 

conducted remotely at the vapor control line. A casualty is allowed to cross the vapor 

control line into the tertiary zone and exit the line if no vapor contamination is 

measured with monitoring equipment. 64 

Figure 5: Liquid and Vapor Control Lines within a Decontamination Line. 

8.2 MCD Decontamination Line Set Up and Operation 

INTENT: Set up and operate multiple decontamination lines, including gross, mass, 

technical, and emergency decontamination lines. Include a mass fatality 

decontamination line as appropriate for the nature and complexity of the 

HAZMAT/WMD incident. 

OSHA recommends achieving decontamination using a high-volume, low-pressure 

water system. 46 MCD can take many forms, utilizing field-expedient, improvised, and 

commercially-available methods: 

• Field-expedient methods may be used based on operational needs and 

resources. An example method includes using an LPS or an EDCS constructed 

with fire engines or fire ladder trucks. 

• Improvised methods, such as swimming pools, school shower facilities, or 

sprinkler systems, may provide supplemental assistance. Fire hydrants may be 

opened in strategic locations so that casualties exiting an area have no choice but 

to proceed through the water spray. 

• Commercially available MCD systems may not be effective in the short term. They 

are usually stored offsite in a trailer-mounted system that requires extended 

deployment times. 15 

46 Original



Regardless of the type of system used—field expedient, improvised, or commercially 

available—the primary objective still remains: Rapidly remove as much of the 

contaminant from as many casualties as possible. The baseline process includes: 

1. Identifying casualties 

2. Removing clothing 

3. Collecting personal effects 

4. Washing casualties 

5. Rinsing casualties 

6. Moving to a clean transport device 

7. Transporting to an appropriate area for treatment or evaluation 

The MCD process begins with the physical set up of the gross, mass, technical, and 

emergency decontamination lines. The gross decontamination line is usually 

established by the first local emergency responders that arrive on scene to rapidly 

remove contaminants from casualties. A mass decontamination line is established 

and operated to thoroughly clean ambulatory and nonambulatory casualties with an 

appropriate decontamination solution, depending on the suspected contaminant. A 

technical decontamination line must be established before responders wearing PPE 

can enter the hot and/or warm zones. An emergency decontamination area is 

prepared for any contingency events. A mass fatality line is set up depending on the 

needs of the scene. Every effort should be made to preserve evidence, especially if 

a terrorist attack is suspected. 

The nature and complexity of the scene, including weather and geological factors, 

determines how MCD set up and operations occur. Actual MCD operations are 

dependent upon 1) available equipment, hazard, time, number of casualties, 

environmental conditions, and resources at the scene and 2) any MCD operations 

must be adaptable, innovative, and, when necessary, improvisational. 7 

Figure 6 in Appendix F provides a decision tree schematic of the overall MCD 

process, including gross, mass, technical, and fatality decontamination lines. We 

discuss the set up and operation of each decontamination line in the following 

subsections. 

Figure 6: Decision Tree Matrix of the Overall MCD Process, including Gross, Mass, Technical, and Fatality Decontamination Lines. 

8.2.1. Gross Decontamination Line Set Up and Operations 

The first civilian responders on the scene begin decontaminating casualties. Civilian 

emergency fire vehicles are used to spray large amounts of water onto casualties 

from a safe distance. For example, a fire department engine company can use an 

attack hose or handline, and the onboard water tank. These resources can usually 

be put into operation in less than 90 seconds from their arrival on scene. Remember 

that speed is of the essence! The initial effort then expands into a more elaborate, 

yet quickly built, system using up to three apparatuses. The responders aim water 

spray to create a decontamination line, and direct ambulatory and some 

nonambulatory casualties to walk through the water flow. 

Original 47 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



8.2.1.1. Gross Decontamination Line Set Up 

INTENT: Set up an area within the warm zone to quickly remove a large portion of 

surface contaminants from a large group of casualties. 

The apparatus arrangement for setting up completely 

depends on the vehicles available at the time. One option 

is an LPS. For this, an aerial apparatus (for example, 

ladder truck or quint) is used, and the ladder is extended 

parallel to the ground. Water is sprayed downward from a 

nozzle that is mounted on the tip or from a hose that is 

secured to an appropriate rung. The steps to construct an 

LPS are shown below, and Figure 7 illustrates the 

indicated LPS: 

1. Park the apparatus 

2. Secure water supply 

3. Extend handline, flow water if so 

equipped 

4. Extend ladder 

5. Secure pinnable waterway to 

middle rung, if possible 

Figure 7: Example LPS System in a Gross Decontamination Line. 

6. Secure handline to rung if needed and 

so equipped 

7. Secure and drop tarps from sides of 

ladder 

8. Extend tarps to make a corridor 

9. Flow water in corridor 

If two fire engines are available, a nozzle can be attached directly to a discharge 

outlet on both of the vehicles. Those vehicles are positioned so the nozzles point at 

each other from a distance of 12 to 20 feet. Water is then sprayed between the two 

trucks, creating an EDCS that casualties can go through. The steps to construct an 

EDCS are shown below, and Figure 8 illustrates the indicated EDCS: 

1. Park the apparatus 

2. Engage pump 

3. Extend handline, flow water 


Gross Decon Line Set Up 

DHS UTL Tasks 

• Res.B2b 8.3.1 


• 03-2-5124 Step 16 

4. Secure water supply 

5. Park 2 nd apparatus in proper position 

in relation to 1 st apparatus 

48 Original

6. Put ladder across trucks, 

protecting paint. Supply water to 

2 nd apparatus 



7. Put nozzles on pump discharge, 

using adaptors if needed 

8. Flow water in corridor 

9. Adjust spray 

Figure 8: Example EDCS System in a Gross Decontamination Line. 

A combination or variation of these basic set ups, such as a system using a deck 

gun to provide water spray, can be used based on needs and availability. 

Regardless of the use of an LPS, EDCS, or a combination, the system should be a 

high-volume, low-pressure set up. Pressure should be no more than 60 pounds per 

square inch and a fog pattern of about 30 degrees. Take care to eliminate as much 

vehicle exhaust from the decontamination line as possible. This is best done by 

carefully positioning exhaust pipes to the exterior or by simply turning off the trucks. 

The decision of what arrangement to use is based on the apparatuses available at 

the time decontamination operations begin. Also, personnel must be familiar with 

those set ups. At no point should initial decontamination be delayed—time is critical! 

Use whatever system works best and fastest for the operational requirements and 

limitations of the situation. If time and resources allow, consider establishing a 

Original 49 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



shuffle pit before the LPS or EDCS. Use a fire hose or other device to collect water 

for casualties to walk through to clean their feet. 

Once the decontamination system is established, position at least four personnel, 

plus the persons on the hose line and in the triage area, at the entry and exit. These 

personnel should be wearing proper PPE. They provide directions to the casualties. 

In addition to the responder who extended the handline toward the casualties, 

additional personnel are assigned the following tasks, as indicated in Figure 8. 

• Responder 1 is located nearest the hot zone. Uses a fire hose to spray casualties 

before they leave the area of release. 

• Responder 2 is located between the hot zone and MCD corridor entry. Directs 

casualties to remove their outermost layer of clothing and proceed into the water 

spray. 

• Responder 3 is located at the entry of the MCD corridor. Instructs casualties on 

the proper actions to take (raising arms, rotating, and pausing) while passing 

through the corridor. 

• Responder 4 is located at the exit of the MCD corridor. Checks the casualties for 

residual contamination, either visually or with appropriate monitoring equipment. 

Tags casualties to identify decontamination status. 

• Responder 5 is located at the exit of the MCD corridor. Provides casualties with 

redress material. Directs them to the observation area for medical triage, 

treatment, and/or transport. 

• Responder 6 is located away from the MCD corridor. Performs triage on 

casualties to sort them in order of injuries for treatment prioritization. 

8.2.1.2. Gross Decontamination Operations 

INTENT: Quickly remove the bulk of the contamination from casualties using an 

LPS, EDCS, or similar set up. 

To begin gross decontamination for ambulatory 

casualties, extend a handline from a fire-fighting 

apparatus and spray water at the point where ambulatory 

casualties are directed to go via the public address 

system. This spray is initial and short-term 

decontamination while other personnel are setting up the 

LPS or EDCS. This simple system is the preferred gross 

decontamination method for nonambulatory casualties, 

particularly for unconscious casualties or those who 


Gross Decon Operations 

DHS UTL Tasks 

• Res.B2b 8.4 and 8.4.2 


• 03-2-5124 Step 5 

cannot protect their own airway. Just use less water pointed away from the face, as 

a large quantity of water being delivered by these gross decontamination systems 

may overwhelm the casualties’ respiratory systems and cause them to aspirate. 

Because of the emergent nature in this stage of the operation, there usually is not 

enough time to separate genders. Direct all casualties to remove their outermost 

50 Original



layer of clothing while they are being sprayed. Begin to collect casualty’s personal 

effects and place them in bags as described in Section 8.1.8. 

Once the LPS or EDCS is established, continue to spray water from the extended 

handline, but direct ambulatory casualties towards the decontamination area by 

using a public address system or bullhorn. Use plain language and simple 

instructions while speaking slowly to ensure as many people as possible can 

understand the messages. 

Some ambulatory casualties may require assistance leaving the area. The 

casualties may be vision impaired or weak and unsteady on their feet. Some 

casualties may not speak the native language and require specialized assistance. 

Section 8.3.1 discusses specialized processes to assist these casualties. 

Direct casualties to shuffle their footwear or bare feet through the standing water, if a 

shuffle pit has been incorporated. This begins to remove contamination from their 

footwear or soles of their feet, which are areas often neglected during 


As the casualties proceed into the spray, direct them to raise their arms and spread 

their legs. Tell them to turn in a complete circle as they stand in the water for at least 

30 seconds. The water contact time is optimized at 3 minutes. However, if a large 

number of casualties require decontamination, reduce this contact time to 30 

seconds to increase the decontamination throughput capacity. 1 To accomplish this, 

all casualties could be ordered to remove 100% of their clothing or simply be 

released from the spray quicker. They should blot their skin, NOT rub it with their 

hands or clothes. This reduces the possibility of spreading the contaminant or 

forcing it into their pores. 

If a mass decontamination line is being used in conjunction with the LPS or EDCS 

gross decontamination line, direct all casualties towards this line. This secondary 

wash takes longer and has a lower throughput capacity, so casualties may need to 

be triaged. Those who are more symptomatic or have a higher probability of being 

contaminated can be washed first. Multiple redundant lines could also be set up to 

increase throughput. 

If gross decontamination is the only decontamination process that is performed, 

casualties will cross the liquid control line and proceed to the monitoring point. 

Casualties should be monitored with appropriate detection equipment for the 

presence of any contaminant. If contamination is detected, the casualty is returned 

to start of the gross decontamination line for another round of decontamination. If no 

monitoring equipment is available, the casualty will be visually inspected to see if 

any contamination can be seen. When a casualty monitors as clean, he/she crosses 

the vapor control line and is directed to a staging area to redress, go through triage, 

and receive emergency medical care (the specific order that this occurs in depends 

on the injuries the casualty has received and the need for urgent medical care). 

Original 51 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



The staging area should provide protection from the elements as much as possible, 

including heat to prevent hypothermia. Gender segregation can usually begin at this 

point. While in this staging area, casualties should be supplied with some sort of 

redress or covering, such as a sheet, for modesty and warmth. The black lawn-type 

trash bag or Tyvek-type covering from the Trash Bag Decon kits can be used here. 

There are additional options for covering. A redress kit can be purchased from a 

commercial vendor and stocked to prepare for an incident requiring MCD operations. 

Medical facilities may be able to reserve old surgical scrubs to give to casualties who 

need redress after decontamination operations are completed. 

This staging area is also the first place from which casualties can be transported by 

EMS to medical treatment facilities. Medical treatment facilities might call for added 

protection against cross contamination for their staff and infrastructure. The facilities 

often require casualty decontamination before allowing potentially exposed 

casualties to enter the facility. During situations involving contaminated casualties, 

most medical treatment facilities conduct their own decontamination processes. 

Medical treatment facilities may have their own personnel decontaminate any 

casualty before being allowed into the facility, regardless of decontamination 

operations performed. Therefore, be sure all affected medical treatment facilities are 

notified of the situation, so they can begin their own preparations. 

Figure 9 in Appendix F provides a decision tree matrix that summarizes the steps for 

conducting baseline gross decontamination operations under ideal conditions. This 

matrix is also available as a checklist in Appendix F. 

Figure 9: Decision Tree Matrix for Gross Decontamination Operations. 

8.2.2. Ambulatory Mass Decontamination Line Set Up and 

Operations 

In ambulatory mass decontamination, casualties have an opportunity to disrobe and 

use soap and water to thoroughly wash themselves. Ambulatory casualties should 

only require guidance from responders to complete the mass decontamination 

process. Because the causalities are decontaminating themselves, instructions and 

directions should be available in multiple languages and for those who are hearing 

impaired or cannot read. 65 

This type of decontamination normally uses a commercial tent system, trailer 

system, or homemade system that can both supply and collect the rinse water. 

Typically, these tent systems have multiple showerheads and stations to increase 

the throughput of ambulatory causalities. The mass decontamination system may 

have both ambulatory and nonambulatory lines in one tent, or they may be set up in 

separate tents. Gender segregation can usually begin at the starting point of mass 


Multiple side-by-side redundant systems can be constructed to further increase 

throughput. Use of multiple systems is based on the number of casualties, 

complexity of the incident, and availability of systems from local response 

52 Original



organizations. The Incident Commander makes the decision to use multiple 

systems. 

Because these systems need to be transported to the incident site before they can 

be used, there is a delay before casualties can use these resources for 

decontamination. Accordingly, these systems are not advised for the initial gross 

removal of contaminants, unless they have been pre-deployed. 

8.2.2.1. Ambulatory Mass Decontamination Line Set Up 

INTENT: Set up an area within the warm zone to thoroughly remove contaminants 

from a large group of ambulatory casualties. 

An ambulatory mass decontamination line can be set up 

as a standalone system or in conjunction with the LPS, 

EDCS, and/or nonambulatory decontamination lines, 

depending on equipment and personnel assets available 

at the scene. If used in conjunction with the LPS and/or 

EDCS, an appropriately-sized buffer area between the 

end of gross decontamination line and the beginning of 

the ambulatory mass decontamination line is required. 

The general steps to construct the ambulatory line are 

shown below, and a sample ambulatory decontamination 

set up is shown in Figure 10: 


for Ambulatory Mass 

Decon Line Set Up 

DHS UTL Tasks 

• Res.B2b 8.3.1 


• 03-2-5124 Steps 12, 16, 

and 18a 

1. Choose the appropriate site based on recommendation or input from the Incident 

Commander. 

2. Remove equipment from the transportation vehicle. 

3. Place ground tarp at the chosen site. If the system uses a containment pit, 

position the pit at the selected location. 

4. Assemble the tent on top of the tarp or containment pit. Use air via a blower or 

SCBA bottle to assemble inflatable tent or construct tent using an internal or 

external rigid frame. 

5. Stage the containment pit(s) inside the tent. 

6. Stage the portable submersible pump in the lowest area of the containment pit. 

7. Stage the plastic pallets in the containment pits to elevate casualties out of runoff 

stream during processing. 

8. Arrange the shower system in the tent. Allow one system to wash and one to 

rinse casualties. Systems exist that use same shower for both purposes. System 

availability varies by local agency assets. 

9. Hook up water supply hoses and place shower curtains in appropriate locations. 

10. Stage direction of casualty movement and instruction signage if included in kit. 

11. Verify all decontamination piping connections are tight. 

12. Hook up and supply heated water if operating in cold weather. Water should be 

lukewarm so that the skin’s pores are less likely to open. 

Original 53 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



13. Locate and hook up wastewater bladder to the submersible pump discharge, 

which is typically located on side of tent near front. The distance from tent is a 

function of length of submersible pump discharge hoses. 

14. Set up the check-in and personal effects collection station near tent entrance. 

Use the following if they are available: chairs, table, trash cans, trash bag decon 

kits for personal effects, and/or coverings. 

15. Set up monitoring point at tent exit, and set up a separate return route to direct 

contaminated casualties back to tent entrance for secondary run through 

decontamination tent. 

16. Verify all systems are ready to receive and process casualties. 

17. Begin processing casualties at a rate proportional to the number of responders 

present. Scrubbing and high-pressure sprays are avoided. 

Figure 10: Ambulatory Decontamination Line Set Up and Operation. 

The following staff assignments are typically needed to minimally operate the 

ambulatory decontamination line, but the actual number of operators may vary from 

site to site based on availability of personnel and guidance from the Incident 

Commander: 

• Responder 1 is located at the front of the decontamination line. Collects personal 

effects and directs casualties to the front of the tent. 

• Responder 2 is located at the front of the line to assist casualties and direct 

females to one side and males to another. 

• Responder 3 is located at rear of the ambulatory decontamination line. Checks 

the casualties for contamination with appropriate monitoring equipment. Tags 

casualties to identify level of decontamination. 

54 Original



• Responder 4 is located at the exit of the decontamination corridor. Logs 

casualties out of the ambulatory decontamination line and into the cold zone for 

medical evaluation. 

8.2.2.2. Ambulatory Mass Decontamination Operations 

INTENT: Allow ambulatory casualties to completely undress, give themselves a 

more thorough cleaning, and redress into clean coverings. 

Operation of the ambulatory mass decontamination line 

begins with checking the casualty into the line and 

collection of their personal effects as described in Section 

8.1.8. The casualty enters the decontamination line once 

personal effects and information have been collected. 

Provide for modesty by separating casualties by gender 

since this stage requires each casualty to disrobe 

completely. Children should be allowed to stay with their 

parent or guardian. 

Each casualty enters the shower station and thoroughly 

washes himself/herself soap, shampoo, and/or water. 

Decontamination team personnel should ensure that 


for Ambulatory Mass 

Decon Operations 

DHS UTL Tasks 

• Res.B2b.9.2.2 and 9.2.3 


• 03-2-5124 Steps 9f and 

11b 

• 03-2-5125 Steps 1,1a, 2, 

2b, 2e, 3, 5, 4a, 4b, and 

6 

casualties clean all body surfaces and crevices, including the eyes, hair, mouth, 

ears, finger nails, groin, between buttocks, under breasts, and in between rolls of 

skin. Casualties should not scrub, but gently wash themselves to remove the 

contaminant. 

Casualties rinse themselves off after the thoroughly washing, paying attention to the 

same areas as during washing. Upon rinsing, casualties will cross the liquid control 

line to dry off and be monitored with an appropriate detection device. If they fail 

monitoring and/or show signs of contamination, they are sent back to the beginning 

to repeat the decontamination process. Some MCD system configurations may 

include a secondary shower system for this purpose. If casualties show no 

remaining contamination, they redress, cross the vapor control line, and exit the line. 

After verification that decontamination was successful, casualties are logged out of 

the ambulatory mass decontamination line and sent to the cold zone for further 

treatment, holding or transport to a medical treatment facility. 

Figure 11 in Appendix F provides a decision tree matrix that summarizes the basic 

steps for conducting baseline ambulatory and nonambulatory mass decontamination 

operations under ideal conditions. This matrix is also available as a checklist in 

Appendix F. 

Figure 11: Decision Tree Matrix for Ambulatory and Nonambulatory Mass Decontamination Operations. 

Original 55 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



8.2.3. Nonambulatory Mass Decontamination Line Set Up and 

Operations 

In nonambulatory mass decontamination, casualties are placed on litters or roller 

system to be processed through the line. Nonambulatory casualties require more 

personnel and resources to be decontaminated than in other lines. Many 

backboards or litters are used in this process. These operations can be conducted in 

the same as ambulatory decontamination or in a separate tent. Overall, the general 

set up and outcome of nonambulatory decontamination is the same as that for 

ambulatory. 

As with ambulatory decontamination, this type of decontamination occurs in a 

commercial tent system, trailer system, or homemade system. The difference is that 

these tent systems use sawhorses and/or roller devices to assist in the movement of 

nonambulatory casualties. These movement systems increase the throughput of 

nonambulatory causalities. The decontamination of this type of casualty can be slow 

because of the increased resource requirements needed to process each casualty. 

The same capabilities and limitations occur for the nonambulatory tents as for the 

ambulatory tents. 

8.2.3.1. Nonambulatory Mass Decontamination Line Set Up 

INTENT: Set up an area within the warm zone to thoroughly remove contaminants 

from a large group of nonambulatory casualties using sawhorse and/or roller 

systems. 

The set up of the nonambulatory decontamination line is 

similar to that for the ambulatory line. In fact, set up steps 

#1-6 and #11–17 are identical. 

7. Stage the plastic pallets in the containment pits to 

elevate responders out of runoff stream during 

processing. The pallets also help stabilize the roller 

component of the decontamination system. 

8. Arrange the roller system in the tent and hook up all of 

the appropriate hoses. Typically two sets of hoses are 

used. One for washing the casualty with 

decontamination solution and another for rinsing the 

casualty off. Some roller systems have a rinse shower 

that connects to the roller and rinses the casualty as 

he/she is processed. 


Nonambulatory Mass 

Decon Set Up 

DHS UTL Tasks 

• Res.B2b 5.2.1, 6.3.2, 

6.3.3, 7.1.3, and 8.4.7 


• 03-2-5126 Step 1, 1b, 

2c, 2g, 3, 4, 5, and 6 

• 03-2-6593 Step 1g 

• 03-3-5128 Step 10b 

9. Place multiple sets of scissors, shears, safety knives, and/or gloves, etc) at the 

rollers located closest to the entrance of the tent for the removal of casualty 

clothing. 

10. Place trash cans near the tools 1) for the disposal of casualty clothing and 2) to 

hold decontamination solution to decontaminate the tools between casualties. 58 

56 Original



A system using litters and sawhorses is set up in a manner similar to the roller 

system. At least eight people are recommended in the decontamination process of a 

nonambulatory casualty: 

• Responders 1 and 2 remove 

clothing from the casualties. 

• Responders 3 and 4 wash the 

casualties. 

• Responder 5 and 6 rinse the 

casualties. 

• Responders 7 and 8 dry and monitor 

the casualties. 

These stations along the nonambulatory decontamination line are shown in Figure 

12 and Figure 13, each showing different options for supporting the backboards. In 

both figures, military personnel are shown working with their civilian counterparts. 

Figure 12: Nonambulatory Decontamination Station Using a Roller System. 

Figure 13: Nonambulatory Decontamination Station Using Sawhorses. 

Original 57 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



8.2.3.2. Nonambulatory Mass 

Decontamination Operations 

INTENT: Thoroughly decontaminate casualties that 

cannot walk using rollers or sawhorses to move them 

through the decontamination process. 


Nonambulatory Mass 

Decon Operations 

DHS UTL Tasks 

• Res.B2b 5.2.1, 6.3.2, 

6.3.3, 7.1.3, and 8.4.7 

Operation of the nonambulatory mass decontamination 

line begins with checking the casualty into the line and 


collection of their personal effects as described in Section • 03-2-5126 Step 1, 1b, 

2c, 2g, 3, 4, 5, and 6 

8.1.8. Position a nonambulatory casualty supine and 

• 03-2-6593 Step 1g 

headfirst as they are transferred to the care of the 

• 03-3-5128 Step 10b 

nonambulatory decontamination team. The casualty is 

moved to the first station where one responder cuts away all clothing from the 

casualty with blunt-nosed scissors while a second responder assists. Log-roll the 

casualty to remove clothing, disposing of clothing in the trash can. Decontaminate 

tools (blunt-nosed scissors, backboard/litter) often and in between casualties. If 

rollers are being used, decontaminate the rollers after the casualty is moved to the 

next station. 

Once clothing has been removed, move the casualty using a backboard/litter or 

rollers to the next station to be washed down from head to toe using soap, shampoo, 

and/or water with brushes or sponges to remove the contamination. Responders 

should pay special attention to eyes, hair, mouth, ears, finger nails, groin, between 

buttocks, under breasts, and in between rolls of skin. Log-roll the casualty to clean 

his/her backside once the front has been cleaned. Maintain c-spine integrity while 

moving, cleaning, and log-rolling the casualty. Move the casualty to the next station 

to be rinsed once he/she has been thoroughly washed. Decontaminate the 

backboard/litter/rollers after the casualty is moved to the rinse station. At the rinse 

station, rinse the casualty using the same log-rolling technique to ensure both sides 

are adequately rinsed. Decontaminate the backboard/litter/rollers after the casualty 

is moved to the rinse station. 

Move the casualty across the liquid control line to the dry/monitor station, where 

he/she is dried off and monitored to ensure decontamination is complete. If the 

casualty fails monitoring and/or shows signs of contamination, he/she is sent back to 

the beginning to repeat the decontamination process. 

If the casualty shows no remaining contamination, he/she is covered and transferred 

by two additional responders onto a clean board/litter across the vapor control line. 

Place the clean backboard/litter immediately downstream from the backboard/litter 

used during decontamination. They casualty is logged out of the line and sent to the 

cold zone for further treatment, holding or transport to a medical treatment facility. 

Figure 12 and Figure 13 show the nonambulatory decontamination process using a 

roller and sawhorse system, respectively. Figure 11 in Appendix F provides a 

decision tree matrix that summarizes the steps for conducting baseline ambulatory 

58 Original



and nonambulatory mass decontamination operations under ideal conditions. This 

matrix is also available as a checklist in Appendix F. 

8.2.4. Technical Decontamination Line Set Up and Operations 

The focus of these Guidelines is the conduct of decontamination for large numbers 

of casualties. However, technical decontamination is also a critical task because all 

exposed response personnel require decontamination. This type of decontamination 

is slower and more purposeful than the other types. The technical decontamination 

line should be physically separated from the casualty lines to reduce cross 

contamination. Also, it should be established before any responder entry is made 

that uses IPE/PPE. 

The extent of decontamination required depends on the amount and type of 

contamination encountered. Responders operating within the hot zone or physically 

moving casualties may require more decontamination than responders working at 

the entrance of the decontamination corridor. Responders working the 

decontamination lines also have to be decontaminated. 

For planning purposes, technical decontamination may also be the primary mission 

of a supporting military organization. The military has the ability to leverage 

significant technical, logistics, and personnel support to an all-hazards consequence 

management mission. Technical decontamination supports MCD, collapsed 

structure rescue, and other operations where there is a need for large numbers of 

responders/rescuers to enter and exit contaminated areas. Technical 

decontamination lines and procedures should be adjusted to the contamination and 

conditions of the incident. 

8.2.4.1. Technical Decontamination Line Set Up 

INTENT: Set up an area to decontaminate responders and equipment. 

Position the technical decontamination line adjacent to 

the casualty decontamination lines, uphill and upwind of 

the hot zone. Ensure it is obviously separate from the 

casualty lines, so that casualties do not get confused 

between the different decontamination lines and 

overwhelm or contaminate the technical decontamination 

line. 

Technical decontamination procedures can be altered 

based on the situation, such as weather conditions, 

available personnel, or the agent’s reactivity with water 

and solubility. Brushing, scraping, or dry techniques are 


Tech Decon Line Set Up 

DHS UTL Tasks 

• Res.B2b 8.4.8 


• 03-2-5124 Step 15 

• 03-3-5129 Steps 1, 4, 

and 4b 

• 03-3-5130 Step 7b 

appropriate alternatives to bleach or peroxide solutions. Other techniques can be 

used based on guidance from the Incident Commander or Safety Officer. All 

wastewater is collected and disposed of as hazardous waste. 

Original 59 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



The number of stations required to complete technical decontamination can extend 

from 3 to over 10, and may include: 2 

1. Equipment Drop 

2. Evidence Drop 

3. Boot Wash or Shuffle Pit 

4. PPE Wash 

5. PPE Rinse 

6. Monitoring Points 

7. Boot Removal 

8. Protective Clothing Removal 

9. Outer Glove Removal 

10. Respirator Removal 

11. Inner Glove Removal 

12. Clothing Removal 

13. Shower and Redress 

14. Medical Evaluation 

Generally, the minimum stations used include the PPE wash, PPE rinse, and 

protective clothing removal stations. The actual technical decontamination set up 

depends upon the PPE and MCD equipment that the responders’ use during 

emergency response. One possible layout of a technical decontamination line using 

10 stations is shown in Figure 14. 

Figure 14: Sample Technical Decontamination Line with 10 Stations. 

Personnel staffing the technical decontamination line should be dressed in a level of 

PPE no more than one level lower than those personnel they are decontaminating. 

They should also be equipped with containers into which they can place the PPE as 

it is removed from the responders. All wash water should be collected and disposed 

of as hazardous waste. 2 

60 Original



Provide walkers or other supports so responders have something to balance 

themselves against as they proceed through the technical decontamination process. 

After all responder PPE is removed, provide responders with a location where they 

can completely disrobe and shower with soap to remove any inadvertent 

contamination. 

8.2.4.2. Technical Decontamination Operations 

INTENT: Thoroughly remove as much contaminant as possible from responders so 

they may remove PPE and proceed to redress and medical monitoring. 

During technical decontamination, responders go from 

station to station and are systematically decontaminated 

in a slow, thorough manner. While the following process 

is considered baseline guidance, the incident and 

contaminant encountered dictate the necessary stations. 

First, any evidence that was collected or equipment used 

is released for separate decontamination and 

accountability. Immediately start a chain of custody form 

for all evidence. The responder then walks through a 

shuffle pit and/or gross decontamination shower. The pit 

and/or show uses an appropriate decontaminant to 

remove any contaminant from his/her boots and suit. 


Technical Decon 

Operations 

DHS UTL Tasks 

• Res.B2b 8.4.8 

• Res.C1a 8.3.3 


• 03-2-5125 Step 9, 9c, 

and 9d 

• 03-3-5129 Step 5, 7, 8, 

and 9 

• 03-3-5130 Step 7c and 

13 

The responder proceeds to the next station to be 

thoroughly scrubbed down with an appropriate decontamination solution. Ensure 

that the bottoms of the boots are scrubbed. Next, the responder moves to the rinse 

station where he/she is thoroughly rinsed, including the bottom of the boots as 

he/she steps out of the station. Monitor the responder to ensure complete 

decontamination before the responder is removed from PPE. 

Once verified as clean, remove the outer layer of PPE in a way that minimizes the 

responder’s contact with the suit material. This doffing procedure should be 

performed by another responder who has not been in contact with the contaminant. 

Once the outer layer of PPE is removed past the responder’s waist, he/she should 

sit on a bench. In the sitting position, the responder can lift his/her feet and rotate 

180 degrees past the liquid control line after the suit is completely removed. 

Note that the respiratory protection (SCBA or air purifying respirator) has not been 

removed at this point. Removal of this protective equipment occurs at the vapor 

control line. Remove the respiratory protection in such a way to minimize the chance 

of exposure by the responder. After the respiratory PPE is removed, take off the 

inner gloves. If any of these tasks require aid from another responder, then that 

responder should be wearing appropriate PPE. 

Original 61 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



Following complete removal of PPE, the responder removes all clothing and takes a 

shower with soap, shampoo, and/or water. After redressing, the responder goes 

through a final monitoring point. Use appropriate detection equipment to ensure 

complete decontamination of the responder. Medical monitoring should then occur, 

to include blood pressure, heart rate, body temperature, respiratory rate, weight (to 

measure for water loss), and electrocardiogram, if possible. 47 

Figure 15 in Appendix F provides a decision tree matrix that summarizes the steps 

for conducting baseline technical decontamination operations under ideal conditions. 

This matrix is also available as a checklist in Appendix F. 

Figure 15: Decision Tree Matrix for Technical Decontamination Operations. 

8.2.5. Emergency Decontamination Line Set Up and Operations 

Use emergency decontamination if a contingency event occurs that requires the 

immediate and emergency removal of a potentially contaminated person into a safer 

setting. This line is primarily for the benefit of responders but can also be used for 

casualties, if needed. Emergency decontamination may be required if: 

• An ambulatory casualty suddenly loses consciousness while in the MCD corridor. 

• A responder in PPE runs out of air in his/her SCBA. 15 

• A responder compromises his/her suit. 

8.2.5.1. Emergency Decontamination Line Set Up 

INTENT: Set up an area for fast emergency decontamination. 

Set up for emergency decontamination can be as simple 

as a bottle of decontamination solution (such as bleach, 

selection is based on the hazard assessment), a water or 

fire hose, and a knife. It is also useful to have a litter or 

other transporting mechanism nearby to carry a casualty 

to a holding area. 

Typically responders set up an emergency 

decontamination line in front of where the technical 

decontamination line will be. This allows the responders 


Emergency Decon 

Line Set Up 

DHS UTL Tasks 

• Res.B2b 8.3.1 and 8.4.5 


• 03-3-5129 Step 4c 

to make entry into the hot zone faster. Once the technical decontamination line has 

been established, the emergency decontamination line may be no longer needed. 

An emergency decontamination line can also process ambulatory casualties. Two 

handlines from a fire truck or hydrant can be used to rinse off casualties while the 

LPS or EDCS is being established. This is easy to set up rapidly and usually 

become part of the LPS or EDCS. 

62 Original



8.2.5.2. Emergency Decontamination Operations 

INTENT: Provide decontamination during a contingency event in which a responder 

or casualty is suddenly and unexpectedly in a life-threatening situation. 

Emergency decontamination can be done at anytime or 

place it is needed. For emergency decontamination, 

perform the following actions: 

1. Quickly splash an appropriate decontamination 

solution on the immediate area of contamination. 

2. Flush the area with large quantities of water. 

3. Quickly remove the person from the location. 

Because this process is used in an unforeseen situation, speed is even more 

important! If the person requiring emergency assistance is a casualty, he/she can be 

moved into a holding area in the warm zone for life-stabilizing assistance. If a 

responder in PPE needs help, cut open the suit with a knife to allow him/her 

immediate doffing of the suit. Cut from the top down to minimize the spread of 


8.2.6. Cold Zone Set Up and Utilization 

INTENT: Set up a support area for casualties and responders away from the 


After casualties are decontaminated and their cleanliness 

is verified using monitoring equipment, they proceed into 

the uncontaminated area, or cold zone. The cold zone is 

for triage, treatment, and transport or observation. This 

area requires some of the following stations, depending 

on operational requirements: 2 

• Medical Holding Area 

• Triage Staging Area 

• Treatment and Stabilization Area 

• Log-In and Log-Out Stations 

• Casualty Movement/Transportation Site 

Additionally, infrastructure needs for these efforts must be supplied, such as: 2 

• Power 

• Fuel 

• Hearing Protection 

• Water 

• Communication 

• Administration 

• Logistics 

• Rehabilitation 

• Restrooms 

• Transportation 


Emergency Decon 

Operations 

DHS UTL Tasks 

• Res.B2b 8.4 


• 03-3-5129 Step 8e 


Cold Zone Set Up 

DHS UTL Tasks 

• Res.B2b 3.2.7 


• 03-2-5124 Step 5 

Original 63 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



8.3 Modified MCD Operations 

8.3.1. Special Needs and Pediatric Populations 

INTENT: Provide decontamination for groups of people requiring additional 

assistance. 

Some casualties will need additional assistance during the decontamination process. 

MCD plans should incorporate the special needs population. The plans should 

anticipate as many contingencies as possible in order to provide the best assistance 

possible. In some cases, it may be easier to process a special needs casualty 

through the nonambulatory decontamination line to save time and resources. Such 

casualties could include the blind, mentally challenged, and physically challenged. 

Some casualties may not speak English. Simple instructions for each step of the 

MCD process should be available in multiple languages. These instructions could be 

preprinted on the decontamination shower walls, in the form of signs with images of 

actions to be taken, or as prerecorded messages in multiple languages. Suggested 

signage includes “Men,” “Women,” “Disrobe,” “Turn Around,” “Stop,” “Raise Arms,” 

and “Proceed.” These signs should also have an image that is associated with the 

term for those persons who cannot read. 

Children, including infants, should be planned for and expected during an MCD 

situation. Preferably, ambulatory children are left with their parent or guardian so that 

they know the person guiding them through the decontamination processes. After a 

parent or guardian decontaminates a child, he/she must wash and rinse—another 

person is required to hold or care for that child while the parent or guardian is 

washing and rinsing. If no parent/guardian is available, or the child is nonambulatory, 

a responder must provide one-on-one assistance to the child. Take special care to 

not treat them as “just small adults.” Provide for each child’s psychological needs 

given that this will be a scary and negative experience for him/her, given the crowds, 

emergency responders, disrobing, and potential washing by complete strangers. 

Directing another casualty to assist a special needs casualty may be the easiest 

method to speed up the process and prevent contamination of responders. 

However, be prepared to provide one-on-one support to these casualties if required. 

These casualties could be processed through the nonambulatory line if necessary. 

8.3.2. Dry Decontamination 

INTENT: Perform decontamination using a technique that does not use water. 

The water used in decontamination operations presents its own set of issues. These 

issues include runoff control, cross contamination, and the collection of the rinse 

water for later disposal. Disrobing is a fast and easy decontamination process that 

can remove upwards of 80% to 90% of external contaminants without using any 

water. This “dry decontamination” is a powerful step and should not be overlooked, 

especially in cold weather situations. 

64 Original



In addition to disrobing, other methods exist to remove contaminants from casualties 

without using large amounts of water. Blotting with an absorbent material, such as 

paper towels or Fuller’s Earth, removes the contaminant and does not create 

excessive waste. The military-style and finger pad-sized M291 can also be used 

because it is saturated with an absorbent powder. Similarly, the larger M295 kits 

may be considered, although they are primarily designed for equipment 

decontamination. For powdered agents, a vacuum system equipped with a high 

efficiency particle air filter could be used. Under extreme circumstances, natural 

materials like sand, dirt, and dry leaves can be used. However, take care to not 

scrape the skin since this could create a point of entry for contamination. 

8.3.3. Alternate Locations 

INTENT: Use facilities other than tents or trailers to perform decontamination. 

In an emergency situation, resources other than pre-positioned equipment, trailers, 

and tent systems can be used. Inclement weather, such as extreme cold or lightning, 

may limit the unit from operating outdoors. Using other facilities can speed up the 

decontamination process and yield a higher degree of decontamination for the 

casualties. Alternate locations could include locker-room showers, swimming pools, 

or rooms equipped with a sprinkler system. If such locations are used, the size of the 

hot and warm zones increases and contamination is spread over a larger area. 

The Incident Commander decides when these facilities are needed and made 

available. Conditions can change countless times during an incident requiring the 

decontamination of a large mass of people. Therefore, the Incident Commander 

should consider the option of using such alternate facilities. 

Think about the runoff or drainage system when using these types of facilities. If 

using a location that drains into a sewage system, such as a school locker room, 

consider blocking the drains. Collect the rinse water similar to a berm system inside 

a tent. If necessary, isolate the drainage system to allow for later collection of the 

contaminated water. 

The alternate location could be a swimming pool, fountain, or car wash. These 

resources recirculate the contaminated water, so monitor the level of contamination 

of the water, if possible. This ensures that the casualties are not going to be 

exposed to dangerous levels. 

8.3.4. Rural Locations 

INTENT: Provide decontamination in locations removed from traditional resources. 

If a large amount of assistance is not available because of the remoteness of a 

scene requiring MCD, other techniques may be used. A desert environment may 

preclude water delivery. A plane crash into a swampy area may limit vehicular 

access except for airboats. A mountainous terrain may keep large vehicles from 

Original 65 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



being able to access the area. Decontamination in these, or other rural settings, 

would begin with dry decontamination if casualties show symptoms of being 

exposed to a hazard. Transport casualties to a more suitable decontamination 

location if 1) they do not show immediate symptoms and 2) monitoring devices do 

not show obvious contamination. Possible locations for decontamination and 

warming resources in rural locations include motor homes, automobiles, or buses. 66 

8.3.5. Urban Locations 

INTENT: Provide decontamination in heavily populated and trafficked locations. 

In a large city, many causes can hinder MCD operations. Examples include the 

width of the street, the height of surrounding buildings, the number of potential 

casualties in a small area, or the multiple routes a person could take leaving the 

area. Therefore, crowd and scene control becomes a critical component. Water 

supply is usually not a concern, but the runoff is channeled into smaller areas. This 

makes runoff control and casualty routing even more important. Controlling this flow 

prevents it from contaminating critical components, such as the Incident Command 

Post, or flowing into buildings. This step also prevents casualties and unnecessary 

personnel from walking through it, reducing the opportunity for cross contamination. 

Tall buildings could allow for unwanted onlookers; therefore, tarps should be 

suspended over streets. A large footprint of ground is not necessary to perform 

MCD. In a situation of narrow streets, an LPS is more appropriate than an EDCS. An 

LPS requires just slightly more than the width of a fire department ladder truck. 

Extend the mounted ladder horizontally, and hang tarps from the ladder’s handrails. 

Secure the tarps on the ground about 15 feet apart. Spray water downward from 

nozzles attached to the ladder. 

Some cities have installed decontamination hardware (for example, pipes, overhead 

nozzles, curtains, etc.) in areas identified as possible targets or recipients of 

casualties. Fire hydrants can be installed just outside the entrances/exits of major 

facilities. Affix nozzles to the hydrants so that when the occupants evacuate the 

buildings, they are rinsed. Hospitals can outfit entrance canopies with overhead 

nozzles to spray anyone who enters the facility. Response-phase operations could 

mimic these set ups if not already in place. Place hoses and nozzles outside of 

building doorways. Use the building’s public address system to give directions to 

evacuees. 

Buildings funnel air, creating “urban canyons” and cause airflow eddies to form 

around the structures, as shown in Figure 16 and Figure 17. 67 Depending on the 

height, width, shape, surface area, and construction materials of the buildings, urban 

canyons can be formed that affect how the agent disperses from the point of 

release. Other factors can also affect how and where the agent will travel such as 

wind speed, direction, and temperature. Pockets of agent can persist in low flow 

areas, thus causing higher concentrations of agent in that area. Sometimes a small 

shift in wind can contaminate a previously safe area, potentially affecting MCD 

66 Original



operations. Knowledge of the layout and environmental conditions is paramount to 

the success of the MCD. 

Figure 16: Top View of Airflow Eddies Forming Urban Canyons Around Buildings. 

Figure 17: Side View of Airflow Eddies Forming Urban Canyons Around and Between 

Buildings. 

Original 67 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



8.3.6. Cold Weather Guidelines 

INTENT: Provide decontamination for people in situations where the outside air 

temperature could produce cold-related injuries. 

Even in cold weather conditions, decontamination operations can still be conducted 

outdoors. The basic concepts of disrobing and flushing with a high-volume, lowpressure 

water shower remain the same for temperatures down to 36ºF. However, 

exposure to water should be minimized if ambient temperatures are below 

65ºF. 1,48,66 

Once casualties are decontaminated, provide them with appropriate materials for 

redress and a heated facility in which to stay. If no fixed facility is available, buses, 68 

heated tents, or motor homes could be brought to the scene to provide warmth. 

Additional heaters may be used in the process. A list of general rules for cold 

weather decontamination operations is in checklist form in Appendix F. Refer to 

Figure 18 for the procedures to use for different temperature situations. 

Figure 18: Cold Weather Decontamination Guidelines. 

If temperatures are below 35ºF, disrobing and dry decontamination operations may 

be used outdoors. After dry decontamination, use the high-volume, low-pressure 

shower in a heated facility. Symptoms of hypothermia begin subtly with fatigue and 

loss of concentration, but they progress to stupor, coma, and resemble rigor mortis. 

Treatment of mild hypothermia is with body heat, warm clothes, and fluids. Moderate 

and severe cases require gentle evacuation and active core rewarming methods. 

Inhalation of warm (40ºC, 104ºF) humidified oxygen is safe, effective, and can be 

initiated in the field. 69 

68 Original



8.3.7. Intense Heat Guidelines 

INTENT: Provide decontamination for people in situations where the outside air 

temperature could cause heat-related injuries. 

Decontaminating casualties in hot weather is not as difficult as in cold weather. 

However, think about the temperature of the water being used to wash the 

casualties. If suddenly exposed to a large and sustained flow of cool water, 

hypothermia can occur in casualties, even in warm weather. Also consider that 

people may be wearing less clothing, allowing more exposed skin to come into 

contact with contaminants. 

8.3.8. Night MCD Operations 

INTENT: Perform MCD operations under the condition of little or no visibility. 

Conducting MCD operations with little or no visibility presents unique challenges. 

Tactical considerations such as light and noise reduction are not a factor in a 

domestic incident. MCD personnel must have illumination to perform essential 

decontamination tasks such as spraying water, applying decontaminants, using 

detection equipment, and doffing the IPE/PPE gear. 15 There are key locations 

through a casualty decontamination line that need ample lighting to conduct MCD 

operations. Those locations include the following: 

• The general area outside the MCD tent, focusing on the entrance to the 

decontamination line and the path leading to the MCD tent. 

• Each decontamination station inside the MCD tent. 

• The transit areas between the MCD tent and the cold zone. 

The type and source of power to run the lights depend on factors such as the 

incident location and asset availability. In a worst-case scenario of minimal lighting, 

MCD operations can be performed without using the tent shell. However, this is 

embarrassing for the casualties. 

If municipal power is on, streetlights may provide the general lighting. Portable 

lighting is still required to light the interior of the tent because streetlights are not 

bright enough. In addition to streetlights, power can pulled from nearby buildings. 

The amount of power available is limited by the size and distance of electrical cords 

used. Electrical cords have current-carrying limitations, so take precautionary 

measures to ensure that cord capacities are not exceeded. Electrical cords are slip, 

trip, and fall hazards. Secure the cords to the ground, tent poles, and another 

supporting device to mitigate the risk. 

If municipal power is not available or not bright enough, alternate power sources can 

be used for night operations. Fire trucks usually have lighting systems mounted to 

the frame that can be directed towards the decontamination line. The engine’s 

headlights can also provide additional lighting if required. Generators can be used to 

Original 69 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



power lighting systems throughout the decontamination line. Large flashlights can be 

used for spot lighting. 

Chemical lights and light sticks can also be used to provide additional lighting. 

Chemical lights are available in different colors, sizes, and output strength. Using 

different colors of chemical lights can color code the decontamination line, as shown 

in Table 10. The Incident Commander, or his/her representative, makes the final 

determination of the color scheme, and all personnel must understand the intent of 

each color. Chemical lights are also an effective tool to illuminate hand signals 

during night operations. 

Table 10: Sample Scheme to Color Code the Decontamination Line. 

Color Use 

Blue Fresh water 

Purple Decontamination solution 

Yellow Rinse water 

Red Hot zone 

Green Cold zone 

Red strobe lights, flashlights, and/or 

rope lights 

Use with traffic cones to mark traffic flow or boundaries 

Light or chemical discs 

Secure on ground to direct casualty flow to the 

decontamination station 

Regardless of the lighting sources used, reflective tape should be used throughout 

the line to indicate safety hazards. The reflective tape denotes the lip or edge of the 

pit, step, curb, block, trailer, table, doorway, bench, stairs, or any other slip, trip, or 

fall hazard. If power is not available, point a flashlight at the tape to make it 

noticeable. If power is available, normal lighting will make it reflective. Reflective 

brassards are an effective way to mark and identify important personnel conducting 

the MCD operations. 

Night operations are also challenging due to reduced air temperatures. Because of 

falling temperatures, try to dry the casualties as quickly as possible and provide 

material to redress them. Give emergency blankets to casualties to help reduce the 

chance of hypothermia. This also applies to responders going through technical 

decontaminations. Heaters may be needed at key locations in the decontamination 

line. Section 8.3.6 provides more detail regarding cold weather MCD operations. 

Colder air temperatures at night also affect the ability to detect some agents at the 

monitoring points along the decontamination lines. Low temperatures during the 

night have a reverse effect on contaminants and tend to increase the persistency of 

chemical and biological contamination. 13 If the contaminant remains effective longer, 

then the amount of vapor present for detection is reduced. In these cases, other 

detection equipment may be needed to determine the completeness of the 

decontamination process. 

70 Original



8.3.9. Shipboard Guidelines 

INTENT: Provide decontamination to a large number of casualties onboard a ship at 

sea. 

MCD operations by cruise ships, merchant marine ships, military ships, and other 

private and commercial ships in open ocean transit near U.S. coasts raise many 

unique scenarios. 70 Decontamination operations, concerns, and actions aboard 

ships should be the same as a land-based attack. Faced with a contamination 

situation, the ship’s captain must decide to what degree decontamination should 

occur. Small pockets of contamination can be addressed using fire-fighting 

handlines. However, a situation requiring MCD of civilians requires a more 

purposeful and preplanned approach. 15 Modern ships have defensive protective 

features, such as fire and/or flooding procedures and systems. These features can 

be used quickly to isolate specific compartments or areas. Example actions include 

closing doors and isolating portions of the heating, ventilating, and air conditioning 

system to create protective zones. Climate-controlled areas and medical facilities 

are available for decontamination operations. 66 

There are various decontamination solutions available to ship owners and operators, 

including soap, hydrogen peroxide, and bleach (see Section 7.3). However, the 

choice of decontamination product and preparedness training remains the 

responsibility of the operator. The National Institute of Standards and Technology 

(NIST) has shown that seawater’s pH makes it a more effective decontaminant than 

“normal” water. 71 Therefore, using seawater during shipboard MCD aids in more 

effective decontamination. 48,71 Because ships moving through U.S. waters are 

required to adhere to the EPA regulatory guidelines, they cannot legally discharge 

contaminated waste overboard until they are moored and can transfer waste water 

to a suitable collection facility. 72 For this reason, the use of large amounts of freeflowing 

water that would normally be used in decontamination should be minimized 

because of the general limited wastewater storage capacity of ships. The ability to 

adequately treat contaminated wastewater varies by ship type and owner. 

The two key challenges to conducting MCD operations on a ship are the resources 

(personnel, supplies, equipment) immediately available and the time required for 

additional support personnel to arrive. Depending on incident size, the USCG has 

capabilities on east, west, and southern coasts. They can rapidly deploy airborne 

and waterborne craft and equipment to assist the ship. 70 However, due to its primary 

mission, the USCG has limitations on the number of medical personnel available in 

any one location to assist the medical department of the affected ship. Additional 

support from military and other agencies in the area will be required under a 

significant mass casualty incident. For radiological incidents, the USCG can provide 

locations of anchorage points for the ship to prevent contamination of intercoastal 

waterways. 

8.3.10. Sand or Wind Storm Guidelines 

INTENT: Provide decontamination for casualties during periods of high wind. 

Original 71 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



If a release occurs and the winds are strong, with or without sand, the storm may 

help to dilute the vapors and remove them from the area quickly. Casualties may still 

be contaminated and require quick assistance. If the weather conditions involve only 

wind and not any other severe weather, MCD can still occur outdoors. Runoff and 

spray containment efforts become even more important because they can be spread 

over a larger area due to the wind. Therefore, position all mission-critical elements 

upwind from the area of release. 

If other severe weather, such as lightning or a sandstorm, is present, use the same 

process as in cold weather. Have casualties perform dry decontamination outdoors 

before moving indoors for a more thorough decontamination shower. After 

decontamination is complete, the wind hastens the onset of hypothermia because of 

convection cooling. Therefore, be sure to provide the casualties with prompt redress 

and shelter after decontamination operations are finished. 

Table 11 explains the combination of several meteorological conditions and their 

effects on the aerosol release of chemical agents. 57 

Table 11: Meteorological Effects on the Aerosol Release of Chemical Agents. 

Factors 

Wind Speed 

(kph) 

Air 

Stability 

Temperature 

(ºC) 

Humidity 

(%) 

Precipitation 

Favorable Steady < 5 Stable > 21 > 60 None 

Moderate Steady 5-13 Neutral 4 – 21 40 – 60 Light 

Unfavorable > 13 Unstable < 4 < 40 Any 

8.4 MCD Operations for Chemical, Biological, and Radiological 

Hazards 

This section provides MCD guidance for incidents caused by chemical, biological, 

and radiological agents. 

8.4.1. Chemical-Specific Guidelines 

INTENT: This section provides guidance on appropriate techniques for 

decontamination in the event of a chemical incident. 

Incidents that involve the release of a chemical can cause both inhalational and 

contact hazards for the casualties. Most symptoms from chemical exposure are 

quickly and directly observable. Some chemicals, like mustard agent, take a longer 

time to cause symptoms. Therefore, decontamination should occur even if a 

casualty is showing no symptoms. 

Direct the casualties to remove their clothing and wash them with a high-volume, 

low-pressure water shower during gross decontamination. Casualties rubbing their 

hands on their skin increases friction and the effectiveness of the shower, especially 

72 Original



if exposed to a vapor or aerosol. However, this action also increases the time 

required. 

Do not have casualties rub thick, oily liquids any more than necessary because this 

may spread the contaminant. Adding a fat-based soap into the process emulsifies 

the contaminant so that it can be flushed away. A soap-and-water shower is usually 

not possible in during gross decontamination but should be provided as soon as 

possible. The addition of soap should not delay any decontamination process. 

8.4.2. Biological-Specific Guidelines 

INTENT: This section provides guidance on appropriate techniques for 

decontamination in the event of a biological incident. 

If a covert biological incident occurs, the onset of symptoms may not occur for days 

to weeks. Onsite decontamination is usually not possible because casualties have 

long left the area. Decontamination is typically not indicated for biological agents if 

the person has bathed in the days since initial exposure. 13 Unless a witness saw the 

dissemination, detection usually occurs through the local public health department 

and treatment occurs at hospitals. 

If a credible threat exists of a biological release, then MCD may be needed. A highvolume, 

low-pressure water wash is still the best course of action. Adding soap is 

always preferred, but water alone can flush away any surface contaminants using a 

flush–strip–flush method. 

Because symptoms have a delay in onset, casualties can be released following 

decontamination and collection of their personal contact information. Ensure they 

have appropriate educational materials on possible symptoms and directions for 

follow-up care. 

8.4.3. Radiological-Specific Guidelines 

INTENT: Provide guidance on appropriate techniques for decontamination in the 

event of a radiological incident. 

Radiological contamination after an attack consists of dust that is radioactive. 

Radioactive dust is an external hazard and should be removed from skin and 

clothing in a timely manner. 23 Casualties can occur from being exposed to any form 

of radiation. If the exposure comes from a radiological dispersal device, then 

responders can expect to see blast injuries as well as radiation injuries from 

particulates or the actual source. Expect to detect radiation in the wounds of the 

casualties. 

There is no true way to decontaminate radioactive materials. Periodic monitoring 

throughout the decontamination process is required to ensure contamination is not 

being spread. Direct casualties to keep the fabric away from their faces when 

disrobing to avoid inhaling radioactive dust from their clothing. To decontaminate 

Original 73 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



intact skin, the following methods and solutions are the recommended approach, 

listed from least to most aggressive: 73 

• Lift off of contamination using the adhesive surface of tape. 

• Flush with water. 

• Cleanse with soap and water. 

• Cleanse with water and a mildly abrasive soap and a soft brush. 

• Cleanse with mildly abrasive skin cleaner. 

• Cleanse with a mild organic such as citric acid. 

Adding soap is always preferred, but water alone can flush away any surface 

contaminants using a flush–strip–flush method. Be sure to pay close attention to 

thorough washing of the eyes, hair, mouth, ears, finger nails, groin, between 

buttocks, under breasts, and in between rolls of skin. 

Initial monitoring and decontamination operations at the scene should focus primarily 

on preventing acute radiation effects to affected individuals. Cross-contamination 

issues are a secondary concern, especially when the contaminated incident site and 

number of casualties is large. Early signs of acute radiation syndrome are nausea 

and vomiting. They occur at whole-body absorbed doses of over 100 to 125 

centigray (cGy). If these symptoms occur, the affected individuals should be quickly 

decontaminated and removed for emergency medical treatment. Keep in mind that 

other agents could cause similar symptoms, so using appropriate detection 

equipment is critical. 74 

Because symptoms have a delay in onset, casualties can be released following 

decontamination and collection of their personal contact information. Ensure they 

have appropriate educational materials on possible symptoms and directions for 

follow-up care. Appendix E lists some of the physiological effects of exposure to 

radiation. 

NOTE: Removing clothes before washing with a water shower is the fastest way to 

decontaminate. Use appropriate PPE and bag clothes immediately after removal to 

minimize the risk of reaerosolizing materials contained on clothing. 1 

8.5 Mass Fatality Decontamination 

INTENT: Coordinate military and civilian efforts and 

provide fatality decontamination after a mass casualty 

incident. 

Incidents that result in a large number of deceased 

persons can occur. Mass fatality management assistance 

can come from DoD Mortuary Affairs Assistance or 

Disaster Mortuary Assistance Teams in moving, 

accounting for, and identifying the bodies. The Joint 

Mortuary Affairs Center trains military personnel on the 


Mass Fatality 


DHS UTL Tasks 

• ResC4a 3.1.2, 3.1.3, 

3.1.4, 3.4.1, 4.3.1, 4.3.2, 

4.4, 5.4, and 5.5.2 


• None specified. 

74 Original



duties related to deceased personnel. Topics include recovery, collection, 

evacuation, establishment of tentative identification, escort, and temporary interment 

of remains. 75 

Disaster Mortuary Assistance Teams work under, and in conjunction with, the 

guidance of local authorities. They provide assistance in identifying and processing 

deceased casualties after a disaster that has resulted in a large number of fatalities. 

Disaster portable morgue units are strategically staged for immediate deployment in 

support of Disaster Mortuary Assistance Team operations. A disaster portable 

morgue unit is a cache of prepackaged equipment and supplies for use as a morgue 

with designated workstations during emergency response. 

Mass fatality decontamination operations are a required element of response for the 

local responders. Remains need to be decontaminated and military assistance may 

be required in this process. Few guidelines on decontaminating physical remains of 

deceased casualties following a mass casualty incident are available to civilian 

agencies. The main directive states that participants in the decontamination process 

should take all available protective measures to ensure their own safety and prevent 

spread of contamination. This guidance is similar to decontamination operations 

involving living casualties. Military response organizations have been provided 

specific decontamination guidance when dealing with human remains. 17,73 

It is assumed that all decontamination of remains occurs following positive 

identification of the type and extent of contamination present. Environmental 

monitoring must occur during this decontamination process to protect responders 

and to ensure complete decontamination. Sensitive moral, religious, cultural, and 

legal issues are involved with handling human remains. Legal issues include site 

security, collection of evidence, and handling of personal effects. Decisions affecting 

the disposition of human remains must be made prior to the release of the human 

remains. Close coordination with the local public health department, medical 

examiner, and/or coroner is essential. 

8.5.1. Decontamination of Remains Following Exposure to 

Chemical Agents 

To prepare remains for decontamination, remove the remains from bags used for 

containment, and remove clothing and personal effects. Bags and effects are 

processed as contaminated items. Wounds are examined, and any visible 

fragments, clothing, shrapnel, etc. are removed and disposed of as contaminated 

waste. The remains are sprayed and gently washed with soapy water, giving special 

attention to eyes, hair, mouth, ears, finger nails, groin, between buttocks, under 

breasts, and in between rolls of skin. Scrubbing and high-pressure sprays are 

avoided. 

When washing is complete, the remains are thoroughly rinsed. Remains are then 

placed in a clean bag with the zipper covered with duct tape. The bag is washed with 

a 1% to 2% sodium hypochlorite solution. The remains are then moved to an area 

Original 75 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



designated for surface monitoring to verify that contamination was removed. Once 

cleared by surface monitoring, the remains can be moved to a clean area for 

processing as normal human remains. 73 


Biological Agents 

The only way to ensure decontamination of remains exposed to biological agents is 

through cremation. Cremation is required due to the risk of exposure to internal 

fluids, organs, and tissues. As a result, it is important that remains are handled using 

appropriate PPE and leak-proof bags. Post-mortem escape of fluids can result in 

secondary transmission of the infectious agent. Contaminant should be removed 

quickly to prevent the risk of reaerosolization of the agent. However, thorough 

decontamination is more critical than speed during decontamination. 

The first step in the decontamination process is to wet the hair and clothing of the 

remains to ensure that the potential for reaerosolization is minimized. Following this 

step, remove the clothing and decontaminate the remains further. Use a largevolume 

water flush of the body followed by a wash and rinse of the casualty. Soap 

and water, and/or bleach solutions can also be used. In order to ensure effective 

decontamination of the agent by bleach, a minimum contact time of 15 minutes is 

recommended. Dry materials, such as dirt, flour, baking powder, Fuller’s earth, 

charcoals, or sawdust, can also be used in the absence of water. 

These procedures are generally effective against most biological agents, except for 

viral hemorrhagic fever. Only trained personnel should contact remains of viral 

hemorrhagic fever casualties. The recommended procedure is prompt burial or 

cremation with minimal handling of the remains. 


Radiological Agents 

Once a survey of the remains is conducted and areas of potential contamination are 

determined, the casualty’s clothing should be carefully removed, paying attention to 

avoid airborne dispersal of radioactive material during removal. The body should be 

inspected for broken skin and open wounds, since these require more rigorous 

decontamination. Intact skin provides a barrier to internal contamination. The 

method for decontaminating intact skin was discussed in Section 8.4.3. 

Start at the outer edges of body and work towards the center to centralize the area 

of contamination. If open wounds are present, then irrigate the area thoroughly with 

lukewarm water followed by cleansing with a swab. Clip the casualty’s fingernails 

since this area is capable of holding additional contamination. Ensure complete 

decontamination via monitoring. 

In some cases, decontamination may not be possible because certain radioactive 

materials become fixed to the surface of the skin. If the dose rate is within local 

environmental tolerances, it may be possible to release the body because it is 

76 Original



considered non-hazardous by local environmental code. If sufficient decontamination 

is not possible, place the casualty in two bags. Mark the outer bag to indicate the 

potential hazard of the contents, including radiation type and the level of 

contamination observed. The site Incident Commander requires the disposition of 

the remains before they are transferred away from the affected zone. 

8.6 Post-MCD Operations 

8.6.1. Casualty Observation 

INTENT: Observe casualties after decontamination for delayed onset of symptoms. 

Transport casualties as necessary to appropriate medical treatment facilities. 

After the casualties have been decontaminated, 

regardless of the technique used, they need to be held for 

a period of time for observation or treatment. While in the 

observation area, monitor the casualties for completeness 

of decontamination and for the onset of delayed 

symptoms. If contamination is suspected, remove the 

person from the general group and survey him/her with an 

appropriate piece of detection equipment. Perform 

additional decontamination if needed. 


Casualty Observation 

DHS UTL Tasks 

• Res.C1a 5.2, 6.1 and 7.2 


• 03-2-5125 Step 6 

• 03-2-5126 Step 6 

Triage the casualties into medical priority groups for treatment and/or transport. 

Coordinate with medical treatment facilities to determine which facilities can receive 

casualties and how many they can support. The Transport Officer dictates which 

persons are transported to which facility. This officer may or may not have a scribe, 

but regardless, all transports should be documented for casualty accountability. 54 

Symptomatic casualties should be transported to definitive care before nonsymptomatic 

casualties. 

After decontamination operations, casualties not requiring medical transport are still 

on the scene. Instruct them on how to reclaim personal effects turned over early in 

the decontamination process. If casualties cannot immediately retrieve their personal 

effects, explain how they can reclaim them later. Before casualties are released from 

the area, inform them of symptoms to watch for and instructions for additional 

medical care, such as following up with their personal physician. Typically all 

casualties at the incident site should be seen by a medical practitioner prior to being 

released. This includes both decontaminated casualties and those not obviously 

contaminated. In any event, be sure they are processed through the log-out station 

to maintain accountability. 

Original 77 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



8.6.2. Demobilization and Restoration 

INTENT: Return the unit to operational readiness. Provide for the mental needs of 

responders and military personnel. 

Monitor all military and civilian responders involved in 

MCD operations for physical stress and symptoms from 

accidental or unknown exposure to the agent. Conduct 

medical examinations including blood pressure, heart 

rate, and temperature to check for heat or cold stress. 1 

Post-decontamination operations allow the unit to 

restore its combat readiness after completing 

decontamination operations. Included are actions 

necessary to return to full operational capability. These 

actions are generally completed in the field or at a unit’s 

home station. Restoration actions may include replacing 

ill/injured personnel, reordering supplies, repairing 

equipment, documenting expenditures, and concluding 

outstanding agreements with civil authorities. 

First, assess the degree to which mission resources 

were used during the decontamination processes, 

including the resources consumed, the status of equipment and personnel, and 

lessons learned. Report the current degree of operational readiness and 

requirements to the Commander. 

After decontamination is completed, sites used for decontamination must be closed 

down. Vehicles used in the contaminated areas, including fire-fighting apparatuses 

involved in gross decontamination, must be washed down. Also, any other 

equipment should be cleaned at a DED line. Once the DED line is closed, the 

military personnel operating those stations are processed in a DTD. The unit then 

marks the area as a contaminated area and reports its exact location using a 

CBRN5 report in accordance with the authority having jurisdiction. 15,57 Coordinate 

with environmental authorities to ensure appropriate decontamination area cleanup 

and disposal of waste materials. 

All assets return to their home stations after being properly relieved from the mission 

or when the civilian authorities no longer need assistance. Proper notification and 

approval from the unit’s headquarters should begin these demobilization activities. 

Ensure all documentation is completed, including a full accountability of supplies, 

personnel, and casualties. Completed documentation should include an after action 

report to note the following information: 

1. Actions taken in response to the incident. 

2. All major contingencies that occurred. 

3. Best practices discovered or reinforced. 

4. Lessons learned for future improvement. 


Demobilization and 

Restoration 

DHS UTL Tasks 

• Res.B2b 9.2, 9.2.4, 10.1 

and 10.4 

• Res.C1a 8.1.2, 8.3.1, 8.3.2 

and 8.3.4 


• 03-2-5125 Step 8 and 12 

• 03-2-5126 Steps 7 and 12 

• 03-3-5128 Step 15 

• 03-3-5129 Steps 10 and 11 

• 03-3-5130 Steps 7b, 17b, 

18a, 19 

78 Original



As operational limits allow, share those best practices and/or lessons learned on the 

LLIS database. This data gives other agencies an opportunity to learn and benefit 

from the MCD scene. 

A critical incident stress debriefing may also be needed. The debriefing assists those 

responders and Soldiers to recover psychologically from this high-stress incident. 

Provide a trained counselor during this voluntary, low-stress time of talking through 

the response. Talking helps the healing process to begin for those who assisted the 

casualties. This practice supports the National Preparedness Guidelines outcome of 

having, “No illnesses or injury to any first responder, first receiver, medical facility 

staff member, or other skilled support personnel as a result of preventable exposure 

to secondary trauma, chemical, radiological release, infectious disease, or physical 

and emotional stress after the initial incident or during decontamination and incident 

follow-up.” 10 

9.0 Summary 

It is important to think about and prepare for the possibility of a HAZMAT/WMD 

incident. A plan for MCD should be in place. MCD is one of the key elements in 

consequence management of such an incident. The decontamination process can 

take many forms, but it always focuses on removing contaminants from the skin of 

casualties. Military resources may be required to assist local emergency responders 

in these procedures. Understanding the terminology and communication processes 

is critical in seamless operations. A suggested baseline set of methods has been 

presented that was developed from many civilian and military documents. Most 

important is the ability to adjust techniques based on conditions on the ground. 

Emergency responders usually begin initial gross decontamination of casualties 

using fire hose sprays. Decontamination lines are constructed using their fire 

apparatuses. Follow-on mass decontamination preferably allows for the introduction 

of a soap-and-water solution. Casualties have the opportunity to completely disrobe 

and wash. Technical decontamination is set up before any staff enters the hot zone. 

Also, technical decontamination should be set up away from the casualty 

decontamination lines to avoid confusion and prevent cross contamination. 

Emergency decontamination is for a contingency event and should be set up near 

the technical decontamination area. 

These Guidelines have included tools for the decision-making process, including 

checklists, explanations of the theories behind the tasks, and graphics. Lessons 

learned and best practices from around the nation are included to make the 

operational requirements best fitting to the needs of the situation. Table 12 compiles 

the best practices and lessons learned, and it also provides the capabilities and 

limitations of the MCD technique. References are provided for most techniques; 

however, some techniques are generally accepted practices of MCD operations. 

Original 79 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



Table 12: Best Practices and Lessons Learned Techniques for MCD Operations. 

Best Practices and Lessons Learned Techniques for MCD Operations 

Technique Approach Capabilities (C) and Limitations (L) 

Use highvolume,lowpressure 

water 

system 1 

Use baby 

shampoo to 

make the soap 

solution 48 

Water flushes the contaminant from C: Flushes contaminants from the body’s 

the skin. If the pressure is too high, it surface 

will be uncomfortable or painful to C: Readily available in most areas 

the casualty. If too little volume is L: Equipment is heavy to haul 

used, there will not be sufficient 

water to physically cleanse the skin 

L: Requires piping or hoses for delivery 

Place 16 ounces of baby shampoo 

into a 5-gallon bucket and fill with 

water to make a soap solution for 

mass decontamination 

Use safety tape 

or cones to mark 

areas of the 

decontamination 

corridor 2 

Casualties should be given a clearly 

marked route to follow through the 

decontamination corridor. They 

should be kept separate from the 

technical decontamination area 

Remain alert for 

secondary 

devices 48 

Use water and 

air heaters when 

operating in cold 

environments 

Seawater has a 

pH that is more 

effective for 


48,71 

Use “Trash Bag 

Decon” kits 48 

Use the START 

triage algorithm 

when performing 

medical triage 

If a release was caused with the 

intent to cause a mass casualty 

incident, another device may be 

strategically positioned to 

subsequently injure responders 

When temperatures are below 65º F, 

hypothermia can become an issue 

when people are disrobed and 

sprayed with water 

Using seawater to decontaminate 

casualties is more effective than 

normal water when decontaminating 

a large number of people on a ship. 

Response agencies can preplan for 

an incident requiring mass casualty 

decontamination by making their 

own redress kits 

Provides an algorithm by which adult 

casualties are triaged for medical 

treatment 

C: Material is easily available 

C: Material is one that casualties are familiar 

with 

L: Not regularly stocked by most HAZMAT 

units 

C: Reduces movement of personnel or 

casualties between hazardous areas 

C: Small, lightweight, and easily deployable 

L: Must be deployed early in the process to 

be effective 

C: Directly addresses safety of personnel 

and casualties 

L: Requires significant time and resources to 

fully investigate 

C: Additional heating reduces likelihood of 

hypothermia 

C: Addresses safety of personnel and 

casualties 

L: Puts additional logistical burdens on 

responders 

L: Heaters require power sources 

C: Gives guidance for alternate techniques 

C: Saltwater is readily available for ships 

L: Saltwater can be corrosive on metal 

pumps 

L: EPA regulatory guidelines mandate that 

ships moving through U.S. waters cannot 

legally discharge contaminated waste 68 

C: Kits are easily assembled and are low in 

cost 

L: Must be assembled and stockpiled before 

an event 

C: Removes subjectivity from responders 

performing triage 

L: Triage personnel must not inject personal 

feelings 

80 Original



Best Practices and Lessons Learned Techniques for MCD Operations 

Technique Approach Capabilities (C) and Limitations (L) 

Use 

JumpSTART 

pediatric triage 

algorithm 63 

Provide 

casualties 

directions in 

multiple 

languages 65 

Provide 

directions for 

those who are 

hearing impaired 

or cannot read 65 

Use alternate 

facilities for 


and warming 

while performing 

MCD operations 

in cold environments 

68 

Provides an algorithm by which 

pediatric casualties are triaged for 

medical treatment 

Some casualties’ native language 

will not be English. Conduct an 

assessment before an event occurs 

for other commonly spoken 

languages in the area and prepare 

signs with directions in those 

languages 

Some people, regardless of their 

native language, are unable to read. 

Therefore, signs should be prepared 

before an event with directions given 

in symbols or figures 

Conducting MCD operations in cold 

weather can hasten the onset of 

hypothermia. Use alternate facilities 

decontaminate and shelter 

casualties. Buses, heated tents, or 

motor homes can be brought to a 

site if no fixed structure is available 

Perform 

monitoring at the 

end of the warm 

zone 64 

After casualties have been 

processed through the 

decontamination line, they should be 

evaluated with an appropriate 

detector to ensure all contamination 

has been removed 

Advise people 

that have been 

potentially 

exposed to a 

biological agent 

to thoroughly 

shower at home 

with soap and 

water 

C: Removes subjectivity from responders 

performing triage 

C: Triage criteria are specific to children 

L: Triage personnel must not inject personal 

feelings, particularly since children are 

involved and some may be expectant. 

C: Provides services for an extended group 

of the population 

C: Potentially increases throughput of 

casualties in the decontamination lines 

L: Address before an incident occurs 

L: Responders must be able to identify a 

casualty’s need for these alternate 

resources 

C: Provides services for an extended group 

of the population 

C: Potentially increases throughput of 

casualties in the decontamination lines 

L: Address before an incident occurs 

L: Responders must be able to identify a 

casualty’s need for these alternate 

resources 

C: Reduces likelihood of hypothermia 

C: Expands operational capabilities of the 

Commander 

L: Could spread contamination 

L: Puts additional logistical burdens on 

responders 

L: Assumes and requires availability of 

alternate facilities 

C: Ensures successful removal of 

contaminants from the casualties 

C: Prevents cross-contamination of the cold 

zone 

L: Takes time to operate the detection 

devices 

L: Proper detectors may not be available 

A biological release may not be 

discovered until days or weeks after 

exposure. 14 C: Reinforces that a biological release 

probably will not require MCD 

A statement should be L: Assumes action of another official 

made by a public health official L: Does not address public misconceptions 

advising those who have been or “worried well” 

potentially exposed to thoroughly 

shower at home with soap and water 

Original 81 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance




82 Original

Appendix A – References 



This appendix identifies the references cited throughout the entire document, 

including each appendix. 

1 U.S. Army Chemical, Biological, Radiological and Nuclear School and U.S. Army 

Edgewood Chemical Biological Center. (2009, June). Guidelines for Mass 

Casualty Decontamination during a HAZMAT/Weapon of Mass Destruction 

Incident, Volumes I and II. Fort Leonard Wood, MO. 

2 U.S. Army Chemical, Biological, Radiological and Nuclear School. (2009, October 

5). Mass Casualty Decontamination Collective Tasks. Fort Leonard Wood, Mo. 

3 Varma, J. K., Greene, K. D., Ovitt, J., Barrett, T. J., Medalla, F., & Angulo, F. J. 

(2005, June). Hospitalization and Antimicrobial Resistance in Salmonella 

Outbreaks, 1984-2002. Emergency Infectious Diseases, 11(6), 943-946. 

4 Olson, K. B. (1999). Aum Shinrikyo: Once and Future Threat? Emerging 

Infectious Diseases, 5(4), 513-516. 

5 U.S. Federal Bureau of Investigation. (2008, August 6). Anthrax Investigation: 

Closing a Chapter. Washington, DC. 

6 Parsons, C. (2007, February 22). Chlorine Bombs Mark New Guerrilla Tactics. 

U.S. Reuters News. Retrieved from http://www.reuters.com 

7 Waugh, Jr., PhD, W. L. (2004, June). Terrorism and the All-Hazards Model. 

Andrew Young School of Policy Studies, Georgia State University. Presented at 

the IDS Emergency Management On-Line Conference, June 28-July 16, 2004. 

8 U.S. Department of Homeland Security. (2008, December). National Response 

Framework and National Incident Management System. Washington, DC. 

9 U.S. Department of Homeland Security. (2006, March). National Planning 

Scenarios. Homeland Security Council. Washington, DC. 

10 U.S. Department of Homeland Security. (2007, September). National 

Preparedness Guidelines. Washington, DC. 

11 U.S. Department of Homeland Security. (2007, September). Target Capabilities 

List: A companion to the National Preparedness Guidelines. Washington, DC. 

12 

U.S. Department of Homeland Security. (2007, February). Universal Task List, 

Version 2.1. Washington, DC. 

Original 83 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



13 U.S. Department of the Army. (2002, October). Health Service Support in a 

Nuclear, Biological, and Chemical Environment: Tactics, Techniques, and 

Procedures (Field Manual 4-02.7). Washington, DC. 

14 English, J. F., et al. (1999, April 13). Bioterrorism Readiness Plan: A Template for 

Healthcare Facilities. Centers for Disease Control and Prevention. 

15 U.S. Army Training and Doctrine Command. (2006, April 4). Multiservice Tactics, 

Techniques, and Procedures for Chemical, Biological, Radiological, and Nuclear 

Decontamination (Field Manual 3-11.5). Fort Monroe, VA. 

16 U.S. Environmental Protection Agency. (1992, May). Manual of Protective Action 

Guides and Protective Actions for Nuclear Incidents (EPA-400-R-92-001). Office 

of Radiation Programs. Washington, DC. 

17 Joint Chiefs of Staff. (2006, June 5). Mortuary Affairs in Joint Operations (JP 4- 

06). Washington, DC. 

18 U.S. Army Training and Doctrine Command. (2005, August). Defense Support of 

Civil Authorities (DCSINT Handbook No. 1.04). Fort Leavenworth, KS. 

19 U.S. Department of Defense. (1993, January 15). Military Support to Civil 

Authorities (MSCA) (DODD 3025.1). 

20 U.S. Department of Defense. (1997, February 18). Military Assistance to Civil 

Authorities (DODD 3025.15). 

21 USARNORTH CCMRF DECON TEO CHECKLIST BIBLIOGRAPHY 

22 U.S. Code of Federal Regulations. Title 29: Labor. Part 1910 – Occupational 

Safety and Health Standards, Subpart H – Hazardous Materials, Standard 

1910.120 – Hazardous waste operations and emergency response. 29 CFR 

1910.120. 

23 U.S. Army Training and Doctrine Command. (2008, April 1). Multiservice Tactics, 

Techniques, and Procedures for Chemical, Biological, Radiological, and Nuclear 

Consequence Management Operations (Field Manual 3-11.21). Fort Monroe, VA. 

24 U.S. Federal Emergency Management Agency. (2003, April). Guidelines for Haz 

Mat/WMD Response, Planning and Prevention Training: Guidance for Hazardous 

Materials Emergency Preparedness (HMEP) Grant Program. Washington, DC. 

25 U.S. Code Title 18: Crimes and Criminal Procedure, Part I – Crimes, Chaper 67, 

Page 89 – Military and Navy, Sec 1385 – Use of Army and Air Force as Posse 

Comitatus. 18 USC 1385. 

84 Original



26 U.S. Federal Emergency Management Agency. (2009). Incident Command 

System Resource Center. 

27 U.S. Army Training and Doctrine Command. (2006, July). The Infantry Rifle 

Company (Field Manual 3-21.10). Fort Monroe, VA. 

28 McCoy, M., Reisch, M., Tullo, A. H., Short, P. L., Tremblay, J. F., Storck, W. J. 

(2006, July 10). “Production: Growth in the Norm.” Chemical & Engineering News, 

59-68. 

29 Anonymous. (2002, June 24). “Production: Down But Not Out.” Chemical & 

Engineering News, 60-65. 

30 Joint Chiefs of Staff. (2006, October 2). Chemical, Biological, Radiological, 

Nuclear, and High-Yield Explosives Consequence Management, Joint Publication 

3-41. Washington, DC. 

31 U.S. Army Training and Doctrine Command. (2005, January). Potential Military 

Chemical/Biological Agents and Compounds (Field Manual 3-11.9). Fort Monroe, 

VA. 

32 U.S. Department of the Army. (2004, June 18). Implementation Guidance Policy 

for Revised Airborne Exposures Limits for GB, GA, GD, GF, VX, H, HD, and HT. 

Office of the Assistant Secretary of the Army, Installations and Environment, 

Washington, DC. 

33 Sidell, F. R., Patrick, W. C., Dashiell, T. R., Alibek, K., Layne, S. (2003). Jane’s 

Chem-Bio Handbook, Second Edition. Jane’s Information Group, Alexandria, VA. 

34 U.S. Department of Health and Human Services, Centers for Disease Control and 

Prevention. (n.d.) Emergency Preparedness and Response: Chemical Categories 

A to Z. Atlanta, GA. 

35 Alibek, K, Handelman, S. (1999). Biohazard. New York, NY: Random House, Inc. 

36 U.S. Army Medical Research Institute for Infectious Diseases. (2008, December). 

Medical Management of Biological Casualties Handbook. International Medical 

Publishing, Maryland. 

37 U.S. Federal Bureau of Investigation. (n.d.) Amerithrax Investigation. 

38 U.S. Department of Homeland Security. (2008, August 1). Planning Guidance for 

Protection & Recovery following Radiological Dispersal Device (RDD) & 

Improvised Nuclear Device (IND) Incidents, Docket ID FEMA-2004-0004, taken 

from Federal Register, 73:149, pp 45029-45048. 

Original 85 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



39 Moe, H. J. (1992, June). Operational Health Physics Training, ANL-88-26, 

Corrected. Argonne National Laboratory, Argonne, Illinois 

40 U.S. Department of Homeland Security. (2009). WMD Mass Casualty Personnel 

Decontamination Student Manual. Domestic Preparedness Equipment Technical 

Assistance Program, Pine Bluff, Arkansas. 

41 National Institute of Justice. (2000, June). Guide for the Selection of Chemical 

Agent and Toxic Industrial Material Detection Equipment for Emergency First 

Responders (NIJ Guide 100-00). Department of Justice, Rockville, MD. 

42 U.S. Department of Transportation. (2008). 2008 Emergency Response 

Guidebook. Neenah, WI: J. J. Keller and Associates Publishing. 

43 U.S. Department of Health and Human Services, Centers for Disease Control and 

Prevention, National Institute for Occupational Safety and Health. (2005, 

September). NIOSH Pocket Guide to Chemical Hazards (DHHS [NIOSH] 

Publication No. 2005-149). Cincinnati, Ohio. 

44 U.S. Army Training and Doctrine Command. (2007, December). Soldier’s Manual 

of Common Tasks, Warrior Skills Level 1 (STP 21-1-SMCT). Department of the 

Army. 


Safety and Health Standards, Subpart H – Hazardous Materials, Standard 

1910.120 – General Description and Discussion of the Levels of Protection and 

Protective Gear. 29 CFR 1910.120 App B. 

46 U.S. Occupational Safety and Health Administration. (2005, November). OSHA 

Best Practices for Hospital-Based First Receivers of Victims from Mass Casualty 

Incidents Involving the Release of Hazardous Substances. Directorate of Science, 

Technology, and Medicine. 

47 National Fire Protection Agency. (2007). NFPA 472 - Standard for Competence of 

Responders to Hazardous Materials/Weapons of Mass Destruction Incidents, 

2008 Edition. Quincy, Massachusetts. 

48 Connecticut Capitol Region Metropolitan Medical Response System. (2006, 

August). Rapid Access Mass Decontamination Protocol. Lessons Learned 

Information Sharing database. 

49 Chemguard, Inc. (2003, January 25). Material Safety Data Sheet: Chemguard 1% 

Aqueous Film Forming Foam C-103. Mansfield, TX. 

50 Departments of the Army, the Navy, and the Air Force. (1996, February 1). NATO 

Handbook on the Medical Aspects of NBC Defense Operations [AMEDP- 6(B)]. 

86 Original



51 BG Zajtchuk, R. and Bellamy, R. F. (eds). (1997). Textbook of Military Medicine: 

Medical Aspects of Chemical and Biological Warfare, Chap. 12, “Riot Control 

Agents,” by Sidell, F, R. Office of the Surgeon General, Department of the Army. 

52 Kirner, W. R. (1946). Summary Technical Report of Division 9, NDRC Volume 1, 

Chemical Warfare Agents, and Related Chemical Problems Part I-II (AD234270). 

UNCLASSIFIED Report. Office of Scientific Research and Development. 

53 U.S. Department of Homeland Security. (2005, September 15). State of Oregon 

Hood Rives County Functional Exercise After Action Report. Lessons Learned 

Information Sharing database. 

54 National Fire Protection Agency. (2007). NFPA 473 - Competencies for EMS 

Personnel Responding to Hazardous Materials/Weapons of Mass Destruction 

Incidents, 2008 Edition. Quincy, Massachusetts. 

55 Conference of Radiation Control Program Directors. (2006, September). 

Handbook for Responding to a Radiological Dispersal Device: First Responder’s 

Guide – The First 12 Hours (CRCPD Publication 06-6). Conference of Radiation 

Control Program Directors, Inc., Frankfort, Kentucky. 

56 Homeland Security Council Interagency Policy Coordination Subcommittee for 

Preparedness and Response to Radiological and Nuclear Threats. (2009, 

January 16). Planning guidance for Response to a Nuclear Detonation, First 

Edition. 

57 U.S. Army Training and Doctrine Command. (2006, February). Multiservice 

Tactics, Techniques, and Procedures for Chemical, Biological, Radiological, and 

Nuclear Contamination Avoidance (Field Manual 3-11.3). Fort Monroe, Virginia. 

58 USARNORTH, CSTA, CSTG – Central. (2009, April 1). Preoperational Position 

Checklist, USAR MCD. 

59 U.S. Environmental Protection Agency. (2000, July). First Responders’ 

Environmental Liability Due to Mass Decontamination Runoff (EPA-550-F-00- 

009). Office of Solid Waste and Emergency Response. Washington, DC. 

60 Comprehensive Environmental Response, Compensation, and Liability Act 

(CERCLA), Chapter 103 – Comprehensive Environmental Response, 

Compensation and Liability, Subchapter I – Hazardous Substances Releases, 

Liability, Compensation. 42USC9607, Page 2215-2226. 

61 U.S. Army Edgewood Chemical Biological Center, formerly the U.S. Army Soldier 

and Biological Chemical Command. (2000, January). Guidelines for Mass 

Casualty Decontamination during a Terrorist Chemical Agent Incident. Aberdeen 

Proving Grounds, Maryland. 

Original 87 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



62 Other triage systems in place around the U.S. include SALT (sort-assesslifesaving 

interventions-treatment/transport; METTAG (medical emergency triage 

tag); SAVE (secondary assessment of victim endpoint); MASS (move, assess, 

sort, send); DIME (delayed, immediate, minimal, expectant); Sacco Triage 

Method; and NATO Casualty Care. 

63 Romig, L. (2002). JumpSTART Pediatric Mass Casualty Incident Triage. 

64 Westmoreland Department of Public Safety. (2005). Exercise Twisted Rail: After- 

Action Report, Westmoreland County, PA. 

65 Multnomah County, Oregon, Health Department. (2008, January). After-Action 

Report of the 4th National Top Officials Exercise Operations of 

Health/Environmental Unified Command, Medical Care Point, and Rapid 

Screening Point at Oregon Venue: October 16 - 19, 2007. 

66 Anchorage Fire Department. (2002, October 18). Operations Plan: Cold Weather 

Decontamination and Triage. Lessons Learned Information Sharing database. 

67 Galatas, Col. I., MD, PhD, MC. (2010, February). Medical/Hospital CBRN 

Defense in Megapolis Environment (towards 2012 Olympic Games). Department 

of Asymmetric Threats, Intelligence Analysis Branch, Joint Military Intelligence 

Division, Hellenic National Defense General Staff. Presented at the Counter 

CBRN Operations: The National and International Challenge Symposium, 

London, UK, 1–2 February 2010. 

68 Titan Systems Corporation. (2004, July 13). Rhode Island: The Station Club Fire 

After-Action Report: State, Local, and Federal Government and the Private 

Sector. Lessons Learned Information Sharing database. 

69 Herr R. D., White G. L. Jr. (1991, March). “Hypothermia: Threat to Military 

Operations.” Journal of Military Medicine. 156(3):140-4. 

70 French, MD, Captain A. J., DiRenzo III, J., Doane, Chris. (2006, Summer). “U.S. 

Coast Guard Health Services Responders in Maritime Homeland Security.” Naval 

War College Review, 59-3. 

71 Lawson, J. R., Jarboe, T. L. (2002, May). Aid for Decontamination of Fire and 

Rescue Service Protection Chemical and Equipment After Chemical, Biological, 

and Radiological Exposures – NIST Special Publication 981. National Institute of 

Standards and Technology. Washington, DC. 

72 EPA Resource Conservation and Recovery Act, Section 311 of the Clean Water 

Act, National Pollutant Discharge Elimination System authorized by the Clean 

Water Act. 

88 Original



73 U.S. Army Center for Health Promotion and Preventive Medicine. (2001, 

October). Guidelines for Protecting Mortuary Affairs Personnel from Potentially 

Infectious Materials (USACHPPM TG 195). 

74 National Council on Radiation Protection and Measurements. (2005, December 

31). NCRP Commentary No. 19 – Key Elements of Preparing Emergency 

Responders for Nuclear and Radiological Terrorism. Bethesda, Maryland. 

75 U.S. Army Quartermaster Center and School. (2009, October 1). Joint Mortuary 

Affairs Center. Fort Lee, Virginia. 

76 Joint Chiefs of Staff. (2001, April 12). Department of Defense Dictionary of Military 

and Associated Terms (Joint Publication 1-02). Washington, DC. 

77 National Fire Protection Agency. (2005). NFPA 1991 – Standard on Vapor- 

Protective Ensembles for Hazardous Materials Emergencies, 2005 Edition. 

Quincy, Massachusetts. 

78 Hydride. (2010). In Encyclopedia Britannica. Retrieved May 06, 2010, from 

Encyclopedia Britannica Online: 

http://www.britannica.com/EBchecked/topic/278278/hydride 


Safety and Health Standards, Subpart I – Personal Protective Equipment, 

Standard 1910.134 – Respiratory Protection. 29 CFR 1910.134. 

80 U.S. Code of Federal Regulations. Title 28: Judicial Administration. Part 0 – 

Organization of the Department of Justice, Subpart P – Federal Bureau of 

Investigation, Section 0.85 – General Functions. 28 CFR 0.85. 

81 Lide, D. R., ed. (1991). CRC Handbook of Chemistry and Physics, 72nd edition. 

CRC Press, Boston. 

82 O’Neil, M. J., Smith, A., Heckelman, P. E., eds. (2001). The Merck Index, 13th 

edition. Merck & Co., Inc., Whitehouse Station, New Jersey. 

83 U.S. National Oceanic and Atmospheric Administration. (n.d.) CAMEO Chemical 

Database. 

84 U.S. Army Center for Health Promotion and Preventive Medicine. (2001, 

December). Glossary of Terms for Nuclear, Biological, and Chemical Agents and 

Defense Equipment (USACHPPM TG 204). 

85 U.S. Occupational Safety and Health Administration. (1999, January 20). OSHA 

Instruction: OSHA Technical Manual TED-01-00-015 [TED 1-0.15A]. 

Original 89 

Table of 

Contents 


Comparison 

Decontaminatio 

n Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 


Reference 

G id 

Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



86 National Institute for Occupational Safety and Health. (n.d.) The Emergency 

Response Safety and Health Database. 

87 Thermo Fisher Scientific, Inc. (n.d.) MSDS Search Database. 

88 U.S. Occupational Safety and Health Administration. (n.d.) NIOSH/OSHA/DOE 

Health Guidelines Database. 

89 Oxford University, (n.d.) Chemical and Other Safety Information Database. 

Physical and Theoretical Chemistry Laboratory. 

90 LabChem, Inc. (n.d.) MSDS Database. 

90 Original

Appendix B – Acronym List 



This appendix defines acronyms used throughout the entire document, including 

each appendix. 

ºC ......................Degrees Celsius 

ºF.......................Degrees Fahrenheit 

AC .....................Hydrogen Cyanide 

ACADA..............Automatic Chemical Agent Detector Alarm 

ACADASIM .......Automatic Chemical Agent Detector Alarm Simulator 

ALARA ..............As Low As Reasonably Achievable 

ALOHA .............Areal Location of Hazardous Atmospheres Model 

APD...................Advanced Portable Detector 

BIDS..................Biological Integrated Detection System 

BTA ...................Bio Threat Alert 

BTU...................British Thermal Unit 

BZ......................3-Quinuclidinyl Benzilate 

CAM ..................Chemical Agent Monitor 

CAMEO .............Computer-Aided Management of Emergency Operations 

CAMSIM............Chemical Agent Monitor Simulator 

CATS-JACE ......Consequence Assessment Tool Set with Joint Assessment of 

Catastrophic Events 

CBIRF ...............Chemical Biological Incident Response Force 

CBRN ................Chemical, Biological, Radiological, and Nuclear 

CBRN 5 .............Nuclear, Biological, or Chemical Report #5 

CBRNE..............Chemical, Biological, Radiological, Nuclear, and Explosive 

CCMRF .............CBRNE Consequence Management Response Force 

CDC ..................Centers for Disease Control and Prevention 

CDS...................Civil Defense System 

CERCLA............Comprehensive Environmental Response, Compensation, and 

Liability Act 

CMS ..................Chip Measurement System 

CERFP ..............CBRNE Enhanced Response Force Package 

CFR...................Code of Federal Regulations 

CG.....................Phosgene 

cGy....................Centigray 

CHRIS ...............Chemical Hazards Response Information System 

CK .....................Cyanogen Chloride 

CMS ..................Chip Measurement System 

CN.....................Chloroacetophenone 

CO.....................Carbon Monoxide 

CO2 ...................Carbon Dioxide 

CS .....................o-Chlorobenzylidene (Tear Gas) 

CWA..................Chemical Warfare Agent 

CX .....................Phosgene Oxime 

DA .....................Diphenylchloroarsine 

Original 91 

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Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



DC.....................Diphenylcyanoarsine 

DED...................Detailed Equipment Decontamination 

DHS...................Department of Homeland Security 

DM.....................Diphenylaminechloroarsine 

DoD...................Department of Defense 

DOT...................Department of Transportation 

DOT ERG..........Department of Transportation Emergency Response Guidebook 

DTD...................Detailed Troop Decontamination 

ECBC ................Edgewood Chemical Biological Center 

ED .....................Ethyldichloroarsine 

EDCS ................Emergency Decontamination Corridor System 

EMS ..................Emergency Medical Services 

EPA...................Environmental Protection Agency 

G .......................G-series nerve agents (e.g., GA, GB, GD, and GF) 

GA.....................Tabun 

GB.....................Sarin 

GD.....................Soman 

GF .....................Cyclosarin 

H........................H-series sulfur mustard blister agents (e.g., H and HD) 

HN.....................HN-series nitrogen mustard blister agents (e.g., HN-1, HN-2, HN-3) 

H2S....................Hydrogen Sulfide 

HAZMAT ...........Hazardous Material 

HD.....................Distilled Mustard 

HT .....................Mixture of 60% Distilled Mustard and 40% T 

ICAM .................Improved Chemical Agent Monitor 

IDLH..................Immediately Dangerous to Life and Health 

JCAD.................Joint Chemical Agent Detector 

JSTDS-SS.........Joint Service Transportable Decontamination System – Small Scale 

JWARN .............Joint Warning and Reporting Network 

L ........................Lewisite 

LLIS...................Lessons Learned Information Sharing 

LPS ...................Ladder Pipe System 

MARPLOT.........Mapping Application for Response, Planning and Local Operational 

Tasks 

MCD..................Mass Casualty Decontamination 

MD.....................Methyldichloroarsine 

mg/m 3 ................Milligram per Cubic Meter 

miniCAD ............Miniature Chemical Agent Detector 

MSHA................Mine Safety and Health Administration 

MSDS................Material Safety Data Sheet 

MOPP................Mission-Oriented Protective Posture 

MSA ..................Mine Safety Appliances 

N/A ....................Not Applicable 

NATO ................North Atlantic Treaty Organization 

NFPA.................National Fire Protection Administration 

NIMS .................National Incident Management System 

92 Original



NIOSH...............National Institute on Occupational Safety and Health 

NRF...................National Response Framework 

O2 ......................Oxygen 

OSHA ................Occupational Safety and Health Association 

PD .....................Phenyldichloroarsine 

PID ....................Photoionization Detector 

PPE...................Personal Protective Equipment 

PPM ..................Parts Per Million 

PS .....................Cyclopicrin 

R........................Roentgen 

RADIAC.............Radiation, Detection, Indication, and Computation 

RAMP................Rapid Analyte Measurement Platform 

SAW..................Surface Acoustic Wave 

SCBA ................Self-Contained Breathing Apparatus 

SMART..............Sensitive Membrane Antigen Rapid Test 

START ..............Simple Triage and Rapid Treatment/Transport 

STEL .................Short Term Exposure Limit 

T........................Bis {2(2-chloroethylthio)ethyl} Ether 

TIB.....................Toxic Industrial Biological 

TIC ....................Toxic Industrial Chemical 

TIM....................Toxic Industrial Material 

TIR ....................Toxic Industrial Radiological 

TTP ...................Tactics, Techniques, and Procedures 

TWA ..................Time-Weighted Average 

U.S. ...................United States 

USAF.................U.S. Air Force 

USACBRNS ......U.S. Army Chemical, Biological, Radiological and Nuclear School 

USCG ...............U.S. Coast Guard 

USMC................U.S. Marine Corps 

V........................V-series Nerve Agent 

VX .....................O-Ethyl-S-(2-diisopropylaminoethyl) Methyl Phosphonothiolate 

WISER ..............Wireless Information System for Emergency Responders 

WMD .................Weapon of Mass Destruction 

Original 93 

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Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance




94 Original

Appendix C – Glossary 



This appendix defines words used throughout the entire document, including each 

appendix. 

Absorption – The process of absorbing or “picking up” a liquid hazardous material to 

prevent enlargement of the contaminated area; movement of a toxicant into the 

circulatory system by oral, dermal, or inhalation exposure. 

Acute Radiation Syndrome – Radiation sickness that occurs when the entire body 

(or most of it) receives a high dose of radiation, usually over a short period of time. 

Adsorption – The adhesion of a contaminant onto the surface of a decontaminant, 

most generally dry decontaminants. 

Aerosols – Liquid droplets or solid particles dispersed in air that are of fine enough 

particle size (0.01 to 100 microns) to remain dispersed for a period of time. 

Ambulatory – Able to walk about without assistance. 

Anthrax – An acute infectious disease caused by the spore-forming bacterium 

Bacillus anthracis. Most commonly occurs in wild and domestic lower vertebrates 

(cattle, sheep, goats, camels, antelopes, and other herbivores), but it can also occur 

in humans when they are exposed to infected animals, tissue from infected animals, 

or from a purposeful release. 

Air Purifying Respirator – A breathing mask with specific chemical cartridges 

designed to either filter particulates or absorb contaminants before they enter the 

worker’s breathing zone. It is intended to be used only in atmospheres where the 

chemical hazards and concentrations are known. 

Aum Shinrikyo – A Japanese religious cult whose members entered the Tokyo 

subway system on March 20, 1995 and released sarin nerve agent. 

Bacteria – These single-celled organisms are usually found throughout the inside 

and outside of our bodies, except in the blood and spinal fluid. Many bacteria are not 

harmful; some are actually beneficial. However, disease-causing bacteria can trigger 

illnesses in infected persons. 

Biological Agents – Biological materials that are capable of causing acute or longterm 

damage to living organisms. 

Blister Agent – Introduced as chemical warfare agents during World War I, these 

manufactured compounds cause blister-like injuries to skin. 

Blood Agent – Poisons that affect the body by being absorbed into the blood. 

Original 95 

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Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



Bootie – A sock-like over-boot protector worn to minimize contamination. 

Botulinum Toxin – The toxin that causes the disease botulism. 

Botulism – A neuroparalytic illness resulting from the action of a toxin produced by 

the bacterium Clostridium botulinum. While rare, a food borne incident may kill 

rapidly, and contaminated products may expose many persons. Therefore, this is 

considered a medical and public health emergency. 

Brassard – A band worn around the upper arm usually bearing an identifying mark. 

Casualty – A person who has been injured or killed by an incident. Used 

interchangeably with “victim” and “patient.” 

CBRN 5 – A report that is used to pass information of an actual contamination and 

the preferred method of dissemination is by map overlay. This report can also 

include areas of possible contamination, but only when the actual contamination 

coordinates are also included in the report. NBC 5 reports usually are prepared by 

division. It is the fifth of six reports, following the Observer’s Initial Report, the 

Evaluated Data Report, the Warning of Predicted Contamination Report, the 

Reconnaissance, Monitoring and Survey Report, but preceding the Detailed 

Information on Chemical and Biological Attack Report. 57 

Celsius (Centigrade, ºC) – Internationally used scale for measuring temperature, in 

which 100 ºC is the boiling point of water at sea level (1 atmosphere), and 0 ºC is the 

freezing point. 

Centigray – A unit of absorbed dose of radiation (one centigray equals one rad). A 

rad is a unit of energy absorbed from ionizing radiation, equal to 0.01 joules per 

kilogram of irradiated material. It has been replaced as a standard scientific unit by 

the gray. 

Chemical Warfare Agent – Chemical substances that are intended for use in warfare 

or terrorist activities to kill, seriously injure, or seriously incapacitate people through 

their physiological effects. This does not include riot control agents when used for 

law enforcement purposes, herbicides, smoke, and flames. 23 

Cleansing Compound – A reagent, such as soap, added to the water spray during 

decontamination to disrupt the bond between the skin and the contaminant, so that 

the contaminant can be washed away by water. Cleansing compounds do not 

change or reduce the toxicity of the agent. 

Clearance Decontamination – Designed to eliminate or reduce to a harmless level 

any remaining hazard on the casualty, equipment, and facilities. This fine level of 

decontamination that usually requires a large amount of logistical support and time, 

96 Original



and returns the casualty, equipment, and facilities to acceptable or precontamination 

levels. 

Cold Zone – The area outside of the warm zone. Equipment and personnel are not 

expected to become contaminated in this area. This is the area where resources are 

assembled to support the hazardous materials operation. 47 This zone is equivalent 

to the tertiary zone that is to the right of the vapor control line. 

Command – The act of directing, ordering, and/or controlling resources by virtue of 

explicit legal, agency, or delegated authority. 

Containment – Preventing the uncontrolled spread of a substance by use of 

mechanical barriers or collection vessels or absorptive material. 

Contamination – An uncontained substance or process that poses a threat to life, 

health, or the environment. 47 

Contamination Control Line – The established line around the contamination 

reduction zone that separates it from the support zone. 

Contingency – An event or occurrence that arises unexpectedly and interferes with 

the normal conduct of operations. 

Contingency Plan – A pre-planned document presenting an organized and 

coordinated plan of action to limit potential pollution in case of fire, explosion, or 

discharge of hazardous materials; defines specific responsibilities and tasks. 

Control – The procedures, techniques, and methods used in the mitigation of a 

hazardous materials incident, including containment, extinction, and confinement. 

Control Zones – The designation of areas at a hazardous materials incident based 

on safety and the degree of hazard. See also Cold Zone, Warm Zone, Hot Zone, 

and Decontamination Corridor. 47 

Cross Contamination – The process by which a contaminant is carried out of the hot 

zone and contaminates people, animals, the environment, or equipment. 

Dangerous Fallout Zone – In nuclear detonation zoning, the zone includes the area 

covered by fallout that impacts responder life-saving operations and/or has acute 

radiation injury potential to the population. This area is not identified by structural or 

other damage—it is based on fallout radiation levels. Typically this zone will consist 

of radiation levels of 10 R/hour or higher. Depending on various parameters (wind, 

atmosphere, and/or geographic terrain), this zone could extend 20 plus miles from 

the point of detonation and can include parts of the no-go, moderate damage and 

light damage zones. Existence of radiation beyond this zone may still require some 

sort of protective action. 56 

Original 97 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



Decontamination – The process of making any person, object, or area safe by 

absorbing, destroying, neutralizing, making harmless, or removing chemical or 

biological agents, or by removing radioactive material clinging to or around it. 23 

Decontamination Corridor – A distinct area within the warm zone that functions as a 

protective buffer and bridge between the hot zone and the cold zone, where 

decontamination stations and personnel are located to conduct decontamination 

procedures. 

Decontamination Team – A group of personnel and resources operating within a 


Decontamination Triage – Performed to determine which casualties should be 

decontaminated first. 

Dike – An embankment or ridge, natural or manmade, used to control the movement 

of liquids, sludges, solids, or other materials. 

Doctrine – Fundamental principles by which the military forces or elements thereof 

guide their actions in support of national objectives. It is authoritative but requires 

judgment in application. 76 

Emergency Decontamination – Required when a contingency incident occurs and 

may be needed at any time, when immediate action is necessary with or without the 

formal establishment of a decontamination corridor. 

Emergency Decontamination Corridor System – A corridor style decontamination 

system that uses fire apparatus, ladders, and tarps to create a privacy barriers and 

corridors for decontaminating casualties. 

Emergency Medical Services – Functions as required to provide emergency medical 

care for ill or injured persons by trained providers. 

Empirical – Based on observation or experience. 

Emulsifies – To dissolve or combine into a smooth mixture. 

Entry Point – A specified and controlled location where access into the hot zone 

occurs at a hazardous materials incident. 

Environmental Protection Agency – The EPA protects and enhances our 

environment today and for future generations to the fullest extent possible under the 

laws enacted by Congress. The Agency’s mission is to control and abate pollution in 

the areas of water, air, solid waste, pesticides, noise, and radiation. EPA’s mandate 

is to mount an integrated, coordinated attack on environmental pollution in 

cooperation with state and local governments. 

98 Original



Evacuation – The removal of potentially endangered, but not yet exposed, persons 

from an area threatened by a hazardous materials incident. 

Expectant – The casualty is expected not to reach higher medical support alive 

without compromising the treatment of higher priority patients. Care should not be 

abandoned, spare any remaining time and resources after Immediate and Delayed 

patients have been treated. 

Exposure – The subjection of a person to a toxic substance or harmful physical 

agent through any route of entry. 

Extreme Caution Radiation Zone – Radiation levels are equal to or exceed 10 R/hr 

in this zone. This radiation zone area, located within the high radiation zone, is 

restricted to the most critical activities, such as lifesaving. Personal dosimetry is 

required, although one monitor for several responders is acceptable if they remain 

near the person with the monitor. Time spent in this zone should be limited to avoid 

acute radiation syndrome. People within this zone at the time of the explosion must 

be surveyed for contamination before being released. 55 

Fahrenheit – The scale of temperature in which 212º is the boiling point of water at 

760 mm Hg and 32º is the freezing point. 

False Negative – A result that is erroneously negative, such as when a detection 

device fails to identify the presence of a chemical, biological, or radiological agent 

that is actually in the environment. 

False Positive – A result that is erroneously positive, such as when a detection 

device incorrectly identifies the presence of a chemical, biological, or radiological 

agent that is not actually in the environment. 

First Responder – The first trained persons to arrive at the scene of a hazardous 

materials incident. May be from the public or private sector of emergency services. 

Forensic Odontologist – A dentist that analyzes dental evidence to identify human 

remains and the origin of bite marks. 

Fuller’s Earth – A highly adsorbent claylike substance consisting of hydrated 

aluminum silicates. 

Fully Encapsulating Suits – Chemical protective suits that are designed to offer full 

body protection, are gas tight, and meet the design criteria as outlined in NFPA 

1991. 77 

Gas – A state of matter in which the material has very low density and viscosity; can 

expand and contract greatly in response to changes in temperature and pressure; 

easily diffuses into other gases; readily and uniformly distributes itself throughout 

Original 99 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



any container. A gas can be changed to a liquid or solid state by the combined effect 

of increased pressure and/or decreased temperature. 

Golden Hour – A casualty’s chance of survival increases exponentially if he/she 

reaches medical care within the first 60 minutes after the injury (the “golden hour”). 

Regarding a nuclear detonation, the most effective life-saving opportunities for 

response officials in the fist 60 minutes will be the decision to safely shelter or 

evacuate people in expected fallout areas. 

Gross Decontamination – Initial decontamination to begin removing contaminants 

from the casualties, and is usually performed by emergency responders through 

handlines, an emergency decontamination corridor system (EDCS), or a ladder pipe 

system (LPS). 

Halogen Gases – any gaseous compound made of, or including, any of the five 

elements in Group 17 of the periodic table: fluorine, chlorine, bromine, iodine, or 

astatine. 

Hazard – Any situation that has the potential for causing damage to life, property, 

and/or the environment. 

Hazardous Chemical – A term used by OSHA to denote any chemical that would be 

a risk to employees if exposed in the workplace. The list of hazardous chemicals is 

found in 29 CFR. 

Hazardous Material – A substance or combination of substances which, because of 

quantity, concentration, physical, chemical, or infectious characteristics, may cause 

or significantly contribute to an increase in deaths or serious illness, and/or pose a 

substantial present or potential hazard to humans or the environment. 

High-Radiation Zone – Radiation levels are range from 1 –



hydrogen and nonmetallic elements. Dimeric (polymeric) hydrides give off large 

amounts of energy when burned and may be useful as rocket fuels. 78 

Immediate Response – When imminently serious conditions resulting from any civil 

emergency or attack exist and time does not permit prior approval from higher 

headquarters, local military Commanders and responsible officials of other DoD 

Components are authorized by DoD Directives, subject to any supplemental 

direction that may be provided by their DoD Component, to take necessary action to 

respond to requests of civil authorities to save lives, prevent human suffering, or 

mitigate great property damage. 19,20 Any Commander or official acting under the 

Immediate Response authority of DoD Directives shall advise the DoD Executive 

Agent through command channels, by the most expeditious means available, and 

shall seek approval or additional authorizations, as needed. 19 

Immediately Dangerous to Life or Health – An atmospheric concentration of any 

toxic, corrosive, or asphyxiant substance that poses an immediate threat to life or 

would cause irreversible or delayed adverse health effects or would interfere with an 

individual’s ability to escape from a dangerous atmosphere. 79 

Incident – An event involving a hazardous material or a release or potential release 

of a hazardous material. 

Incident Action Plan – A plan developed at the field response level that contains 

objectives reflecting the overall incident strategy and specific tactical actions and 

supporting information for the next operational period. The plan may be oral or 

written. 26 

Incident Command – A disciplined method of management established for the 

specific purpose of control and direction of resources and personnel. 26 

Incident Commander – The individual responsible for overall management of the 

incident at the field level. 26 

Incident Command System – The combination of facilities, equipment, personnel, 

procedures, and communications operating within a common organizational 

structure, with responsibility for the management of resources to effectively 

accomplish stated objectives pertinent to an incident. 26 

Individual Protective Equipment – In chemical, biological, radiological, or nuclear 

operations, the personal clothing and equipment required to protect an individual 

from chemical, biological, and radiological hazards and some nuclear hazards. 76 

Interferent – a chemical, biological, or radiological agent that causes a detection 

device to erroneously measure the true agent of interest. An interferent can cause 

false positive or false negative from a detection device. 

Original 101 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



Ladder Pipe System – A corridor-style decontamination system typically comprising 

two engines (also creating the corridor) that provide water spray from both sides 

using hose lines and deck guns, while the ladder pipe provides a high-volume, lowpressure 

flow from above. 

LCt50 – Concentration that is lethal to 50% of the exposed population in mg/m 3 for 1 

minute. 

LD5 – A measurement of acute toxicity that represents the dose required to kill 5% of 

a population of test animals. 

LD10 – A measurement of acute toxicity that represents the dose required to kill 10% 

of a population of test animals. 

LD50 - A standard measurement of acute toxicity that represents the dose required to 

kill 50% of a population of test animals. 16 





LD100 – A measurement of acute toxicity that represents the dose after which 

survival is statistically impossible in test animals. 

Level of Protection – In addition to appropriate respiratory protection, designations of 

types of personal protective equipment to be worn based on NFPA standards. Level 

A – Vapor protective suit for hazardous chemical emergencies; Level B – Liquid 

splash protective suit for hazardous chemical emergencies; Level C – Limited use 

protective suit for hazardous chemical emergencies. 

Light Damage Zone – In nuclear detonation zoning, buildings in this zone typically 

will have broken windows with light damage to other infrastructure. A majority of the 

casualties will be ambulatory and can self-evacuate for decontamination and 

treatment. Radiation levels in this zone maybe slightly elevated from normal 

background levels. 56 

Liquid Control Line – The boundary between the primary and secondary 

contamination zones within a decontamination line. No liquid contamination is 

expected to be present on the right side of the boundary in the secondary zone. 

There is a high probability of vapor contamination in both the primary and secondary 

zones. This boundary is embedded within the warm zone of the incident site. 

Low-Radiation Zone – Radiation levels are range from 0.01 – 0.1 R/hr in this zone. 

Restrict access to essential response individuals. Initial decontamination of first 

102 Original



responders should occur near the outer boundary of this zone. Uninjured people 

within this zone at the time of the release can be directed to proceed directly home 

to shower if resources do not permit contamination surveying at the scene. 55 

Mass Casualty Decontamination – Decontamination of large numbers of people, in 

the event of contamination by a harmful substance. 

Mass Decontamination – Often established after gross decontamination, optimally 

uses a soap and water solution and allows for the casualties to be completely 

disrobed and decontaminated. 

Material Safety Data Sheet – A document that contains information regarding the 

specific identity of hazardous chemicals, including information on health effects, first 

aid, chemical and physical properties, and emergency phone numbers. 

Medical Triage – Performed to determine which casualties should receive medical 

treatment first. 

Medium-Radiation Zone – Radiation levels are range from 0.1 – 1 R/hr in this zone. 

Serves as a buffer zone/transition area between the high and low radiation zones. 

Restrict access to only authorized personnel that are wearing and using personal 

dosimetry. People within this zone at the time of the explosion should be surveyed 

for contamination before being released. 55 

Mission-Oriented Protective Posture – A flexible system of protection against 

chemical, biological, radiological, and nuclear decontamination. This posture 

requires personnel to wear only that protective clothing and equipment appropriate 

to the threat level, work rate imposed by the mission, temperature, and humidity. 23 

Monitoring Equipment – Instruments and devices used to identify and/or quantify 

contaminants. 

Moderate Damage Zone – In nuclear detonation zoning, this zone has significant 

building damage and rubble, downed utility poles, overturned vehicles, and fires. 

Radiation levels in this zone are expected to be elevated and may be very high in 

some areas, but this is the zone has the greatest lifesaving potential. Casualties will 

come from this zone and will have radiation burns, thermal burns, and blast trauma 

injuries. Most of the injured will require help and/or extraction to receive 

decontamination and treatment. 56 

Nerve Agent – Originally produced in a search for insecticides, their high toxicity 

brought these manufactured compounds into the realm of military use. Highly lethal, 

these chemicals have been used in wars and by terrorists. 

Neutralization – To render a substance less harmful through a chemical reaction 

between it and a reagent. 

Original 103 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



No-Go Zone – In nuclear detonation zoning, this zone has the most damage to 

infrastructure, which will most likely be completely destroyed. The radiation level is 

very high and it is unlikely that any casualties will survive in this zone. However, 

people in substructures such as subterranean parking garages or subway tunnels 

may survive the initial blast. 56 

Nonambulatory – Unable to walk about without assistance. 

Operations – The coordinated tactical response of all field operations in accordance 

with the Incident Action Plan. 

Personal Protective Equipment – Equipment provided to shield or isolate a person 

from the chemical, physical, and thermal hazards that may be encountered at a 

hazardous materials incident. Adequate personal protective equipment should 

protect the respiratory system, skin, eyes, face, hands, feet, head, body, and 

hearing. Personal protective equipment includes personal protective clothing, selfcontained 

positive pressure breathing apparatus, and air purifying respirators. 47,76 

Physical Removal – The act of reducing the amount of a contaminant on a surface 

through flushing, blotting, absorbing, or any other process that moves the product 

away to reduce its threat. 

Pike Pole – A pole with a hooked metal head that is used in fire fighting to tear down 

walls or ceilings. 

Pinnable Waterway – A nozzle that is hard-piped to the end of an apparatus’ 

mounted ladder that can be moved to another position along the ladder. 

Plague – An infectious disease that affects animals and humans, caused by the 

bacterium Yersinia pestis. Commonly found in rodents and their fleas and naturally 

occurs in many area of the world. Also could be used in an aerosol attack to cause 

cases of the pneumonic form of the disease. 

Posse Comitatus Act (18 U.S.C. § 1385): Whoever, except in cases and under 

circumstances expressly authorized by the Constitution or Act of Congress, willfully 

uses any part of the Army or the Air Force as a Posse Comitatus or otherwise to 

execute the laws shall be fined under this title or imprisoned not more than two 

years, or both. 

Powered Air Purifying Respirator – An air purifying respirator with a portable motor 

to force air through the filtering/purifying cartridges for use only in atmospheres 

where the chemical hazards and concentrations are known. 

Preparation Phase – The portion of incident management in which personnel are 

involved in preparing for future HAZMAT/WMD incidents. 

104 Original



Procedure – Standard, detailed steps that prescribe how to perform specific tasks. 76 

Psychosomatic symptoms – Referring to physical symptoms that are caused or 

significantly influenced by emotional factors. 

Public Information Officer – The individual assigned to act as the liaison between the 

Incident Commander and the news media, as well as other groups. 

Pulmonary Agent – Chemicals that cause severe irritation or swelling of the 

respiratory tract. 

Radioactive – The spontaneous disintegration of unstable nuclei accompanied by 

emission of nuclear radiation. 

Radiodermatitis – skin irritation, a cutaneous inflammatory reaction, after exposure 

to biologically effective levels of ionizing radiation. 

Radiological Dispersal Device – An improvised assembly or process, other than a 

nuclear explosive device, designed to disseminate radioactive material in order to 

cause destruction, damage, or injury. 23,76 

Recovery Phase – The portion of incident management in which responsibility for all 

scene operations are released back to the local emergency responders. 

Rescue – The removal of casualties from an area determined to be contaminated or 

otherwise hazardous by appropriately trained and equipped personnel. 

Response Phase – The portion of incident management in which personnel are 

involved in controlling HAZMAT/WMD incidents. 

Restoration Phase – The portion of incident management in which the 

decontamination section or unit is returned to its full operational capability following a 

HAZMAT/WMD incident, and will usually be completed at a unit’s home station. 

Ricin – A poison found naturally in castor beans that prevents cells from making the 

proteins they need, leading to cell death. 

Roentgen – A unit of gamma or x-ray exposure in air. It is the primary standard of 

measurement used in the emergency responder community in the U.S. 56 

Safety Officer – Selected by the Incident Commander, a person at an emergency 

incident responsible for ensuring that all overall operations performed at the incident 

by all agencies present are done so with respect to the highest levels of safety and 

health. The Safety Officer shall report directly to the Incident Commander. 26 

Scene – The location impacted or potentially impacted by a hazard. 

Original 105 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



Self-Contained Breathing Apparatus – A positive pressure, self-contained breathing 

apparatus, or combination SCBA/supplied air breathing apparatus certified by 

NIOSH and MSHA, or the appropriate approval agency for use in atmospheres that 

are immediately dangerous to life or health. 77 

Shuffle Pit – Pit, box, tub, etc. lined with plastic and filled with a decontamination 

solution or an absorbent designed to remove gross contamination from the feet. 

Smallpox – A highly contagious, and sometimes fatal disease caused by the variola 

virus for which there is no specific treatment, and the only prevention is vaccination. 

Staging Area – The area established for temporary location of available resources 

closer to the incident site to reduce response time. 

Symptoms – Descriptions pertaining to their condition from a person who is ill or 

injured. 

Tactics – The employment and ordered arrangement of forces in relation to each 

other. 76 

Technique – Non-prescriptive ways or methods used to perform missions, functions, 

or tasks. 76 

Technical Decontamination – Designed to remove contaminants from responders in 

PPE, their equipment, and evidence. A step-by-step process to perform a thorough 

decontamination before being allowed to enter the cold zone. Can be used for 

casualties in an emergency situation. 

Terrorism – The unlawful use of force and violence against persons or property to 

intimidate or coerce a government, the civilian population, or any segment thereof, in 

furtherance of political or social objectives. 80 

Tertiary Medical Center – Healthcare facility equipped and staffed for specialized 

investigation and treatment of casualties and their afflictions. 

Tier I Response – Normally implemented for small-scale, localized CBRNE incidents 

that meet Secretary of Defense criteria outlined in the Chairman of the Joint Chiefs 

of Staff (CJCS) Concept Plan (CONPLAN) 0500, Military Assistance to Domestic 

Consequence Management Operations in Response to a Chemical, Biological, 

Radiological, Nuclear, or High-Yield Explosive Situation. In a Tier I situation, the 

defense coordinating officer can effectively exercise command over the small 

number of DOD forces required and still execute his functional responsibilities with 

respect to processing mission assignments. 23 

Tier II Response – Normal response posture for CBRNE incidents having met the 

Secretary of Defense criteria to implement CJCS CONPLAN 0500 and the need to 

106 Original



establish a joint task force to respond to the incident. Specialized units, 

detachments, teams, supplies, and equipment will likely be required from DOD in 

Tier II. 23 

Tier III Response – Response to extremely complex CBRNE scenarios impacting a 

wide geographic area or a large population—or threatening national security. 23 

Toxic – Poisonous; relating to or caused by a toxin; able to cause injury by contact 

or systemic action to plants, animals, or people. 

Toxic Industrial Biological – Any biological material manufactured, used, transported, 

or stored by industrial, medical, or commercial processes that could pose an 

infectious or toxic threat. 23,76 

Toxic Industrial Chemical – A chemical developed or manufactured for use in 

industrial operations or research by industry, government, or academia, for example, 

pesticides, petrochemicals, fertilizers, corrosives, and poisons. These chemicals are 

not primarily manufactured for the specific purpose of producing human casualties or 

rendering equipment, facilities, or areas dangerous for human use. Hydrogen 

cyanide, cyanogen chloride, phosgene, and chloropicrin are industrial chemicals that 

also can be military chemical agents. 23,76 

Toxic Industrial Material – A generic term for toxic or radioactive substances in solid, 

liquid, aerosolized, or gaseous form that may be used, or stored for use, for 

industrial, commercial, medical, military, or domestic purposes. Toxic industrial 

material may be chemical, biological, or radioactive and described as toxic industrial 

chemical, toxic industrial biological, or toxic industrial radiological. 23,76 

Toxic Industrial Radiological – Any radiological material manufactured, used, 

transported, or stored by industrial, medical, or commercial processes. 23,76 

Toxin – A naturally occurring compound from a plant or animal that can cause illness 

or death if internalized. 

Transport Officer – Responsible for the movement of casualties by land, sea, or air 

to medical treatment facilities. Responsible for tracking casualties and maintaining a 

dynamic list of medical treatment facility availability. 

Trash Bag Decon – A method of conducting improvised MCD under the conditions of 

limited equipment, supplies, and human resources. This technique allows for a 

casualty to be tracked, personal effects to be stored and transported with the 

casualty. This technique is also allows a casualty to disrobe and rinse off in privacy 

should a shelter not be available during the decontamination process. 

Trash Bag Decon Kit – A kit that allows for the tracking of a casualty and the 

casualty’s personal effects during the decontamination process. The kit contains 1) 

Original 107 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



pre-numbered armband for patient; 2) medium zip-lock bag (for casualty personal 

effects); 3) large zip-lock bag (for casualty clothing); 4) large zip-lock bag (to carry 

other two zip-lock bags); and 5) black lawn-type trash bag (for casualty privacy if no 

other shelter is present). 

Triage – The act of sorting casualties based on a prioritization system. Also called 

medical triage and decontamination triage. 

Triage Officer – Responsible for operational oversight of medical triage. Facilitates 

the movement of victims to the treatment area in a prioritized and timely manner 

(based on the victim's classification). Monitors the safety of the triage team. 

Uncontrolled Radiation Zone. Radiation levels are similar to natural background 

radiation in this zone. The best location for Incident Command and decontamination 

activities. 55 

Unity of Command – Hierarchical organization principle that no subordinate should 

report to more than one boss; a key component of the Incident Command System. 26 

Vapor – An air dispersion of molecules of a substance that is normally a liquid or 

solid at standard temperature and pressure. 

Vapor Control Line – The boundary between the secondary and tertiary 

contamination zones within a decontamination line. The tertiary zone is equivalent to 

the cold zone. No liquid contamination is expected to be present on either side of the 

boundary in the secondary and tertiary zones. There is a high probability of vapor 

contamination on the right side of the boundary in the secondary zone. There is a 

low probability of vapor contamination on the left side of the boundary in the tertiary 

zone. 

Victim – A person who has been injured or killed by an incident. Used 

interchangeably with “casualty.” 

Virus – A protein-encapsulated strand of genetic material that cannot reproduce or 

survive outside of another cell. They cause illness by invading healthy cells and 

reproducing, killing the host cell. 

Vulnerability – The susceptibility of life, the environment, and/or property to damage 

by a hazard. 

Warm Zone – The area where personnel and equipment decontamination and hot 

zone support takes place. It includes access control points and assists in reducing 

the spread of contamination. This may be referred to as the “decontamination,” 

“contamination reduction,” “yellow zone,” “contamination reduction zone,” or “limited 

access zone” in other documents. 47 

108 Original



Water Buffalo – Bag-style storage devices for water that can be fed or emptied by a 

pump or gravity through a series of tubing and connectors. The bags can be rolled 

up and stored when not in use. 

Weapons of Mass Destruction – Weapons capable of inflicting massive destruction 

to property and/or population, using chemical, biological, or radioactive material. 

Worried Well – a person who was not directly affected by an incident, but suffered 

psychological trauma and became concerned for his/her welfare. 

Original 109 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance




110 Original



Appendix D – Cross-Reference Guide with Civilian 

Equipment Specifications 

The Cross-Reference Guide presented in Table 13 compares military 

decontamination equipment to that used by civilians. Military personnel will have an 

idea of the types of equipment they might encounter when providing assistance to 

civilians during a mass casualty incident. Types of equipment compared include 

MCD, detection, and individual protective equipment (IPE) and personal protective 

equipment (PPE). Appendix D provides information on capabilities, limitations, and 

operational specifications of some common equipment civilian responders’ use. 

The military equipment list provides an example of a well-supplied Army element 

with significant MCD capabilities. Actual elements could have more or less of the 

MCD equipment listed. The civilian responder equipment listed in Appendix D was 

compiled from sources such as LLIS, Responder Knowledge Base, and Department 

of Justice guides. 40,41 Equipment available to fire, emergency medical service, and 

law enforcement personnel is included. However, the appendix focuses on the 

specific equipment available to jurisdictionally-based fire departments because they 

are responsible for conducting MCD operations. 

NOTE: It is impossible to list all variations in equipment available to civilian 

responders. Equipment caches vary from city to city and from station to station 

within the smallest of towns. The same is true for military elements. NO product 

endorsement is implied. 

In the tables, the equipment listed in the “Civilian Equivalent” column is basic due to 

the variety of the equipment that may be encountered in the field (for example, 

“Truck” for Line 1.1). Acronyms are defined in Appendix B. 

Table 13: Cross-Reference Guide Comparing Military and Civilian MCD Equipment. 

System List 

Line Description Civilian Equivalent 

1 Operations Command, Control, and 

Communication 

Operations Command, Control, and 

Communication 

2 Personal Protection Personal Protection 

3 Entry Detection Equipment Entry/Detection Equipment 

6 MCD Decontamination Equipment MCD Decontamination Equipment 

7 Casualty Care/Transportation Equipment Casualty Care/Transportation Equipment 

Original 111 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



Systems List 

Operations Command, Control, and Communication (Line 1) 


1.1 Prime mover, 30000 lbs gross combined 

weight rating (eq.) diesel, 4 x 4 crew cab 

Truck, variable, upwards from ½ ton 

1.2 Trailer, 32' MCD configuration with built-in 

four-bottle 6000 pounds per square inch 

(w/booster) cascade system 

1.3 Portable public address system. IML Corp, 

system model: Sound Commander 1000 

1.4 Radio, handheld, Motorola XTS 5000 Model 3 

ruggedized 

Trailer 

Public address system on truck 

Handheld radio (e.g., Motorola, Kenwood) 

1.5 Earpiece microphone system BDN6641A Throat-microphone, earpiece 

1.6 Push-to-talk interface module for ear 

microphone system BDN6671 

N/A 

1.7 Battery charger for XTS 5000 radios, 

Motorola model #WPLN4108BR or 

#WPLN4130A 

Battery chargers (e.g., Motorola, Kenwood) 

1.8 Voice amplifier, M7A1, for M40 mask Voice amplifier 

1.9 Binocular, range finding, with compass, 

Leupold 9x32 RXB IV 

Binoculars 

1.10 Weather station, Kestrel 4500 weather tracker Weather station 

1.11 Questemp heat stress monitor Oral thermometer, blood pressure cuff, 

stethoscope 

1.12 Fire extinguisher, ANSUL model SY-2014 

(authorized substitute 4210-00-889-2492) 

Fire extinguisher, ABC-type, CO2, and/or 

water, upwards from 20 pounds 

1.13 Computer w/reference library Computer w/reference library 

Personal Protection (Line 2) 


2.1 SCBA Drager model PSS 7000 Scott, MSA, Interspiro, Drager SCBAs 

2.2 Spare bottle, SCBA, Drager compatible Spare bottle, SCBA, manufacturer-specific 

2.3 Powered air purifying respirator model# C420 Scott, MSA, Interspiro, or Drager PAPRs 

NIOSH approved 

2.4 Filter, canister, C2A1 Filter, canister specific to chemical and 

respirator 

2.5 Level B suit, Tychem Responder CSM 

Style: RC128T Mil spec butyl gloves attached 

Level B suit, DuPont, Kapler ® , Trelleborg 

2.6 Level C suit, w/hood, Tychem BR 

style: BR128T 

Level C suit, DuPont, Kapler ® , Trelleborg 

2.7 Coverall, ProShield NexGen style: NG122S Coverall, ProShield NexGen style: NG122S 

2.8 Gloves, chemical protective, rubber (15Mil) Gloves, nitrile or butyl 

2.9 Gloves, examination, nitrile Gloves, examination, nitrile 

112 Original

Systems List 



2.10 Boots, HAZMAT, steel toe Boots, HAZMAT, steel toe and/or boot 

covers 

2.11 Chemical-resistant tape Chemical-resistant tape 

2.12 Vest cooling, w/cooling pack inserts (PCP2) Vest cooling, with cooling pack inserts or 

circulated air 

2.13 Bag HAZMAT gear Bag HAZMAT gear 

Entry/Detection Equipment (Line 3) 


3.1 ICAM Smiths Detection CAM, Draeger CDS, 

Draeger CMS, Smiths Detection APD2000, 

Smiths Detection HazmatID, Ahura 

FirstDefender, MSA SAW MiniCAD mkII, 

MSA HAZMATCAD Plus, M8, M9, M256A1, 

M18A3 

3.2 CAMSIM, monitor, training simulator N/A 

3.3 ACADA Draeger CDS, Smiths Detection APD2000, 

Smiths Detection HazmatID, Ahura 

FirstDefender, MSA SAW MiniCAD mkII, 

MSA HAZMATCAD Plus, M8, M9, M256A1, 

M18A3 

3.4 ACADASIM, training simulator N/A 

3.5 Radiac set, AN/VDR-2 Ludlum Model 2241-2, Ludlum Model 3, 

Civil Defense V-Series detectors, MGPI 

DMC 2000S, Thermo Eberline FH 41 B, 

Thermo Eberline FH 40 G, Sensor 

Technology Radiation Pager- S 

3.6 Radiac set, AN/PDR-77 (detects & measure 

alpha, beta, gamma) 

3.7 Detector, Radiac, AN/UDR-13 - initial issue 

Detector, Radiac, AN/UDR-14 - updated 

issue 

Ludlum Model 2241-2, Ludlum Model 3, 





Ludlum Model 2241-2, Ludlum Model 3, 





3.8 MultiRAE MultiRAE, or other similar equipment, such 

as Area RAE, QRAE, MSA Orion, Passport 

5 Star 

3.9 M-4 JCAD (Smiths Detection LCD-FR) Smiths Detection Lightweight Chemical 

Detector, Draeger CDS, Draeger CMS, 

Smiths Detection APD2000, Smiths 

Detection HazmatID, Ahura FirstDefender, 

MSA SAW MiniCAD mkII, MSA 

HAZMATCAD Plus, M8, M9, M256A1, 

M18A3 

Original 113 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



Systems List 

MCD Decontamination Equipment (Line 6) 


6.1 Decon shelter, 5XBI (20'Lx15.3'Wx10.6'H) Zumro, TVI, Reeves shelter 

6.2 Decon shelter, 3XBI (12'Lx15.3'Wx10.6'H) Zumro, TVI, Reeves shelter 

6.3 Bag, carry, shelter, rigid frame Bag, carry, shelter, rigid frame 

6.4 Push pole, XB part number A602600 N/A 

6.5 Integrated plumbing system with 3/4" SS 

male Camlock fittings (w/plug) 

6.6 Containment BERM, heavy duty, for use with 

decon shelter, 5XBI (20'Lx16'Wx8"H) 

Plumbing system, integrated or standalone 

Containment BERM, heavy duty, for use 

with decon shelter 

6.7 Floor mat 12'Lx15.3'W' (undress/redress) Grids, flooring for shelter 

6.8 Grids, flooring for 5XBI (8) 3 X 5.5 (4) 3 X 8 Grids, flooring for shelter 

6.9 Self-heating water system, Reeves G2 multifuel 

425,000 BTU with 3/4" SS male Camlock 

(w/cap) outlets 

Water heater 

6.10 Water transfer pump, submersible, automatic Submersible pumps 

on/off, 30 gals per minute, built-in check valve 

6.11 Overhead light, 50 watt, daisy chain kit for 

5XBI & 3XBI. One 50 watt dead end part 

number RDL001 Three 50 watt stringable part 

number RDL002 

Lights 

6.12 Collapsible roller system, 8 feet Collapsible roller system 

6.13 Privacy curtains Privacy curtains 

6.14 Divider curtains Divider curtains 

6.15 Hydrant wrench, universal Hydrant wrench, universal 

6.16 Tie down stake kit (shelter) Tie down stake kit (shelter) 

6.17 Repair kit (shelter) Repair kit (shelter) 

6.18 Depot level repair kit (kit, parts, spare, depot 

XB green) part number RDPK0075 

N/A 

6.19 Handrail, stand, collapsible frame, w/storage 

bag 

6.20 Ties, cable, 100 package, (authorized 

substitute 8135-00-846-8409) 

Walkers or folding chairs 

114 Original 

N/A 

6.21 Trash can, plastic, 32 gallon Trash cans 

6.22 Spine board Spine board 

6.23 500-watt wobble light 

Reeves, item number: RDL0006 

N/A 

6.24 Sponge (authorized sub 7920-00-884-1115) Sponges, scrub brushes 

6.25 Heater, kerosene, forced air 110,000 

BTU/hour 

Heater 

6.26 Drip pans (30" X 24") N/A

Systems List 

6.27 Folding tables (4 foot) Folding tables 

6.28 Saw horses Saw horses 



6.29 Visquene (plastic) 100 foot roll Visquene (plastic), tarps, salvage covers 

6.3 Plastic containers (18" X 18" X 12") for masks Plastic tubs 

6.31 Extension cords, 25 foot Extension cords 

6.32 Absorption pads, 100 pads per roll N/A 

6.33 Sprayer, 3.5 gallon, hand pump Sprayer, 3.5 gallon, hand pump 

6.34 Bags, trash 55 gallon, package Bags, trash 55 gallon, package 

6.35 Buckets, 50 gallon N/A 

6.36 Bucket, 5 gallon, (authorized substitute 7240- 

00-255-7536) 

Buckets, 3-gallon or 5-gallon 

6.37 Manifold, hydrant, gated Y Manifold, gated Y 

6.38 Adapter, fire hose (authorized substitute, 

4210-01-081-0419) 

6.39 Hose, fire, synthetic, 1 ½” X 100’ (authorized 

substitute, 4210-01-037-7031) 

Adapter, fire hose 

Fire hose, 1", 1-1/2", 1-3/4" 

6.40 Hydrant wrench, universal Hydrant wrench, universal 

6.41 Spanner wrench, non-metallic Spanner wrench 

6.42 Brush, long handle, (authorized substitute 

7920-00-255-7536) 

Brush, long handle 

6.43 Potable water cooler (40 gal) Potable water cooler 

6.44 Cooler, storage of cooling vest inserts (min 40 

quart) 

Cooler 

6.45 Emergency medical technician shears, red Emergency medical technician shears 

6.46 Emergency medical technician shears, black Emergency medical technician shears 

6.47 Light, work zone, tripod, 1000 watt Work lights 

6.48 Cord, extension, 12 gauge Cord, extension 

6.49 Cord, multi-outlet 12 gauge (authorized 

substitute 6150-00-485-6149) 

6.50 Tape, caution, (authorized substitute, 9905- 

00-194-9703) 

Cord, multi-outlet 

Caution/fire tape rolls 

6.51 Folding tables (6 foot) Folding tables 

6.52 Folding chairs Chairs, folding benches 

6.53 UNI-PAK sleeve w/ drop panel N/A 

6.54 UNI-PAK sleeve w/out drop panel N/A 

6.55 UNI-PAK space saver top N/A 

6.56 UNI-PAK space saver bottom N/A 

6.57 Clear Nylobraid 3/4" supply hose, 50' w/ 3/4" 

SS Camlock fittings, male & female for G2I 

heater part number 1005140 

Supply hose 

Original 115 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



Systems List 

6.58 Clear Nylobraid 3/4" supply hose, 50' w/3/4" 

SS Camlock fittings, male & female w/ball 

valve @ male end part number 1005141 

6.59 30 GPM totally submersible pump, w/2ea 10', 

3/4" discharge hoses part number 1005136 

6.60 Berm, containment, 12'W X 8'L X 8"H "decon 

pool" part number 1005142 

6.61 25' rigid fire hose, 1 1/2" male NST X 1 1/2" 

female NST for 65 GPM pressure pump part 

number RD30170H 

6.62 600gl box style wastewater bladder 2300ltr 

red, part number RDB0004 

Supply hose 

Submersible pumps 

Berm 

Fire hose, 1", 1 1/2", 1/3/4" 

Gray water bladder, drums 

Other Bags, 5 mil, for personal effects 

Casualty Care/Transportation Equipment (Line 7) 


7.1 Medic bag Medic bag 

7.2 Towel, bath (authorized substitute, 7210051- 

5837, box of 12). 

Redress kits, towels 

7.3 Robes Redress kits, large black trash bags 

7.4 Blanket, grey, 36” X 60” (authorized 

substitute, 7210-00-205-2804) 

Blankets 

7.5 Booties, (75 pair per box ) Redress kits, surgical booties 

7.6 Bags, sequentially numbered, red, poly mesh, Redress kits, trash bags 

w/drawstring and corresponding plastic 

numbered wrist bracelet 13.5” X 30” 

7.7 Litter, decon, mass casualty (Raven) Litter, back boards 

7.8 Carrier, litter, wheeled, military Litter, back boards, with or without wheels 

Sub-Systems List 

SCBA Draeger Model PSS7000 (Line 2.1) 


2.1.1 Harness assembly, with frame and regulator Harness assembly, with frame and 

regulator 

2.1.2 Bottle, high pressure, 4500 pounds per 

square inch 

2.1.3 Case, hard, transport for harness and 

regulator 

Bottles pressures 2800 pounds per square 

inch, 4500 pounds per square inch 

Case, hard, transport for harness and 

regulator 

2.1.4 Face piece (mask) Face piece (mask) 

Powered Air Purifying Respirator (Line 2.3) 


2.3.1 C420 blower assembly Blower assembly 

116 Original




2.3.2 C420 remote cable assembly Remote cable assembly 

2.3.3 C420 shower decontamination caps Shower decontamination caps 

2.3.4 Breathing tube assembly Breathing tube assembly 

2.3.5 Belt assembly Belt assembly 

2.3.6 Battery, LiSO2, (BA 5800-U) Battery 

2.3.7 Airflow indicator Airflow indicator 

2.3.8 Filter gasket, C420 blower Filter gasket 

Chemical Agent Monitor Simulator (Line 3.2) 


3.2.1 CAMSIM Manufacturer provided check source 

specific to monitor 

3.2.2 Area G source N/A 

3.2.3 Area H source N/A 

3.2.4 Vehicle G source N/A 

3.2.5 Vehicle H source N/A 

3.2.6 Small low power point G source N/A 

3.2.7 Small high power point G source N/A 

3.2.8 Small low power point H source N/A 

3.2.9 Small high power point H source N/A 

3.2.10 Large low power point G source N/A 

3.2.11 Large high power point G source N/A 

3.2.12 Large low power point H source N/A 

3.2.13 Large high power point H source N/A 

3.2.14 Simulation confidence check N/A 

3.2.15 System carry case N/A 

3.2.16 Nozzle protective cap N/A 

3.2.17 Simulation nozzle filter N/A 

3.2.18 Battery adapter N/A 

3.2.19 Instructor control key N/A 

3.2.20 Instruction manual N/A 

3.2.21 Error reporting cards (G / H) N/A 

3.2.22 D cell battery adapter N/A 

Multi-gas Monitor, Multi-Rae Line (3.8) 


3.8.1 Monitor, multi-gas RAE Systems MultiRAE, RAE Systems 

AreaRAE, RAE Systems QRAE, RAE 

Systems Q-RAE Plus, MSA Orion, MSA 

Passport 5 Star, M18A3 

3.8.2 Case, shipping Case, shipping 

3.8.3 Tygon tubing, 15' Tygon tubing, 15' 

Original 117 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance




3.8.4 Hand pump, constant flow Hand pump, constant flow 

3.8.5 Tool kit Tool kit 

3.8.6 Lamp cleaning kit Lamp cleaning kit 

3.8.7 Four gas mix (50% lower explosive limit, 

20.9% O2, 25 ppm H2S, 50 ppm CO) 

w/regulator, accessories, case, kit 

Tie Down Stake Kit (Shelter) (Line 6.16) 

Four gas mix (50% lower explosive limit, 

20.9% O2, 25 ppm H2S, 50 ppm CO) 

w/regulator, accessories, case, kit 


6.16.1 Stakes Stakes 

6.16.2 Double face hammer Double face hammer 

6.16.3 Bag, carry Bag, carry 

Repair Kit (Shelter) (Line 6.17) 

Line Description Civilian Equipment 

6.17.1 Bag, repair kit Bag, repair kit 

6.17.2 Tape, 100-mph Tape 

6.17.3 Scissors Scissors 

6.17.4 Wrench, pipe 20” Toolbox 

6.17.5 Pipe cutter Pipe cutter 

6.17.6 Pipe, aluminum N/A 

6.17.7 Rope Rope, utility and life safety 

6.17.8 Patch material Patch material 

6.17.9 Glue, patch (tube) Glue, patch (tube) 

6.17.10 Replacement strut Replacement strut 

Depot Level Repair Kit (Shelter) (Line 6.18) 


6.18.1 Keeper looped w/O-ring, white N/A 

6.18.2 Keeper looped w/O-ring, green N/A 

6.18.3 Keeper w/O-ring only, green N/A 

6.18.4 Hub top, white N/A 

6.18.5 Hub bottom, white N/A 

6.18.6 Hub top, green N/A 

6.18.7 Hub bottom, green N/A 

6.18.8 Screw, panhead Phillips #8 x 1/2 N/A 

6.18.9 Ratchet screw driver Screw drivers 

6.18.10 A side pair strut, XB series, blue N/A 

6.18.11 B side pair strut, XB series, red N/A 

118 Original


6.18.12 A sub pair strut, XB series, green N/A 

6.18.13 B sub pair strut, XB series, yellow N/A 

6.18.14 Spanner wrench Spanner wrench 



6.18.15 Spare parts kit bag (complete) Spare parts kit bag (complete) 

6.18.16 50' RD30020H yellow lay flat hose N/A 

6.18.17 RD300275 stainless steel clamps N/A 

6.18.18 RD300375 clamp protectors N/A 

6.18.19 RD30050Q poly T-fittings N/A 

6.18.20 RD30070Q shower head quick connects Shower head quick connects 

6.18.21 RD300175 red rubber caps N/A 

6.18.22 RD300380 teflon tape Teflon tape 

6.18.23 RD300095 shower heads Shower heads 

6.18.24 RD300260 spray wand gun Spray wand gun 

6.18.25 RD300270 stainless steel band crimp tool N/A 

6.18.26 RD30055Q female cam N/A 

6.18.27 RD300280 O-rings for T-fittings N/A 

As stated in Section 8.1.2, knowing the contaminating agent allows the Incident 

Commander to alter decontamination efforts to best fit the situation. For example, in 

the case of oily agents like VX or HD, casualties should not rub their skin with their 

hands without the use of soap. Rubbing without soap spreads the oil further across 

the skin without being rinsed away. To identify the agent, detection equipment must 

be used. Table 14, Table 15, and Table 16 contain information to aid in the selection 

of the most appropriate monitoring devices. The devices are divided into chemical, 

biological, and radiological, respectively. 40 

This is not a complete listing of available equipment. However, the tables represent 

the standard types of equipment that are usually available to civilian emergency 

response personnel. The table for the chemical threat detectors is organized by 

method of detection, and includes instruments that use more than one technology 

for threat detection. 

The tables list the manufacturer and name of the instrument along with a description 

of the device. Finally, a brief description of each device’s characteristic capabilities 

and limitations is provided. It is important to note that all manufacturers use different 

designs. However, the basic function of a given detection method tends to stay 

relatively unchanged. As a result, most instruments that use the same detection 

method usually show many of the same strengths and weaknesses, regardless of 

the manufacturer. It is also important to know that even if a technology shows a 

weakness, it may still be functional in a particular situation. The possible reduced 

Original 119 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



ability of the device may need to be considered when interpreting the results 

provided. This is an example of needing to confirm initial results with a second 

device that uses a different detection method to determine the validity of the initial 

results. 

Table 14: Capabilities, and Limitations of Chemical Detection Equipment. 

Equipment Description Capabilities Limitations 

Chemical Agent Manually operated 

Colorimetric Technology Devices 

• Not dependent on electrical • Older colorimetric technology 

Detection Paper sampler used to test for power 

creates a strong potential for 

and Tape L, V-, G-, and H-series • Extremely simple to use interference reaction and false 

M8/M9 agents 

• Can be used as either an active positive readings 

or passive device 

• Shelf-life limitations 

Draeger Chip Rapid measurement of • Chips are currently available for • Detection is limited to those 

Measurement chemical vapors in a wide variety of chemicals chips that are currently 

System (CMS) ambient air, such as • Chips are available for different available 

ammonia and chlorine, measurement ranges of many • Chips have shelf-life and 

via gas-specific chips of the chemicals that can be storage requirements 

detected 

• Requires maintenance that 

needs to be performed at an 

offsite facility 

Chemical Agent Manually-operated • Independent of electrical power • Requires good manual dexterity 

Detection Kit sampler used to test for • Able to detect multiple threats while user is wearing PPE 

M256A1 V-, G-, and H-series simultaneously with single • Complete test can be very time 

agents, L, AD, CK, and application 

consuming 

CX 

• Colorimetric theory of operation 

ABC-M18A3 Manually operated to 

Chemical Agent test for V-, G-, and H- 

is fairly selective relative to 

other devices 

Detection Kit series agents, L, CD, 

ED, and MD 

Drager Manually operated 

Simultest Kit device detects a 

• Civil Defense number of chemicals 

Kit (CWAs) when present at or 

• Drager 

Clandestine 

Lab Kit (TICs) 

above a specified level. 

Ion Mobility Spectrometry (IMS) Devices 

Smiths Handheld device used • Provides a rapid indication of • Highly subject to interference 

Detection for analysis of unknown increasing levels of agent • Does not fully quantify agent 

Sabre 4000 substances, such as • Easily used as a point source levels 

CWAs, explosives, 

drugs, and TICs 

monitor 

• Subject to regulatory 

• Operation is usually not affected requirements associated with 

Graseby Handheld detector by weather extremes 

radioactive sources 

(Smiths semi-quantitatively 

• Sample inlet filter can become 

Detection) measures V-, G-, and 

contaminated and is 

Chemical Agent H-series agents, L, AC, 

susceptible to particulate and 

Monitor (CAM) CG, and chlorine 

moisture 

Smiths Handheld detector used 

Detection APD to semi-quantitatively 

2000 

measure V-, G-, and Hseries 

agents, L, and 

pepper spray. 

120 Original




Microsensor 

Systems Inc. 

SAW Minicad 

mkII 

Mine Safety 

Appliances 

Passport PID II 

RAE Systems 

• MiniRAE Plus 

• ToxiRAE Plus 

• MiniRAE 2000 

• MiniRAE 3000 

Ahura First 

Defender 

Smiths 

Detection 

HazMatID 

Handheld detector used 

to measure select G- 

and H-series agents 

Portable PID device 

used to quantitatively 

measure a variety of 

volatile TICs. 

Handheld device used 

for analysis of such as 

CWAs, explosives, 

drugs, and TICs 

Surface Acoustic Wave (SAW) Devices 

• Provides a rapid indication of 

increasing levels of agent 

• Easily used as a point source 

monitor 

Photo Ionization Detection (PID) Devices 

• Good first entry tool for rapid 

determination of presence of a 

threat 

• PID allows for broadband 

detection of a wide range of 

volatile organic compounds 

• Device can electronically store 

results of sampling for future 

reference 

Raman Spectroscopy Devices 

• Can be used for measurement 

of liquids and powders 

• Capable of identifying discrete 

components of mixed 

compounds 

Fourier Transform Infrared (FTIR) Devices 

Portable device used for • Analyzes powders, liquids, 

rapid analysis of such pastes, and gels 

as CWAs, explosives, • Operated locally or remotely 

drugs, and TICs from an available laptop 

computer 

• Electronically store results of 

sampling for future reference 

• Relatively slow response time 

requiring users to conduct 

surveys more slowly 

• Adversely affected by electromagnetic 

interference 

• Do not initially confirm or 

quantify a particular compound 

• Re-configure to quantify once 

the agent is confirmed 

• Lose up to 50% of their 

sensitivity in conditions of 

greater than 95% humidity 

• Results depend on material 

tested being a characterized 

entry within the equipment 

library 

• DOES NOT identify agents. 

Requires confirmation of results 

• Validity of results requires good 

sample integrity 

• Cannot sample vapors 

• Results depend on tested being 

a characterized entry within the 

equipment library 

• DOES NOT absolutely identify 

agents 

Electrochemical Devices for Toxic Gases and Catalytic Bead Devices for Combustible Gases 

Industrial 

Scientific M40 

Multi Gas 

Monitor 

Industrial 

Scientific ITX 

Multi Gas 

Monitor 

Handheld device used • Installed PID allows for 

for measurement of broadband detection of a wide 

multiple chemical range of volatile organic 

vapors simultaneously, compounds 

such as H2S, oxygen, • User can configure equipment 

and carbon monoxide. to identify a variety of unknown 

Chemicals detected toxic materials using available 

depend on configuration electrochemical sensors 

• Able to detect multiple threats 

simultaneously with single 

application 



reference 

• User can configure equipment 

to identify a variety of unknown 

toxic materials using available 

electrochemical sensors 


• Electrochemical sensors are 

negatively affected by high and 

low temperature extremes 

• Combustible gas sensors are 

adversely affected by high 

concentrations of silicone and 

lead compounds 

• Electrochemical and 

combustible gas sensors are 

subject to storage and shelf-life 

considerations 

Original 121 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance




RAE Systems 

QRAE 

Mine Safety 

Appliances 

Passport 

• FiveStar 

• Orion Multi 

Gas Monitor 


application 



reference 

Microsensor 

SAW/ E-Chem Devices 

Handheld detector used • Provides a rapid indication of 

Systems Inc. to measure V, G and H increasing levels of agent 

Hazmatcad Plus series agents along • Easily used as a point source 

with AC, CG, hydride 

gases, and halogen 

gases when present at 

monitor 

or above a specific level 

RAE Systems 

• MultiRAE 

Plus 

• AreaRAE 

Mine Safety 

Appliances 

Sirius 

Platform designed for 

detection of multiple 

gases simultaneously, 

such as H2S, oxygen, 

and carbon monoxide. 

Can be used as a stand 

alone unit or as part of 

a remote satellite 

configuration when 

networked with the RAE 

Systems operating 

system 


for measurement of 

multiple chemical 

vapors simultaneously, 

such as H2S, oxygen, 

and carbon monoxide. 

Chemicals detected 

depend on 

configuration 

PID/E-Chem/Catalytic Bead Devices 

• Unit can be set up at a fixed 

location in the hot or warm zone 

and monitored at a remote 

command post when used with 

RAElink system 





• Installed PID allows for 

broadband detection of a wide 

range of volatile organic 

compounds 



application 



reference 





• Installed PID allows for 

broadband detection of a wide 

range of volatile organic 

compounds 



application 



reference 

• SAW sensors have a slow 

response times 

• SAW sensors can be adversely 

affected by electro-magnetic 

interference 




• All maintenance including 

electrochemical cell 

replacement must be performed 

by the manufacturer 

• PID sensors do not initially 

confirm or quantify a particular 

compound 

• Once a determination of the 

compound of interest is 

confirmed with additional 

equipment the device can then 

be re-configured to quantify the 

agent 

• PID sensors can lose as much 

as 50% of their sensitivity in 

conditions of greater than 95% 

humidity 




• Combustible gas sensors are 

adversely affected by high 

concentrations of silicone and 

lead compounds 

• Electrochemical and 

combustible gas sensors are 

subject to storage and shelf-life 

considerations 

122 Original



Table 15: Capabilities, and Limitations of Biological Detection Equipment. 


Rapid Analyte 

Measurement 

Platform 

(RAMP) 

Sensitive 

Membrane 

Antigen Rapid 

Test II 

(SMART-II) 

Guardian Bio 

Threat Alert ® 

(BTA) System 

Comprised of 

three main parts: 

• Guardian 

Reader 

• BTA Test 

Strips 

• BTA 

Proficiency Kit 

Portable biological 

agent identification. 

Currently available test 

strips detect: botulinum 

toxin, anthrax, ricin, 

smallpox 

Manually operated 

device used for 

screening of suspect 

biological materials for 

presumptive analytical 

results, such as anthrax 

and ricin. 

Portable biological 

agent identification and 

documentation 

screening system. 

Currently available test 

strips detect: 

• Anthrax 

• Ricin 

• Staphylococcal 

enterotoxin B 

• Botulinum toxin 

• Plague 

• Bacillius thuringiensis 

• Tularemia 

• Orthopox 

• Brucella 

Biological Detection Devices 

• Rapid identification of presence 

of biological 



reference. 

• Not dependent on electrical 

power 

• Provides a rapid identification of 

presence of biological materials 

as compared to the time 

required for sample analyses at 

an offsite laboratory 

• Performs analysis of sample 

results under difficult lighting 

conditions and when low 

concentrations of agent are 

present 

• Generates evidentiary 

documentation for sample 

chain-of-custody assurance and 

easier record keeping 

• Detects endospore-forming 

bacteria, proteinaceous toxins, 

or soluble antigens including 

bacteria 

• Screens for granular, powder, 

liquid, and aerosol 

• Internal memory stores the last 

200 test results, and data 

logging capabilities allow 

storage and printing of results 

Table 16: Capabilities, and Limitations of Radiological Detection Equipment. 

• Materials require appropriate 

storage conditions to maintain 

shelf-life 

• Presumptive test only. 

Confirmation testing may be 

required. 

• Materials require appropriate 

storage conditions to maintain 

shelf-life 

• Presumptive test only. If 

suspect agent is not identified 

with initial test then additional 

testing is required 

• Cannot electronically capture 

test results 

• Does not alarm positive if agent 

count is below threshold value 

• Reliability depends sample 

integrity 

• Testing can be time consuming 

• Cannot be used below 40° F or 

above 105° F 

• Cannot be used in direct 

sunlight 

• Cannot be used 6,500 feet 

above sea level 

• Maximum relative humidity 80% 

for temperatures up to 88° F 

• Test strips are agent specific, 

temperature sensitive, and 

shelf-life varies according to 

test strip 

• Test strips may be affected by 

non-specific binding, crossreactivity, 

and the hook-effect 

• Test strips cannot be reused 

Equipment Description Capabilities 

Radiological Detection Devices 

Limitations 

MGP 

Handheld device used • Very compact 

• Not inherently safe 

Instruments for detection of gamma • Provides dose and dose rate • Does not detect alpha or beta 

DMC-2000S radiation 

measurements of gamma radiation 

radiation 

• May become saturated in high 

Thermo 

Electron 

FH 41 B 

radiation areas 

Radiation 

Pager-S 


for semi-quantitative 

detection of gamma 

radiation 

• Very compact 

• Not intrinsically safe 

• Measures increasing levels of • Does not measure actual levels 

gamma radiation 

of radiation 

• Can negate increasing radiation Does not detect alpha or beta 

levels to locate a source radiation 

Original 123 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance




Thermo 

Electron 

FH 40 G-L 

Radiological Detection Devices 

Handheld device for the • Unit has internal probe for 

quantitative detection of gamma dose and dose rate 

gamma radiation. The measurements 

natural background • Can be operated with a variety 

radiation probe 

of external probes allowing for 

increases sensitivity to detection of beta and alpha 

gamma radiation. radiation measurements or 

Detects alpha and beta operation in extremely low 

radiation with optional energy areas 

sampling probe. • Electronically stores data 

Inovision 451B Handheld device used 

for detection of beta 

and gamma radiation 

Ludlum 

Measurements 

Inc. 

• Model 2241-2 

• Model 3 

• Model 14C 


to quantitatively detect 

alpha, beta, and 

gamma radiation. Types 

of radiation that are 

detectable depend on 

probe selected for use 

• Provides accurate 

measurement of gamma and 

beta radiation dose and dose 

rate 

• Discriminates between gamma 

and beta radiation using the 

installed beta shield 

• Allows for accurate 

measurement of dose and dose 

rate 

• Probes discriminate between 

the three types of radiation 

present 

• Can be used for detection of 

both exposure levels and 

contamination 

• External probes are easily 

damaged 

• Requires annual calibration at 


• Probes may become saturated 

in high radiation areas 

• Detector face can be easily 

damaged when beta shield is 

open 



• Probes can be easily damaged 



• Operates using high voltages 

• Probes may become saturated 

in high radiation areas 

124 Original



Appendix E – Properties and Symptoms of Chemical, 

Biological and Radiological Agents 

Being able to identify the agent causing the MCD situation could aid in the more 

efficient decontamination of casualties. For example, if particularly oily chemicals are 

present, the casualties should not rub their skin without soap because the compound 

spreads instead of being washed away. Detection equipment was discussed in 

Appendix D, but knowing the properties of these compounds and their 

corresponding symptoms can also help identify the agent. Also, detectors may not 

be readily available or ready for use on initial arrival. In such a situation, it is 

necessary to use the available clues, such as the presentation of the casualties. 

E.1. Chemical Materials 

Table 17 was adapted from Jane’s Chem-Bio Handbook. The table shows a matrix 

that connects chemical agents to symptoms that casualties may be display upon 

exposure. 33 White boxes indicate that the symptom is possible for the agent class. 

Black boxes mean that the symptom does not usually occur. To use the matrix, 

evaluate each symptom and if the symptom is present, place a checkmark in each 

white box to the right of the symptom. This means that a checkmark is placed in 

each column if the symptom is present. After marking all applicable symptoms, count 

the number of marked boxes in each column and write that total in the bottom row. 

More symptoms marked in a column indicate a higher probability that this is the type 

of agent present. 

Table 17: Chemical Agent Symptom Matrix. 

Symptoms 

Prostration 

Twitching 

Convulsions 

Coma 

Bleeding from mouth 

Coughing 

Sneezing 

Vomiting 

Muscle contractions 

Cyanosis (skin is blue or 

purple) 

Gray area of dead skin 

Pain, irritation 

Clammy 

Sweating, local or general 

Nerve 

Agents 

Blister 

Agents 

Blood 

Agents 

Appearance 

Skin 

Choking 

Agents 

Pulmonary 

Agents 

Tear/Riot 

Control Agents 

Original 125 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



Small pupils 

Symptoms 

Involuntary closing 

Tearing 

Burning, irritation 

Headache, pain around 

eye 

Dim vision 

Blurred vision 

Burning pain in eyes 

Redness 

Coughing 

Runny nose 

Tight chest (shortness of 

breath) 

Burning, irritation in nose 

Slow heart rate 

Fast heart rate 

Defecation 

Nausea 

Total 

Nerve 

Agents 

Blister 

Agents 

Blood 

Agents 

Eyes 

Respiratory 

Cardiovascular 

Digestive 

Choking 

Agents 

Pulmonary 

Agents 

Tear/Riot 

Control Agents 

Table 18 specifies various properties of selected chemical agents and the most 

common TICs. 14,31-33,43,57,81-90 Be sure to know the following before using a protective 

mask: 

1. Identity of the contaminant 

2. Concentration of the contaminant 

3. Concentration of the oxygen in the work area 

If these facts are known and an air purifying respirator is on hand that can filter out 

the contaminant, it may be worn. However, if all three items are not known or at any 

time the oxygen level is below 19.5%, an SCBA or supplied air respirator must be 

used. 85 

NIOSH established an IDLH value to determine the airborne concentration from 

which a worker could escape without injury or irreversible health effects from an 

IDLH exposure in the event of the failure of respiratory protection equipment. The 

IDLH was considered a maximum concentration above which only a highly reliable 

breathing apparatus providing maximum worker protection should be permitted. In 

determining IDLH values, NIOSH considered the ability of a worker to escape 

without loss of life or irreversible health effects along with certain transient effects, 

126 Original



such as severe eye or respiratory irritation, disorientation. The combination of these 

symptoms can slow down or even prevent escape. As a safety margin, IDLH values 

are based on effects that might occur as a consequence of a 30-minute exposure. 

However, the 30-minute period was NOT meant to imply that workers should stay in 

the work environment any longer than necessary. Every effort should be made to 

exit immediately. 43 

Table 18: Chemical Agent Properties. 

Agent 

c 

a, b Chemical Agent 

Type 

Nerve Agents 

Blister Agents 

Blood Agents 

Choking Agents 

Riot Control 

Agents 

State at 

20 ºC d 

CS (O- 

White crystalline 

chlorobenzylmalon solid 

onitrile, tear gas) 

Odor e Signs and Symptoms f PPE g 

Civilian Detection 

Equipment h 

Colorimetric, PID, 

IMS, SAW, IR 

Military Detection 

Equipment i 

IDLH j LD50 k LCt50 l STEL m 

GA (Tabun) Colorless to brown Faintly fruity; none Mild: eye pain, miosis, Protective 

M8 paper, M9 paper, 0.1 1,500 70 0.0001 

liquid 

when pure drooling, chest tightness mask and 

M256A1 CADK, M8A1 

Moderate: coughing, clothing 

ACAA, M90 AMAD, M21 

GB (Sarin) 

GD (Soman) 

Colorless liquid 


None when pure 

Fruity; camphor 

when impure 

wheezing, nausea, vomiting, 

diarrhea 

Severe: weakness, muscle 

twitching, loss of 

consciousness, convulsions, 


IMS, SAW, IR 

Colorimetric, IMS, 

SAW, FTIR 

ACAA, M22 ACADA, 

0.1 

CAM/ICAM, M272 Water 

Testing Kit, M18A3 

CADK, M18A2 CADK, 0.05 

MM1, CAPDS, IPDS, 

1,700 

350 

35 

35 

0.0001 

0.0002 

GF (Cyclosarin) Liquid None when pure; severe respiratory distress, 

Colorimetric, SAW AN/KAS-1 CWDD, JCAD 0.05 350 15 0.0002 

sweet; musty; 

peaches; shellac 

paralysis, apnea 

VX [O-Ethyl-S-(2- Colorless to amber None when pure 


0.003 5 15 0.00001 

diisopropylaminoethyl) 

methyl 

phosphonothiolate] 

liquid 

IMS, SAW, FTIR 

HD (Distilled Colorless to pale Garlic or 

Redness, pain, blisters Protective Colorimetric, PID, M8 and M9 paper, M21 0.7 1,400 1,000 0.003 

Mustard) 

yellow liquid to horseradish occurring hours to days after mask and IMS, SAW, FTIR ACAA, M256A1CADK, 

dark brown 

exposure 

clothing 

M90 AMAD, MM1, M22 

ACADA, CAM/ICAM, 

M272, M18A3 CADK, 

M18A2 CADK, JCAD 

HN-1 (Nitrogen Colorless when Faint, fishy, soapy Conjunctivitis, laryngitis, 

Colorimetric, IMS M8 paper, M9 paper, 7 20 1,000 N/A 

Mustard) 

pure; dark oily or musty 

bronchitis, hoarseness, 

M256A1 CADK, 

liquid if not 

coughing, elevated 

temperature, headache, 

CAM/ICAM, MM1 

HN-2 (Nitrogen 

Mustard) 


when pure 

Fishy or soapy 

nausea, and vomiting up to 

12 hours after exposure 

Colorimetric, IMS N/D 20 1,000 N/A 

HN-3 (Nitrogen Colorless when None if pure; 

Colorimetric, IMS, M8 paper, M9 paper, N/D 20 1,000 N/A 

Mustard) 

pure; dark oily geranium-like if not 

SAW, FTIR M256A1 CADK, 

liquid if not 

CAM/ICAM, MM1, 

JCAD 

L (Lewisite) Colorless to brown Variable, may Immediate burning to skin, 

Colorimetric, IMS, M9 paper, M256A1 N/D 20 1,000 N/A 

liquid 

resemble 

eye irritation 

FTIR 

CADK, M21 ACAA, M22 

geraniums 

ACADA, M272 Water 

Testing Kit, MM1, JCAD 

PD 

Colorless to yellow None 

Immediate irritation, delayed 

PID M18A2 CADK, M18A3 No toxicity estimates are N/A 

(Phenyldichloroarsi liquid 

blisters, lacrimation 

CADK, MMI 

available because data is 

ne) 

lacking 

MD 

Colorless liquid Fruity, but biting; 

No toxicity estimates are N/A 

(Methyldichloroarsi 

irritating 


ne) 

lacking 

ED 

Colorless to yellow Extremely irritating; 


(Ethyldichloroarsin liquid 

none when pure 


e) 

lacking 

CX (Phosgene Colorless, 

Sharp, penetrating, Skin pain, irritation, tissue 

Colorimetric M256A1 CADK, M18A3 N/A N/A 3,200 N/A 

Oximedichloroforox crystalline, damp new-mown hay at damage; eye pain, 

CADK, M18A2 CADK, 

ime) 

solid when pure low concentrations conjunctivitis, inflammation 

MM1 

AC (Hydrogen Colorless gas Bitter almonds or Lacrimation, drooling, Protective mask; Colorimetric, PID M256A1 CADK, M272 55 N/A 2,860 5 

Cyanide) 

peach kernels pulmonary edema protective IMS, E-Chem water testing kit, M18A2 

clothing if 

CADK, M18A3 CADK, 

liquefied 

MMI, JCAD 

CK (Cyanogen Colorless liquid Lachrymatory and 

Protective mask Colorimetric, PID, 


Chloride) 

irritating 

IMS 


lacking 

CG (Phosgene) Readily liquefied Musty hay or Lacrimation, drooling, Protective mask Colorimetric, PID, M18A2 CADK, MM1 8 N/A 1,500 4 

colorless gas rotting fruit pulmonary edema 

IMS, SAW, E- 

Chem 

PS (Chloropicrin) Oily clear liquid Lachrymatory and Eye, skin irritation; Protective mask PID, colorimetric JCAD* 13.4 250 97.5 (rat) N/L 

irritating 

nausea/vomiting, 

diarrhea; abnormal 

cardiac rhythm; 

respiratory distress 

and clothing GC/MS 

(rat) 

CN 

Solid Apple blossoms Burning and irritation to Protective mask; IMS None Listed 

15 50 8,500 N/A 

(Chloroacetopheno 

eyes, irritated skin clothing secured 

(rats) 

ne) 

at wrists, neck, 

ankles 

Pepper 

IMS 

2 178 52,000 - N/A 

(rat) 61,000 

Incapacitating 

Agents 

Respiratory Irritant Agents 

(formerly known as 

Vomiting Agents) 

BZ (3-quinuclidinyl 

benzilate) 

White crystalline 

solid 

DA 

Colorless 

(Diphenylchloroarsi crystalline solid 

ne) 

when pure 

DM 

Yellow to green 

(Diphenylaminechl crystalline solid 

oroarsine) 

DC 

Colorless 

(Diphenylcyanoarsi crystalline solid 

ne) 

None Blurred vision, dilated Protective mask 

pupils, hallucinations, dry and clothing 

mouth, flushed face 

None Vomiting, mucous 

membrane irritation, 

coughing, salivation, 

nasal discharge 

Protective mask 

None, but irritating Vomiting, eye irritation, 

burning and tightening of 

chest 

Bitter almond-garlic Vomiting, nose/throat 

mixture 

irritation, salivation, 

profuse eye/nose secretions; 

feeling of suffocation 

and headache 

N/A MMI No toxicity estimates are 


lacking 

IMS JCAD* No toxicity estimates are 


lacking 

NA NA N/A N/A 11,000 N/A 

IMS JCAD* No toxicity estimates are 


lacking 

Original 127 

N/A 

N/A 

N/A 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



Agent 

c 

a, b Chemical Agent 

Type 

Industrial Chemicals 

Ammonia (NH3) 

Ammonium Nitrate 

(NH4NO3) 

State at 

20 ºC d 

Colorless gas, 

shipped as 

compressed liquid 

Odor e Signs and Symptoms f 

Pungent, 

suffocating odor 

Transparent Odorless 

crystalline or white 

granule solid 

Benzene (C6H6) Colorless to lightyellow 

liquid 

Chlorine (Cl2) Greenish-yellow 

gas 

Ethylene (C2H4) Colorless gas 

Ethylene dichloride 

(C2H4Cl2) 


PPE g 

Coughing, wheezing, Protective mask 

irritated or burning eyes, and clothing 

pulmonary edema, skin 

burns 

Civilian Detection 

Equipment h 

Colorimetric, PID 

IMS, E-Chem 

N/A N/A Colormetric, IMS, 

Raman, FTIR 

Aromatic Irritated eyes, shortness Protective mask 

of breath, headache, and clothing 

nausea, irritated mucous 

membranes 

Pungent, 

suffocating odor 

Burning of eyes, nose, 

mouth, lacrimation, 

coughing, nausea, 

vomiting, pulmonary 

edema, frostbite 

Faintly sweet Drowsiness, dizziness, 

asphyxia, 

unconsciousness 

Pleasant, like 

chloroform 

Irritated eyes, opaque 

corneas, nausea, 

vomiting 


and clothing 


and clothing 


and clothing 


E-Chem 


E-Chem 


E-Chem 

Military Detection 

Equipment i 

IDLH j LD50 k LCt50 l STEL m 

N/A 210 43 

mg/kg 

5,000 ppm 27 

FIDO, SABRE 4000 2,217 

(rat) 

128 Original 

N/A 

JCAD* 1,595 N/A N/A 8 

JCAD 29 N/A N/R 3 

N/A D/U N/A ~1,090,000 

(mice) 

PID, colormetric N/A 45 670 

(rat) 

N/A 2 

Phosphoric acid Colorless liquid Odorless Irritation to eyes, skin, Protective mask NA N/A 1,000 1,250 25.5 (rat) 3 

(H3PO4) 

upper respiratory system, and clothing 

burns to eyes or skin 

(rat) 

Propylene, AKA Colorless gas, Petroleum-like Asphyxia, decrease in Protective mask Colormetric, PID N/A D/U N/A N/A N/A 

Propene (C3H6) shipped as 

pain, dizziness, and clothing 

compressed liquid 

drowsiness; skin burns in 

contact with liquid 

Sodium hydroxide Colorless to white Odorless Irritation to eyes, skin, Protective mask N/A N/A 10 > 90 N/A N/A 

(NaOH) 

solid, or in 

mucous membranes; and clothing 

mg/kg 

colorless solution 

burns to eyes or skin 

(rat) 

Sulfuric acid Colorless to dark Odorless Irritation to eyes, skin, Protective mask Colormetric N/A 15 2,140 510 (rat) 3 

(H2SO4) 

brown, oily liquid 

nose, throat; pulmonary 

edema, burns to eyes or 

skin 

and clothing 

(rat) 

a. Abbreviations Used in Table. Not Applicable (N/A), Not Determined (N/D), Not Listed (N/L), Not Recorded (N/R), Data 

Unavailable (D/U) 

b. Agent Type. Type of chemical agent. 

c. Chemical Agent. Common or chemical name (Military abbreviation). 

d. State at 20ºC. Physical characteristics at 20ºC. 

e. Odor. The property or quality of a substance that affects, stimulates, or is perceived by the sense of smell. 

f. Signs and Symptoms. Information related by an individual about himself/herself that may indicate illness or injury. Signs 

or observations are made about an individual or an animal that may indicate illness or injury. 79 

g. PPE. Recommended personal protective equipment to protect a responder from the agent. 

h. Civilian Detection Technologies. Technologies commonly available to civilian emergency responders that can detect this 

particular agent. 

i. Military Detection Technologies. Equipment that is commonly available to military personnel that can detect this 

particular agent. 

j. IDLH. Immediately dangerous to life and health value in mg/m 3 . 

k. LD50. Dose that is lethal to 50% of the exposed population in mg/70 kg person. 

l. LCt50. Concentration that is lethal to 50% of the exposed population in mg/m 3 for 1 minute 

m. STEL. Short term exposure limit that is the concentration in mg/m 3 to which workers can be exposed continuously for a 

short period of time without suffering from: (1) irritation, (2) chronic or irreversible tissue damage, or (3) narcosis of 

sufficient degree to increase the likelihood of accidental injury, impair self-rescue, or materially reduce work efficiency, 

provided that the daily time-weighted average (TWA) is not exceeded. The TWA concentration for a normal 8-hour workday 

and a 40-hour workweek, to which nearly all workers may be repeatedly exposed, day after day, without adverse effect. 79 

E.2. Biological Materials 

Table 19 shows different properties of various biological agents, adapted from Field 

Manual 3-11.9. 33 Note that lethality (that is, the ability to cause death) and stability 

information is based on studies of natural, widespread strains of these agents. The 

lethality and/or stability of some agents can be changed through various laboratory 

alterations and/or the use of stabilizing chemicals. 

Note that these symptoms take days to weeks to be noticed. A covert biological 

release will probably not require MCD because it will be detected through the public 

health system. In such a situation, a public health official should advise those who 

have been potentially exposed to thoroughly shower at home with soap and water. 14 

N/A

Table 19: Biological Agent Properties. 

Biological 

Agents 

Dissemination 

Methods 



Transmissibility Infectivity Lethality a Stability a 

Anthrax 

(Inhalation) 

Spores in aerosols None Moderate High 

Brucellosis Aerosol; sabotage 

(food supply) 

None High Low 

Cholera 

Sabotage 

(food/water supply); 

aerosol 

Negligible Low 

Moderate to 

High 

Spores are highly 

stable 

Long persistence in 

wet soil and food 

Unstable in aerosol 

and pure water; 

more so in polluted 

water 

Glanders Aerosol DNA b DNA DNA DNA 

Melioidosis Aerosol Negligible High Variable Stable 

Plague 

(Pneumonic) 

Aerosol; infected 

vectors 

High High Very high 

Less important 

because of high 

transmissibility 

Psittacosis Aerosol Negligible Moderate Very low Stable 

Shigellosis 

Sabotage 

DNA 

(food/water supply) 

DNA DNA DNA 

Tularemia Aerosol Negligible High 

Moderate if 

untreated 

Not very stable 

Typhoid Fever 

Sabotage 

(food/water supply); Negligible 

aerosol 

Moderate 

Moderate if 

untreated 

Unknown 

Q Fever 

Aerosol; sabotage 

(food supply) 

None High Very low Stable 

Rocky Mountain 

Spotted Fever 


vectors 

None High High Not very stable 

Trench Fever 


vectors 

None DNA Low DNA 

Typhus Fever 


vectors 

None High High Not very stable 

Chikungunya Aerosol None High Very low Relatively stable 

Crimean-Congo 

Hemorrhagic 

Fever 

Aerosol Moderate High High 

Relatively stable 

Dengue Fever Aerosol None High Low Relatively unstable 

Eastern Equine 

Encephalitis 

Aerosol None High High Relatively unstable 

Western Equine 

Encephalitis 

Aerosol None High Low Relatively unstable 

Ebola Fever 

Far Eastern Tick- 

Aerosol Moderate High High Relatively unstable 

borne 

Encephalitis 

Hantaan Virus 

Aerosol; milk None High Moderate Relatively unstable 

[Korean human 

foamy virus 

Juinn 

Aerosol None High Moderate Relatively stable 

Hemorrhagic 

Fever 

Aerosol DNA DNA DNA DNA 

Original 129 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



Biological 

Agents 

Dissemination 

Methods 

Transmissibility Infectivity Lethality a Stability a 

Machuo 

Hemorrhagic 

Fever 

Aerosol DNA DNA DNA DNA 

Lassa Fever Aerosol Low to moderate High Unknown Relatively stable 

Lymphocytic 

Aerosol 

Choriomeningitis 

None DNA Low DNA 

Monkeypox Aerosol DNA Unknown Unknown Unknown 

Rift Valley Fever Aerosol; infected 

vectors 

Low High Low Relatively stable 

Smallpox Aerosol High High High Stable 

Venezuelan 

Equine 

Encephalitis 


vectors 

Low High Low Relatively unstable 

Yellow Fever Aerosol 

Sabotage 

None High High Relatively unstable 

Botulinum Toxin 

Clostridium 

(food/water supply); None 

aerosol 

N/A High Stable 

Perfringens 

Toxins 

Sabotage; aerosol None N/A Low Stable 

Conotoxins 


(food supply) 

None N/A High DNA 

Shigatoxins 


(food supply) 

DNA N/A DNA DNA 

Microcystin 


(food supply) 

None N/A DNA DNA 

Ricin Aerosol None N/A High Stable 

Saxitoxin Sabotage; aerosol None N/A High Stable 

Staphylococcal 

Enterotoxin B 

Aerosol; sabotage None N/A Low Stable 

Tetrodotoxin Sabotage; aerosol None N/A High Stable 

Trichothecene 

Mycotoxins 

Aerosol None N/A High Stable 

a. Lethality and stability information is based on studies of natural, endemic strains of these agents. There is 

potential that the lethality and/or stability of some agents may be changed through various laboratory 

alterations and/or the use of stabilizing chemicals. 

b. DNA – Deoxyribonucleic acid. 

E.3. Radiological Materials 

Radiological exposure can be either chronic or acute. Chronic exposure occurs over 

an extended period of time and slowly causes symptoms to appear. Some possible 

delayed consequences of radiation injury could include: 57 

• Shorter life 

• Cancer 

• Cataract formation 

• Radiodermatitis 

• Decreased fertility 

• Genetic mutations 

The effects of a radiological dispersal device or radiation emitting device depend on 

the nature of the device and the method of deployment. A point source of radiation 

130 Original



produces physical injury only to those persons within its immediate vicinity. If the 

device was explosive, traditional blast injuries may be observed. Physiological 

symptoms from short-term exposure to radiation are listed in Table 20, taken from 

Field Manual 3-11.3. 57 

Table 20: Radiological Exposure and Symptomology Chart. 

Total Dose 

Estimate 

(cGy) 

Symptoms 

US baseline 20% lifetime risk of 



Total Dose 

Estimate 

(cGy) 

830 - 3,000+ 

LD90 - LD100 

Symptoms 

Severe nausea, vomiting, 

fatigability, weakness, dizziness, 

disorientation, possible high fever, 

and sudden vascular collapse 

Initial 

Symptoms 

Interval a 

Disposition 

Without 

Medical Care 

Medical Care 

Requirement 

Onset End 



Appendix F – MCD Decision Tree Matrices and Easy 

Reference Checklists 

Figure 6: Decision Tree Matrix of the Overall MCD Process, including Gross, Mass, Technical, 

and Fatality Decontamination Lines. 

Original 133 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



Figure 9: Decision Tree Matrix for Gross Decontamination Operations. 

134 Original



Gross Decontamination Execution Checklist 

� Direct those casualties who can walk to move to a certain area, initiating triage. 

� Provide an initial decontamination using a fire hose or other field expedient 

method. 

� Instruct casualties to remove at least their outermost later of clothing. 

� Construct an EDCS or LPS, using a high-volume, low-pressure (approximately 

40 to 60 pounds per square inch) water shower. 

� Establish and initiate a method for collecting and tracking personal effects (for 

example, bag labeled with casualty name/number). 

� Instruct ambulatory casualties to move through the EDCS, based on operational 

priorities. No decontaminants should be added to the water flowing from the fire 

trucks. 

� DO NOT process casualties through an EDCS or LPS who are unable to protect 

their own airways. 

� Using short, concise, and common language, instruct casualties to: 

� Tilt their heads backward. 

� Raise their arms and spread their legs to wash armpits and groin. 

� Proceed slowly. 

� Turn occasionally, ensuring a complete turn occurs. 

� Provide casualties with some sort of redress material for warmth and modesty. 

� Perform an assessment to identify those casualties who are a higher priority for 

secondary decontamination. 

� If a secondary Mass Decontamination Line is not yet established: 

� Identify those who have been decontaminated, such as with a tag. 

� Segregate symptomatic casualties for additional treatment or 

decontamination as needed. 

� Send non-symptomatic casualties to observation areas. 

� If a secondary Mass Decontamination Line is ready, direct casualties into that 

system based on the triage. 

� After exiting a Decontamination Line, perform monitoring with an appropriate 

detector to verify decontamination is complete. 

Original 135 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



Figure 11: Decision Tree Matrix for Ambulatory and Nonambulatory Mass Decontamination 

Operations. 

136 Original



Ambulatory Mass Decontamination Execution Checklist 

� Direct those casualties who can walk to move to a certain area, initiating triage. 

� If not already accomplished, instruct casualties to remove at least their 

outermost later of clothing. 

� Establish and initiate a method for collecting and tracking personal effects (for 

example, bag labeled with casualty name/number). 

� Instruct ambulatory casualties to move through the decontamination line, based 

on operational priorities. Wash time should be between 30 seconds and 3 

minutes. 

� Using short, concise, and common language, instruct casualties to: 

� Tilt their heads backward. 

� Raise their arms and spread their legs to wash armpits and groin. 

� Proceed slowly. 

� Turn 90 degrees (1/4 turn) occasionally, ensuring a complete turn occurs. 

� DO NOT scrub the skin if liquid chemicals are suspected. 

� This could cause abrasions that could allow the chemicals to enter 

the body. 

� Without the use of soap, this may also spread oily contaminants to 

other parts of the body. 

� Casualties should use their hands or a known clean cloth or sponge to 

gently rub their skin in an attempt to aid the decontamination process. 

� Washing should begin at the head and progress to the feet 

� Provide casualties with some sort of redress material for warmth and modesty. 




� Segregate symptomatic casualties for additional treatment or decontamination 

as needed. 

� Send non-symptomatic casualties to observation areas. 

Original 137 

Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



Nonambulatory Mass Decontamination Execution Checklist 

� Have responders don appropriate PPE. 

� Upon making entry into the hot zone, triage all casualties for extraction. 

� Using appropriate extraction equipment and proper lifting technique, remove 

nonambulatory casualties in accordance with the priorities established in triage. 

� Perform an initial gross decontamination using a fire hose, taking care to protect 

the casualty’s airway from a deluge of water. 

� Deliver the casualty to the nonambulatory decontamination line, keeping them 

on the device used for extraction. 

� Cut away all clothing, removing it in such a way to reduce spreading 


� Use a method for collecting and tracking personal effects (for example, bag 

labeled with casualty name/number). 

� Using soap and a brush, wash the casualty from top down and from the head to 

the feet. 

� Use an appropriate number of responders to log roll the casualty so their back 

can be decontaminated. 

� After rinsing, move the casualty to a clean board for removal from the 



� Cover the casualty with a blanket for warmth and modesty. 



� Triage based on injuries, and segregate appropriately for treatment and/or 

transport. 

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Figure 15: Decision Tree Matrix for Technical Decontamination Operations. 

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Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



Technical Decontamination Execution Checklist 

� Verify technical decontamination station ready to receive personnel. 

� Establish equipment drop station at the boundary of the hot zone. 

� Surrender any collected evidence or equipment used in the hot zone at the 

equipment drop station. 

� Generate/use a chain of custody form for evidence. 

� Proceed through shuffle pit, if it has been established. 

� Proceed through gross decontamination shower. 

� Proceed to wash station to remove decontamination from suit and boots. 

� Proceed to rinse station where suit and boots are rinsed. 

� Monitor responder to ensure contamination has been removed. 

� If contamination is found, return to wash station. 

� Remove upper outer layer of PPE, taking measures to reduce crosscontamination. 

� Sit on bench/chair to while removing the lower outer layer of PPE and boots. 

� Shift body 180º out of the liquid control line following removal of PPE. 

� Move to vapor control line. 

� Remove respiratory protection. 

� Remove inner gloves. 

� Move to shower station. 

� Remove clothing and proceeds to wash with water, soap, and shampoo. 

� Redresses. 

� Monitor responder to ensure contamination has been removed. 

� If contamination is found, return to wash station. 

� Move to cold zone for medical monitoring. 

� Proceed to rehabilitation area for further instructions following clearance from 

medical monitoring. 

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General Rules for Cold Weather Decontamination 

� If contamination is suspected, casualties MUST be decontaminated, regardless 

of outdoor temperatures. 

� Remove clothing outdoors. 

� If temperatures are




142 Original



Appendix G – USARNORTH MCD Operational 

Requirements and External Evaluation 

Standards 

Establish a CBRN Incident Response Operations Center 

1. ____ Commander receives mission, conducts mission analysis and develops 

courses of action by establishing areas of responsibilities between the 

Command and Operations sections. 

2. ____ Advance Party conducts preparations to establish an area of operations. 

a. ____ Conducts initial meeting with the Incident Commander, in order 

to determine mission requirements and gather information to 

initiate intelligence preparations of the battlefield, (IPB). 

b. ____ Provides initial briefing to the Commander. 

c. ____ Identifies location to establish decontamination, 

reconnaissance, search & extraction sites, and area of 

operation. 

d. ____ Prepares site occupation plan. 

e. ____ Emplace early warning detection devices and other equipment if 

available and if hazard is known. 

f. ____ Prepares safety plan for integration into the Incident Command 

System safety plan. 

3. ____ Operations section establishes and supervises the operation center. 

a. ____ Supervises the preparation of the staff actions. 

b. ____ Supervises and approves the updated site safety plan no later 

than one hour after the arrival at the incident site. 

c. ____ Inspects all the actions for conformity in accordance with 

commander's or Incidence Commander's guidance. 

d. ____ Coordinates the assigned missions with the section leaders. 

e. ____ Coordinates the site characterization and verifies that the 

elements operational area was free of contamination. 

4. ____ Operations section verifies site setup and operations of support function. 

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Table of 

Contents 

Introduction MCD Equipment Decontamination 

Comparison Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



a. ____ Establishes communication. 

b. ____ Conducts pre and post medical screening. 

c. ____ Sets up a technical decontamination line. 

d. ____ Initiates the administrative log. 

5. ____ Operations section exchanges information with other elements at the 

incident site. 

a. ____ Translates pertinent information into usable data for decision 

making. 

b. ____ Coordinates information exchange internally and externally. 

c. ____ Provides situation reports (SITREPs) to the Incident 

Commander. 

6. ____ Operations section supervises the activities of the reconnaissance, 

decontamination, search and extraction, and medical elements. 

a. ____ Issues the Commander's or Incident Commander's guidance to 

the unit. 

b. ____ Assigns specific tasks to the subordinate sections (operations, 

safety, liaison, etc). 

c. ____ Monitors the performance of the subordinate sections. 

d. ____ Monitors the effectiveness of the support plans. 

7. ____ Operations section advises the Incident Commander on the appropriate 

responses to a CBRNE incident. 

8. ____ Commander establishes the appropriate protective posture. 

a. ____ Requires that all personnel, on order, establish a minimum level 

of protective posture. 

b. ____ Conducts internal and external communications checks on the 

assigned equipment. 

9. ____ Operations section conducts mission tracking. 

a. ____ Coordinates follow-on meetings through liaison with the Incident 

Commander. 

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b. ____ Updates the commander's critical information requirements 

(CCIR) information from the liaison officer or the Incident 

Commander. 

c. ____ cInitiates an incident log. 

d. ____ Posts a situation map sketch and all available intelligence. 

e. ____ Establishes report control and information-management 

procedures. 

f. ____ Prepares the initial survey, site safety, and force protection 

plans. 

10. ____ Commander establishes a Liaison Officer to provide information between 

the Operations Center and the Incident Command Post. 

11. ____ Liaison Officer conducts military support operations. 

a. ____ Maintains liaison with the Incident Command Post according to 

the liaison task. 

b. ____ Coordinates and assist the Department of Defense, (DOD) 

response elements integration into the Incident Commander's 

incident response plan. 

c. ____ Provides public affairs information, as required. 

12. ____ Liaison Officer provides the operations center personnel with an updated 

situation report within one hour of the main body arriving on the site and 

the start of operations. 

a. ____ Updates the CCIR information. 

b. ____ Provides the status of communications with civilian response 

agencies. 

c. ____ Provides the status of the first responder's surveys to date. 

d. ____ Provides the status of the site safety plan. 

e. ____ Provides the status of force protection (protective posture level). 

f. ____ Provides the status of medical screening baseline checks. 

13. ____ Operations section supports the Incident Commander's action plan. 

a. ____ Conducts mission planning and mission analysis. 

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Table of 

Contents 




Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



(1) ____ Develops site characterization and the safety plan. 

(2) ____ Develops objectives to support the Incident 

Commander's action plan. 

(3) ____ Develops specific objectives for the survey team. 

(4) ____ Synchronizes the Incident Commander's critical 

information requirements. 

b. ____ Maintains communication and reporting procedures. 

c. ____ Monitors and adjusts the detachment's response plan. 

(1) ____ Updates the incident safety plan. 

(2) ____ Refines operational objective for follow-on survey 

teams. 

(3) ____ Maintains the incident log and staff journal. 

(4) ____ Updates the situation map or sketch and the 

information display. 

(5) ____ Updates modeling according to the assessment task. 

d. ____ Plans and monitors logistical requirements. 

e. ____ Advises the commander on the current situation and proposed 

courses of action. 

f. ____ Disseminates the approved survey, site safety, and logistics 

support plans. 

g. ____ Authorizes entry and monitors the survey team incident site 

operations. 

h. ____ Provides assessments to the Incident Commander. 

14. ____ Operations section processes a confirmatory sample for shipment. 

15. ____ Operation section plans for follow-up operations. 

a. ____ Plans for transition or hand-off operations and procedures. 

b. ____ Coordinates and executes transition or hand-off operations, (exit 

strategy). 

16. ____ Operation section prepares to redeploy the element. 

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a. ____ Submits all the reports before departure from the incident site. 

b. ____ Coordinates debriefing by the Incident Commander before 

termination. 

Establish Mass Casualty Decontamination Site 

1. ____ Element leader receives and analyzes the mission. 

a. ____ Determines support requirements. 

b. ____ Determines mission sustainment requirements for personnel 

and equipment. 

c. ____ Coordinates for medical, force protection and security support. 

d. ____ Coordinates for logistical and resupply support. 

e. ____ Coordinates additional lighting for limited visibility. 

f. ____ Configures equipment based on updated mission statement. 

2. ____ Element sets up the hazardous waste site in the proposed Hot Zone. 

NOTE: The operations center determines the location of the hazardous waste 

site. Coordinates the hazardous waste disposal plan and whether 

contaminated liquid collection or runoff is authorized. 

a. ____ Determines the direction the contaminated liquid will flow. 

b. ____ Positions hazardous waste collection equipment at least 50 

meters from the decontamination site. 

c. ____ Places protective sheeting over the ground. 

d. ____ Prepares and clearly marks the hazardous waste collection 

points. 

e. ____ Positions hazardous waste receptacles at the stations that 

require them. 

f. ____ Marks drainage line(s) as "contaminated waste". 

g. ____ Marks the perimeter if collecting contaminated liquid into an 

open site. 

h. ____ Performs the following procedures if contaminated liquid is not 

contained: 

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Table of 

Contents 




Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



(1) ____ Determines the route contaminated liquid will run. 

(2) ____ Clearly marks the corridor the contaminated liquid will 

run. 

(3) ____ Conducts ditching or damming divert procedures to 

route the contaminated liquid to the appropriate 

location. 

(4) ____ Avoids routes that require personnel to step over the 

contaminated liquid. 

3. ____ Element sets up the following as part of the designated Warm Zone: 

NOTE: The decontamination site may be configured in one, two or three lanes 

according to mission requirements. The Decontamination shower tents are 

constructed first based on site layout. The number of stations and personnel 

required will vary depending on the factors such as the number and type of 

injuries, agent used and weather. 

a. ____ Station 1. Casualty collection point to include: 

(1) ____ Triage and stabilization. 

(2) ____ Emergency Medical treatment area. 

b. ____ Station 2. Self/Emergency decontamination. 

NOTE: Emergency decontamination procedures are conducted by medical 

personnel (for open wounds, burns and wet down) prior to casualties 

processing through the mass casualty decontamination corridor. 

c. ____ Station 3. Clothing and personal items removal (ambulatory 

and non-ambulatory). 

d. ____ Station 4. Contaminate removal and shower (ambulatory and 

non-ambulatory). 

e. ____ Station 5. Monitoring point (ambulatory and non-ambulatory). 

NOTE: Personal property, equipment and technical decontamination sites are 

established adjacent to the ambulatory and non-ambulatory casualty 

decontamination lanes. 

4. ____ Element sets up the following as part of the designated Cold Zone: 

a. ____ Station 6. Redress area for ambulatory and non-ambulatory. 

b. ____ Station 7. Patient disposition. 

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Point -- The following is part of station 7: 

(1) ____ Medical holding area. 

(2) ____ Triage and stabilization. 

(3) ____ Log-in and log-out stations. 



(4) ____ Casualty movement/transportation site. 

5. ____ Element ensures the following is set up in the cold zone in support of the 

decontamination site: 

a. ____ Power generation and water station. 

b. ____ Command and control center. 

c. ____ Administration and logistics site. 

d. ____ Resupply and reconstitution site. 

e. ____ Rest areas. 

6. ____ Element establishes the casualty collection point. 

a. ____ Identifies ingress and egress to the collection point. 

b. ____ Prepares litters and litter dollies for use. 

c. ____ Establishes communications with operation center. 

d. ____ Prepares spray bottles or pressure sprayers for radiation or 

biological contamination. 

e. ____ Prepares decontamination/rinse solution and containers. 

7. ____ Element establishes the triage and emergency treatment station. 

NOTE: Medical personnel perform triage and emergency treatment. The 

decontamination element will assist at the station. 

a. ____ Identifies the location for expectant, immediate, delayed and 

minimal casualties. 

b. ____ Identifies four patient condition locations for the medical 

treatment station. 

c. ____ Contains litters, litter stands and waste containers. 

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Table of 

Contents 




Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



d. ____ Establishes an equipment storage site to handle multiple 

casualties. 

e. ____ Identifies litter and contaminated litter locations. 

NOTE: If rollers are not available, two wheel dollies are prepared for use. 

8. ____ Element establishes the non-ambulatory clothing and personal items 

removal station, as required. 

a. ____ Places protective sheeting over the ground for undress tent. 

b. ____ Erects the non-ambulatory undress tent with lighting. 

c. ____ Prepares containers to hold decontamination/rinse solution and 

contaminated clothing. 

d. ____ Prepares roller system. 

NOTE: Prepares litter on stands or saw horses if rollers are not available. 

e. ____ Installs light set. 

f. ____ Ensures station is equipped with cutting tool or scissors. 

g. ____ Ensures station is equipped with a radio. 

9. ____ Element establishes ambulatory clothing and personal items removal 

station, as required. 

a. ____ Places protective sheeting over the ground for undress tent. 

b. ____ Erects the ambulatory undress tent with lighting. 

c. ____ Establishes partition wall to separate male and female 

personnel. 

d. ____ Prepares saw horses or handrail stands. 

e. ____ Prepares decontamination/rinse solution and containers. 

NOTE: The waste containers are set outside of the undress tent to hold the 

contaminated clothing. 

10. ____ Element establishes the ambulatory and non-ambulatory decontamination 

shelters. 

a. ____ Places protective sheeting over the ground where the shelter 

will be set up. 

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b. ____ Emplaces the containment berms and pumps to capture 

contaminated liquid waste. 

c. ____ Erects decontamination shelters. 

d. ____ Establishes the non-ambulatory roller system from entrance to 

exit of the shelter. 

e. ____ Installs and secures floor pallets. 

f. ____ Installs lane divider for male and female entrance. 

g. ____ Prepares decontamination/rinse solution and containers. 

h. ____ Installs light set. 

NOTE: Contaminated wastewater is pumped directly from the decontamination 

shelter into the contaminated waste water container. 'The drainage lines and 

containers are clearly marked "contaminated waste." The contaminated waste 

site is located 50 meters from the entrance of the decontamination line in the 

hot zone. 

11. ____ Element establishes the shower system for ambulatory and nonambulatory 

decontamination station. 

a. ____ Installs shower system to provide decontamination and rinse 

solution. 

b. ____ Installs male and female dividers in ambulatory tent. 

c. ____ Connects shower apparatus to water and decontamination 

delivery systems. 

d. ____ Connects wands for non-ambulatory decontamination auxiliary 

ports of the decontamination apparatus located in the Cold 

Zone. 

e. ____ Ambulatory decontamination station contains the following: 

(1) ____ Backboards. 

(2) ____ Sponges. 

(3) ____ Decontamination and rinse solution. 

f. ____ Non-ambulatory decontamination station contains the following: 

(1) ____ Sponges. 

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Table of 

Contents 




Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



(2) ____ Cutting tools. 

(3) ____ Contaminated waste containers with liners. 

(4) ____ Brushes. 

(5) ____ Prepares decontamination/rinse solution and 

containers. 

g. ____ Tests shower system. 

12. ____ Element establishes the male and female ambulatory monitoring stations. 

NOTE: Ensure there is at least 20 feet between the decontamination tent and 

the redress tent. 

a. ____ Emplaces monitoring equipment adjacent to Cold Zone. 

b. ____ Places protective sheeting over the ground in the monitoring 

area. 

c. ____ Places containers with absorption pads next to the liquid 

controls line. 

d. ____ Prepares decontamination/rinse solution and containers 

e. ____ Identifies the liquid and vapor control lines. 

f. ____ Establishes the liquid and vapor control line. 

g. ____ Emplaces chemical agent alarm to monitor the vapor control 

line. 

h. ____ Installs dividers between male and female area and lanes. 

i. ____ Prepares handrails or sawhorses. 

j. ____ Installs lighting. 

13. ____ Element establishes the non-ambulatory monitoring station. 

a. ____ Positions roller system. 

NOTE: If rollers are not available, prepare litter on stands or sawhorses. 

b. ____ Prepares monitoring equipment adjacent to the Cold Zone. 

c. ____ Installs dividers between male and female area and lanes. 

152 Original



d. ____ Places protective sheeting over the ground in the monitoring 

area. 

e. ____ Identifies the liquid and vapor control lines. 

f. ____ Establishes the liquid and vapor control line. 

g. ____ Places containers with absorption pads next to the liquid 

controls line. 

h. ____ Prepares decontamination/rinse solution and containers. 

i. ____ Emplaces the chemical agent alarm to monitor the vapor control 

line. 

j. ____ Installs lighting. 

14. ____ Element establishes the equipment and property decontamination station. 

a. ____ Protects the ground from contamination at the decontamination 

b. ____ Prepares the neutralization station. 

c. ____ Prepares the equipment/property wait time station. 

d. ____ Prepares equipment/property rinse station. 

e. ____ Prepares monitoring equipment for the contaminated check 

station. 

f. ____ Emplaces containers for solid waste and personal effects items. 

g. ____ Emplaces chemical agent alarm at vapor control line. 

h. ____ Positions station parallel and adjacent to the casualty 


i. ____ Identifies personal effects collection station. 

15. ____ Element establishes the technical decontamination site. 

NOTE: The number of stations required for technical decontamination will vary 

depending on factors such as the type of agent and the weather. Personnel 

will perform technical decontamination in the wash and rinse stations not 

used in the non-ambulatory decontamination tent if a separate technical 

decontamination station is not established. 

a. ____ Prepares containers for equipment drop. 

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Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



b. ____ Prepares personal protective equipment decontamination 

station. 

c. ____ Prepares portable sprayer for suit decontamination. 

d. ____ Establishes monitoring point. 

e. ____ Establishes the protective clothing removal station. 

f. ____ Establishes the clothing/respirator removal station. 

g. ____ Places containers with absorption pads next to the liquid control 

line. 

16. ____ Element establishes the ambulatory redress area. 

a. ____ Places protective sheeting over the ground for redress tent. 

b. ____ Erects the ambulatory redress tent. 

c. ____ Establishes partition wall to separate male and female 

personnel. 

d. ____ Installs the light set. 

e. ____ Emplaces the heater system. 

f. ____ Ensures station contains temporary clothing or blankets to cover 

casualties. 

17. ____ Element establishes the non-ambulatory redress area. 

a. ____ Places protective sheeting over the ground for redress tent. 

b. ____ Erects the non-ambulatory redress tent. 

c. ____ Prepares rollers, or litters and stands. 

d. ____ Installs light set. 

e. ____ Ensures station contains temporary clothing or blankets to cover 

casualty. 

18. ____ Element establishes the power and water stations. 

a. ____ Emplaces flash heaters. 

b. ____ Emplaces generator(s). 

154 Original

c. ____ Installs plumbing for decontamination site. 



19. ____ Element personnel establish the patient holding, triage and stabilization 

stations. 

a. ____ Erects treatment and triage tents. 

b. ____ Establishes communication with medical operations. 

c. ____ Identifies locations for expectant, immediate, delayed and 

minimal casualties. 

d. ____ Places medical equipment sets in designated tents to handle 

multiple casualties. 

NOTE: Coordination is made for casualty movement or transportation to a 

medical facility. Casualties are moved to the log-in and log-out stations for 

pick up. 

20. ____ Element personnel establishes the patient log-in and log-out patient 

disposition point. 

a. ____ Sets up table and chairs for casualties. 

b. ____ Establishes communication with undress tents and operations 

center. 

c. ____ Prepares log-in and log-out sheets for casualty accountability. 

21. ____ Element safety officer inspects and certifies the decontamination site is 

ready for operations prior to the Safety Officer's inspection. 

Conduct Ambulatory Casualty Decontamination 

1. ____ Element processes casualties through separate male and female clothing 

and personal items removal stations. 

NOTE: Personal belongings are placed in containers with patient clothing 

unless directed by the Incident Commander to collect and decontaminate. 

Attention is paid to modesty issues. 

a. ____ Instructs casualties on clothing and personal items removal. 

NOTE: Casualty stands in plastic bag and removes their own clothing and 

personal belongings. Generally, ambulatory casualties can remove their 

clothing without assistance. Provide assistance only if needed. 

b. ____ Cuts clothing with cutting devise (scissors or safety knife) if 

required decontaminates devise to avoid cross contamination. 

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Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



NOTE: Pressure bandages and splints are not removed. Clothing is cut around 

them and any material under the bandage or splint is left in place. Cutting 

device is then decontaminated and rinsed. 

c. ____ Consolidates contaminated clothing and personal items in 

container. 

d. ____ Transports contaminated clothing and personal items to 

contaminated waste containers. 

2. ____ Element processes the casualties through separate male and female 

decontamination stations. 

a. ____ Directs casualties on decontamination procedures. 

b. ____ Centers the casualties in decontamination shower with hands 

and arms raised to allow water flow to all part of the body. 

c. ____ Directs upper nozzles to the head and side sprayers to the 

sheltered portions of the body. 

d. ____ Discontinues the flow of decontamination solution once 

casualties are decontaminated. 

e. ____ Directs casualties to the rinse station. 

NOTE: If a casualty develops complications during the decontamination 

process, the station operator will stop the flow of decontamination or rinse 

solution. The station operator will summons medical aid. The casualty is 

moved away from the contaminated water. Medical personnel will dictate if the 

casualty either continues the decontamination process or is reclassified as a 

non-ambulatory casualty. 

3. ____ Element processes the casualties through separate male and female rinse 

stations. 

a. ____ Instructs the casualties on the rinse procedures. 

b. ____ Places casualties in the center of the shower with hands and 

arms raised to allow water to flow to all parts of the body. 

c. ____ Directs upper nozzles to head and side sprayers to the 

sheltered portions of the body. 

d. ____ Discontinues the flow of rinse solution when casualties are 

thoroughly rinsed. 

e. ____ Directs the casualties to the monitoring station. 

156 Original



4. ____ Element processes casualties through separate male and female 

monitoring stations. 

NOTE: Utilize two types of monitoring -- continuous or periodic only. 

a. ____ Monitors casualties for contamination. 

b. ____ Reroutes the casualties back through the decontamination line if 

contamination is detected. 

5. ____ Element processes the casualties through separate male and female 

redress areas. 

a. ____ Issues temporary clothing to casualties. 

b. ____ Provide medical stabilization as required by medical personnel. 

c. ____ Assists casualties to the patient triage, stabilization, holding, 

and disposition point as required. 

6. ____ Medical element processes the casualties through the patient triage, 

stabilization, holding, and disposition point. 

a. ____ Treat, stabilize, and hold casualties until ready for transport. 

b. ____ Prepares log-in / log-out sheets for casualty accountability. 

c. ____ Log-in / log-out (track) casualties for departure. 

d. ____ Updates the operation center of the number of personnel 

processed. 

7. ____ Element leader is directed by higher headquarters (HQ) to close the site. 

NOTE: The element leader informs higher HQ or the Incident Commander 

when the last group of casualties has processed through the casualty 

collection point. Guidance is provided to station operators to begin closing 

the decontamination site starting from the casualty collection point. 

8. ____ Station operators consolidate all liquid and solid waste at each station. 

NOTE: Unit Standing Operating Procedure (SOP) will dictate what station 

operators will assist other stations in the site closure process. 

a. ____ Empties all buckets (contaminated liquid) into the waste 

containment berm. 

b. ____ Consolidates all solid contaminated waste in containers. 

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Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



c. ____ Transports monitoring equipment to the technical 

decontamination site. 

d. ____ Transports all expendable equipment and supplies to 

wash/rinse tent. 

9. ____ Station operators conduct a technical decontamination in the nonambulatory 

tent. 


depending on factors such as the type of agent and the weather. 

a. ____ Conducts equipment drop. 

b. ____ Instructs soldier to stand in a plastic bag. 

c. ____ Conducts personal protective equipment decontamination. 

d. ____ Conducts monitoring procedures. 

e. ____ Conducts protective clothing removal. 

f. ____ Conducts mask/respirator removal. 

10. ____ Monitoring station personnel will perform the following: 

a. ____ Disconnects the roller system at the edge of the vapor control. 

b. ____ Places roller system in the center of the wash tent. Line. 

c. ____ Cuts tarp at the vapor control line and places over equipment. 

d. ____ Clearly marks the tarp as hazardous waste. 

e. ____ Conducts decontamination procedures. 

f. ____ Closes or zips the non-ambulatory tent. 

g. ____ Exits to the monitoring area. 

11. ____ Element closes the technical decontamination site. 

a. ____ Decontaminates all sensitive equipment and secure items in a 

plastic bag. 

b. ____ Drains contaminated liquid waste into the berm. 

c. ____ Seals all waste containers containing personal protective 

equipment. 

158 Original



NOTE: Technical decontamination personnel will conduct the final check of 

the contaminated waste water blivit or container. Personnel will report the 

number of gallons of contaminated waste water in the container, and conduct 

a technical decontamination. 

12. ____ Element leader reports the following to higher HQ or Incident Commander: 

a. ____ Number of gallons of contaminated waste water left on site. 

b. ____ Amount (in pounds) of solid contaminated waste left on site. 

c. ____ All consumable and accountable property being left on site. 

Conduct Non-Ambulatory Casualty Decontamination 

1. ____ Element processes casualties through the clothing and personal items 

removal station. 

NOTE: If the casualty is unconscious, personal information is obtained from 

the casualty's personal belongings. This information is relayed to the log-in 

and log-out station. Personal belongings are placed in containers with the 

casualty's clothing unless directed by the Incident Commander to collect and 

decontaminate. 

a. ____ Litter transfer team transports casualties to the clothing and 

personal items removal station. 

b. ____ Places casualties "head first" on to the roller system. 

c. ____ Cuts clothing from casualties and rolls fabric back from exposed 

skin. 

d. ____ Decontaminates cutting device during the clothing removal 

process. 

NOTE: Decontaminate cutting device utilizing a 5% bleach solution after each 

cut. 

e. ____ Transports contaminated clothing and personal items to waste 

collection site. 

2. ____ Element processes casualties through the decontamination station. 

NOTE: If a casualty develops complications during the decontamination 

process, the station operator will stop the flow of decontamination or rinse 

solution. Roll the casualty on their side in case the casualty begins to vomit. 

Medical personnel will dictate if the casualty either continues the 

decontamination process or is evacuated to a medical treatment facility. 

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Table of 

Contents 




Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



a. ____ Instructs casualties on decontamination procedures. 

b. ____ Centers the casualties in decontamination shower. 

c. ____ Sprays or wipes casualties with decontamination solution. 

NOTE: The station operator must use caution not to obstruct breathing of the 

casualties during the decontamination and rinse process. 

d. ____ Raises or rolls the casualty’s upper body and wipes under side. 

e. ____ Removes contaminated clothing from litter. 

f. ____ Decontaminates the litter. 

g. ____ Raises or rolls casualty’s lower body and wipes under side. 

h. ____ Assists the casualties to the rinse station. 

3. ____ Element processes the casualties through the rinse station. 

a. ____ Instructs the casualties on decontamination procedures. 

b. ____ Centers the casualties in the rinse shower. 

c. ____ Sprays or wipes casualties with rinse solution. 

d. ____ Raises or rolls the casualty’s upper body and wipes under side. 

e. ____ Raises or rolls the casualty’s lower body and wipes under side. 

f. ____ Assists the casualties to the monitoring point. 

4. ____ Element processes casualties through the monitoring station. 

NOTE: Utilize two types of monitoring – continuous or periodic only 

a. ____ Monitors the casualties for contamination. 

b. ____ Reroutes the casualties back through the decontamination line if 

contamination is detected. 

5. ____ Element processes the casualties through the redress area. 

a. ____ Issues temporary clothing to cover casualties. 

b. ____ Provides medical stabilization as required by medical personnel. 

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c. ____ Assists non-ambulatory casualties to patient triage, stabilization, 

and disposition point. 

6. ____ Medical element processes the casualties through the patient triage, 

stabilization, and disposition point. 

a. ____ Treat, stabilize, and hold casualties through the patient triage. 

b. ____ Assists casualties to the log-in / log-out station and operation 

center. 

c. ____ Log-in / log-out casualties for departure. 

d. ____ Updates the operation center of the number of personnel 

processed. 

7. ____ Element leader is directed by higher headquarters (HQ) to close the site. 

NOTE: The element leader is informed by HQ or the Incident Commander when 

the last group of casualties has processed through the casualty collection 

point Guidance is provided to station operators to begin closing the 

decontamination site starting from the casualty collection point. 

8. ____ Station operators consolidate all liquid and solid waste at each station. 

NOTE: Unit Standing Operating Procedure (SOP) will dictate what station 

operators will assist other stations in the site closure process. 

a. ____ Empties all buckets (contaminated liquid) into the waste 

containment berm. 

b. ____ Consolidates all solid contaminated waste in containers. 

c. ____ Transports monitoring equipment to the technical 


d. ____ Transports all expendable equipment and supplies to 

wash/rinse tent. 

9. ____ Station operators conduct a technical decontamination in the nonambulatory 

tent. 


depending on factors such as the type of agent and the weather. 

a. ____ Conducts equipment drop. 

b. ____ Instructs soldier to stand in a plastic bag. 

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Table of 

Contents 




Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



c. ____ Conducts personal protective equipment decontamination. 

d. ____ Conducts monitoring procedures. 

e. ____ Conducts protective clothing removal. 

f. ____ Conducts mask/respirator removal. 

10. ____ Monitoring station personnel will perform the following: 

a. ____ Disconnects the roller system at the edge of the vapor control 

b. ____ Places roller system in the center of the wash tent. 

c. ____ Cuts tarp at the vapor control line and places over equipment. 

d. ____ Clearly marks the tarp as hazardous waste. 

e. ____ Conducts decontamination procedures. 

f. ____ Closes or zips the non-ambulatory tent. 

g. ____ Exits to the monitoring area. 

11. ____ Element closes the technical decontamination site. 

a. ____ Decontaminates all sensitive equipment and secure them in a 

plastic bag. 

b. ____ Drains contaminated liquid waste into the berm. 

c. ____ Seals all waste containers containing personal protective 

equipment. 

NOTE: Technical decontamination personnel will conduct the finial check of 

the contaminated waste water blivit or container. Personnel will report the 

number of gallons of contaminated wastewater in the container, and conduct a 

technical decontamination. 

12. ____ Element leader reports the following to higher HQ or Incident Commander: 

a. ____ Number of gallons of contaminated wastewater left on site. 

b. ____ Amount (in pounds) of solid contaminated waste left on site. 

c. ____ All consumable and accountable property being left on site. 

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Conduct Incident Tracking 

1. ____ Operations section conducts mission tracking. 



a. ____ Coordinates follow-on meetings with the Incident Commander. 

b. ____ Updates Commander's Critical Information Requirements 

(CCIR) information from the liaison officer or Incident 

Commander. 

c. ____ Maintains incident log. 

d. ____ Establishes report control and information management 

procedures. 

2. ____ Commander establishes a minimum level of protective posture. 

a. ____ Establishes a minimum level of protective posture. 

b. ____ Directs the emplacement of monitoring equipment based upon 

METT-TC. 

3. ____ Unit Safety Officer provides commander with an updated situation report. 

The report includes the following information at a minimum: 

a. ____ Status checks of the CCIR. 

b. ____ Communications status with civilian response agencies. 

c. ____ Briefing on the site safety plan upon arrival. 

d. ____ Status of force protection (protective posture level). 

e. ____ Communication and reporting procedures. 

f. ____ Adjusts contingency plans as necessary. 

(1) ____ Provides updates to the incident safety plan. 

(2) ____ Refines operational objectives for follow on forces. 

(3) ____ Maintains incident log. 

(4) ____ Updates Risk Assessment. 



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Table of 

Contents 




Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



4. ____ Operations section requests the information on the incident from the 

Incident Command System. 

Some of the information requested may include: 

a. ____ Time of incident. 

b. ____ Type of contamination. 

c. ____ Type of CBRNE hazard. 

d. ____ Number of ambulatory and non-ambulatory casualties. 

e. ____ Signs and symptoms of casualties. 

f. ____ Type of release or agent (if known). 

g. ____ Information on other known or suspected hazards. 

h. ____ Other response agencies on the scene. 

5. ____ Operations section maintains equipment readiness to react to subsequent 

CBRNE events. 

6. ____ Commander establishes operational exposure guidance (OEG). 

7. ____ Operations section briefs exposure levels to the Commander. 

8. ____ Commander verifies certification of the decontamination line by the 

Incident Command System site safety officer, validates the search and 

extraction team and ensures medical personnel are prepared to conduct 

operations. 

9. ____ Operations section maintains situational awareness. 

a. ____ Monitors Incident Command System CBRNE mitigation 

activities. 

b. ____ Monitors force protection condition (FPCON) level. 

c. ____ Monitors augmentation from both civilian and military forces. 

d. ____ Compiles with federal, state and local laws and regulations 

pertaining to operational safety and health. 

e. ____ Advises Commander on the current situation and proposed 


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f. ____ Tracks ambulatory and non-ambulatory casualties and 

evacuees. 

Conduct Casualty Collection Procedures 

1. ____ The element maintains control of the casualty collection point. 

a. ____ Maintains ingress and egress to the collection point. 

b. ____ Maintains control lines using engineer tape or existing 

obstacles. 

c. ____ Controls casualties at the collection site. 

d. ____ Ensures casualties do not bypass the decontamination line. 

e. ____ Separates ambulatory and non-ambulatory casualties. 

f. ____ Escorts or transports casualties to the triage station. 

g. ____ Directs litter transfer team to appropriate area. 

2. ____ Medical element performs triage and stabilization. 

NOTE: The decontamination element will assist the medical section as 

required. 

a. ____ Operates medical triage station. 

b. ____ Triages and stabilizes casualties. 

c. ____ Identifies or marks casualties with proper medical category. 

d. ____ Escorts or transports casualties to either the ambulatory or nonambulatory 

clothing/personal items removal tents. 

3. ____ The element processes the casualties through the casualty collection. 

a. ____ Processes casualties as directed by the Incident Commander. 

b. ____ Performs tracking of responsive and unresponsive casualties. 

NOTE: If the casualty is unresponsive, perform a cursory inspection of their 

personal property to identify the casualty, and assign a casualty number. 

Information obtained from the casualty is provided to the log-in and log-out 

station. 

c. ____ Establishes communication with medical operations and unit 

operation center. 

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Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



d. ____ Maintains log-in and log-out sheets for casualty accountability. 

NOTE: Casualty log-in and log-out is located in one location at the rear of the 


e. ____ Updates the operations center with number of casualties that 

processed through the casualty collection point. 

Establish Area of Operations 

1. ____ Advance Party conducts preparations to establish an area of operator. 

a. ____ Conducts initial meeting with the Incident Commander, in order 

to determine mission requirements and gather information to 

initiate intelligence preparations of the battlefield, (IPB). 

b. ____ Provides initial briefing to the Commander. 

c. ____ Identifies location to establish decontamination, 

reconnaissance, search & extraction sites, and area of 

operation. 

d. ____ Prepares site occupation plan. 

e. ____ Emplace early warning detection devices and other equipment if 

available and if hazard is known. 

f. ____ Prepares safety plan for integration into the Incident Command 

System safety plan. 

2. ____ Commander develops a plan to support the Incident Command System 

Incident Action Plan. 

a. ____ Conducts IPB mission analysis and mission planning. 

b. ____ Synchronizes the Incident Action Plan and the Commander's 

Critical Information Requirements, (CCIR). 

c. ____ Provide the Incident Command System with personnel status 

report to include training and medical certifications, as required. 

3. ____ Operations section establishes the area of operations. 

a. ____ Establishes reporting procedures with the Incident Command 

System. 

b. ____ Initiates Incident Log. 

c. ____ Posts the situation map sketch. 

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4. ____ Communication section develops a communications plan. 

a. ____ Establishes internal and external communications. 

b. ____ Provides organic communications support. 

c. ____ Performs troubleshooting procedures on the assigned 

equipment and software. 

5. ____ Operations section monitors the marking of projected Hot, Warm and Cold 

Zones within the decontamination area. 

a. ____ Posts safety cones. 

b. ____ Posts safety tape (red, white, or yellow). 

c. ____ Establishes water and electrical requirements. 

6. ____ Commander adjusts CCIRs to support the Incident Command System 

Incident Action Plan mission. 

7. ____ Operations section requests copies of building diagrams, blueprints, water 

and gas utilities and/or any other building information through the Incident 

Command System. 

8. ____ Commander provides liaison capability to the Incident Command Post. 

a. ____ Establishes and maintains liaison with the Incident Command 

Post. 

b. ____ Coordinates the integration of the unit into the Incident Action 

Plan. 

c. ____ Briefs the Incident Commander on unit capabilities and 

limitations. 

d. ____ Obtains current incident information for the unit. 

e. ____ Advises the Incident Command System as to security forces 

available for force protection. 

Conduct Technical Decontamination 

NOTE: Setup and preparation of the decontamination site may be done in 

personal protective equipment (PPE). 

1. ____ Element leader selects the decontamination site according to the mission, 

terrain, troops, time available, and civil considerations (METT-TC). 

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Table of 

Contents 




Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



a. ____ Establishes the decontamination site upwind in the cold zone. 

b. ____ Selects the decontamination site based on the prevailing 

weather conditions. 

c. ____ Designates the entry point at the beginning of the 


d. ____ Defines decontaminant and method of decontamination. 

2. ____ Element leader selects either wet or dry decontamination procedures 

based on the agent, hazard, and weather. 

3. ____ Element establishes and maintains communications with site commander 

and unit personnel entering the hot zone. 

NOTE: Weapons of Mass Destruction-Civil Support Team (WMD-CST) 

personnel may not communicate with the site commander. 

4. ____ Element establishes the technical decontamination lane. 

a. ____ Sets up the decontamination site to decontaminate personnel, 

equipment, and non-ambulatory or injured personnel. 

b. ____ Establishes the decontamination site sequential actions. 


depending on the factors such as type of agent and the weather. Personal 

clothing removal, shower and redress may be unnecessary if contamination 

did not penetrate the protective clothing. Monitoring equipment should be 

used to verify if any contamination has penetrated the protective suit. 

(1) ____ Station 1 - Equipment drop. 

(2) ____ Station 2 - PPE decontamination. 

(3) ____ Station 3 Monitoring point. 

(4) ____ Station 4 - Protective clothing removal. 

(5) ____ Station 5 - Clothing and respirator removal. 

(6) ____ Station 6 - Shower and Redress. 

(7) ____ Station 7 - Medical evaluation. 

c. ____ Establishes the emergency decontamination lane. 

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NOTE: Decontamination procedures may differ depending on the 

circumstances and hazards at the scene. Dry decontamination such as 

brushing or scraping, is an appropriate alternative for other contamination 

removal. Other considerations such as the hazard's reactivity with water and 

its solubility are factors in determining the appropriate decontamination 

method. 

5. ____ Element leader adjusts and maintains the decontamination site based on: 

a. ____ Reactivity hazards. 

b. ____ Environmental conditions. 

c. ____ Safety. 

d. ____ Waste management/runoff. 

e. ____ Additional resources. 

f. ____ Incident commander, unit commander, or safety officer 

guidance. 

6. ____ Decontamination element performs decontamination of sample container. 

7. ____ Decontamination element monitors the chain of custody of the samples 

through the decontamination line. 

8. ____ Decontamination element performs decontamination of entry team 

personnel. 

a. ____ Removes gross contamination. 

b. ____ Avoids the spread of contamination through the 


c. ____ Verifies the completeness of the decontamination and redirects 

personnel as required. 

d. ____ Containerizes the entry suits and label with name, date, and 

location information. 

e. ____ Utilizes emergency decontamination if required. A basic set of 

emergency decontamination procedures is as follows: 

NOTE: When the emergency decontamination lane requires activation, normal 

decontamination operations will stop until the situation is mitigated. Normal 

operations resume once the casualty has been safely processed through the 

emergency decontamination lane. WMD-CST missions do not necessarily stop 

for emergency decontamination operations. 

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Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



(1) ____ Removes the casualty from the contaminated area. 

(2) ____ Washes immediately any exposed body parts with 

water. 

(3) ____ Removes casualty's clothing and/or PPE. If possible, 

cutting from the top down in a manner that minimizes 

the spread of contamination. 

(4) ____ Performs a quick cycle of head-to-toe wash, and 

rinse. 

NOTE: Only required if deemed necessary due to suit breach or contaminated 

skin. 

(5) ____ Transfers the casualty to treatment personnel for 

assessment, first aid, and medical treatment. 

(6) ____ Ensures that ambulance and hospital personnel are 

notified on the contamination involved and 

appropriate PPE required. 

9. ____ Decontamination element performs decontamination of the entry 

team's equipment. 

10. ____ Decontamination element terminates the decontamination operation. 

a. ____ Requests permission to terminate the decontamination 

operation. 

b. ____ Receives permission and began terminating decontamination 

operations. 

c. ____ Decontaminates recoverable equipment. 

d. ____ Centralizes, packages, marks, and labels hazardous waste. 

NOTE: Some items may not be able to be centralized or containerized due to 

their size and weight. 

e. ____ Completes personal decontamination (buddy team). 

11. ____ Decontamination element notifies the operations center that the 

decontamination site is ready for transfer of responsibilities to the incident 

commander's representative for waste disposal. 

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Establish a Platoon Command Post 



1. ____ Platoon Leader / Sergeant receives mission and initiates troop leading 

procedures: 

a. ____ Receives the mission. 

b. ____ Issues a warning order. 

c. ____ Makes a tentative plan. 

d. ____ Starts the necessary movement. 

e. ____ Reconnoiters -- conduct a personal reconnaissance to verify the 

terrain analysis. 

f. ____ Completes the plan. 

g. ____ Issues the complete order. 

h. ____ Supervises platoon preparation for the mission. 

2. ____ Platoon Leader / Sergeant task organizes the platoon into the following 

elements: 

a. ____ Command element. 

b. ____ Operations element. 

c. ____ Liaison element. 

d. ____ Communications element. 

e. ____ Decontamination element. 

f. ____ Survey / Sampling element. 

g. ____ Back-up (emergency decontamination) element. 

h. ____ Support element. 

3. ____ Command element arrives / meets with incident Commander, or 

representative. 

a. ____ Conducts initial meeting with Incident Commander or 

representative. 

b. ____ Advises Incident Commander or representative on platoon 

assets, capabilities, and limitations. 

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Table of 

Contents 




Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



c. ____ Identifies support assets available. 

d. ____ Determines communications channels and procedures. 

e. ____ Identifies the location to setup operations center and other 

required sites. 

f. ____ Identifies and obtains incident data and information. 

g. ____ Determines other response assets, capabilities, and limitations 

on the scene. 

h. ____ Assists in integrating into the incident response. 

i. ____ Provides an initial assessment and recommendation. 

j. ____ Recommends protective measures and actions. 

k. ____ Provides liaison officer. 

l. ____ Issues warning orders to subordinates personnel. 

4. ____ Operations element stages vehicles, equipment, and personnel. 

a. ____ Identifies the location of the vehicle staging area and place 

vehicles within area. 

b. ____ Identifies the location of the equipment staging area and place 

equipment within area. 

c. ____ Identifies the location of the personnel staging area and place 

personnel within area. 

5. ____ Operations element establishes / maintains the operations center. 

a. ____ Supervises the preparation of the staff actions. 

b. ____ Supervises and approved the updated site safety plan no later 

than one hour after the arrival at the incident site. 

c. ____ Inspects all the actions for conformity in accordance with 

Commander's or Incident Commander's guidance. 

d. ____ Coordinates the assigned missions with the section leaders. 

e. ____ Coordinates the site characterization and verified that the 

platoon's operational area was free of contamination. 

172 Original



6. ____ Command element develops critical information requirements (CCIR) to fit 

the actual incident. 

7. ____ Operations element verifies site setup and operations of support functions. 

a. ____ Establishes communications. 

b. ____ Conducts pre and post medical screening. 

c. ____ Sets up a technical decontamination line. 

d. ____ Begins site characterization and survey operations. 

e. ____ Initiates the administrative log. 

f. ____ Requires that all personnel, on order, establish minimum level of 

protective posture. 

g. ____ Conducts internal and external communications checks on the 

assigned protective equipment. 

8. ____ Command element monitors the establishment of safety lanes for passage 

through the operations site. 

a. ____ Posts safety cones. 

b. ____ Posts safety tape (red, white, or yellow). 

c. ____ Posts lighting (if applicable). 

9. ____ Command element exchanges information with other elements at the 

incident site. 

a. ____ Translates pertinent information into usable data for decision 

making. 

b. ____ Coordinates information exchange internally and externally. 

c. ____ Provides situation reports (SITREPs) to the Incident 

Commander. 

10. ____ Communications element establishes communications. 

a. ____ Establishes initial communications with the Incident Commander 

within 15 minutes of occupation by main body and mission. 

b. ____ Establishes communications with the CBRN company and 

supporting agencies with 45 minutes of occupation. 

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Table of 

Contents 




Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



c. ____ Establishes data reach-back communications within 90 minutes 

of occupation by main body and mission assumption, (if directed 

and or required). 

11. ____ Operations element conducts mission tracking. 

a. ____ Coordinates follow-on meetings through liaison with the Incident 

Commander. 

b. ____ Updates the CCIR. 

c. ____ Initiates an incident log. 

d. ____ Requests copies of the building floor diagrams or blueprints for 

review. Consider Lock-out / Tag-out reduction procedures. 

e. ____ Posts a situation map sketch and all available intelligence. 

f. ____ Establishes reports control and information-management 

procedures. 

g. ____ Prepares the initial survey, site safety, and force protection 

plans. 

h. ____ Conducts mission planning and mission analysis. 

(1) ____ Develops site characterization and the safety plan. 

(2) ____ Develops objects to support the Incident 

Commander's action plan. 

(3) ____ Develops specific objectives for the survey team. 

(4) ____ Synchronizes the Incident Commander's critical 

information requirements. 

i. ____ Maintains communication and reporting procedures. 

j. ____ Monitors and adjusted the element's response plan. 

(1) ____ Updates the incident safety plan. 

(2) ____ Refines operational objectives for follow-on survey 

teams. 

(3) ____ Maintains the incident log and staff journal. 



174 Original



(5) ____ Updates modeling according to the assessment task. 

k. ____ Plans and monitors logistical requirements. 

l. ____ Advises the commander on the current situation and proposed 


m. ____ Disseminated the approved survey, site safety, and logistics 

support plans. 

n. ____ Authorized entry and monitored the survey team incident site 

operations. 

o. ____ Provides assessments to the Incident Commander. 

p. ____ Provides the status of the first responder's surveys to date. 

q. ____ Provides the status of the site safety plan. 

r. ____ Provides the status of force protection, (protective posture 

level). 

s. ____ Provides the status of medical screening baseline checks. 

12. ____ Liaison element continues to conducts civil support operations. 

a. ____ Maintains liaison with the Incident Command Post according to 

the liaison task. 

b. ____ Coordinates the integration into the Incident Commander's 

incident response plan. 

c. ____ Assists in the integration of other DOD response elements into 

the incident response plan as required. 

13. ____ Command element disseminates chemical /biological sample chain of 

custody procedures. 

14. ____ Operations element processes a confirmatory sample for shipment. 

15. ____ Command element issues fragmentary order (FRAGO) to execute or 

modify the courses of action. 

16. ____ Operations element continues to monitor situational awareness. 

a. ____ Monitors the Incident Command System mitigation activities. 

b. ____ Monitors the threat condition, (THREATCON) level. 

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Table of 

Contents 


Comparison 


Overview 


Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



c. ____ Seeks guidance for public information releases. 

d. ____ Provides Incident Commander or representative information and 

advice based on survey and analysis results. 

(1) ____ Provides identification, classification, and location of 

CBRN hazards. 

(2) ____ Provides contamination control and containment 

operations / procedures. 

(3) ____ Provides information on appropriate protective 

measures / requirements. 

(4) ____ Provides decontamination measures to include 

response personnel status; individual and casualty 

status and equipment status. 

(5) ____ Provides safety measures. 

(6) ____ Obtains updated / follow-on mission guidance from 

the Incident Commander or representative. 

17. ____ Operations element plans for follow-up operations. 

a. ____ Plans for transition or hand-off operations and procedures. 

b. ____ Coordinates and executed transition or hand-off operations. 

18. ____ Operations element prepares for redeployment. 

a. ____ Submits all the reports before departure from the incident site. 

b. ____ Coordinates debriefing by the Incident Commander before 

termination. 

c. ____ Establishes communications with supported unit and higher 

headquarters, (HQ). 

d. ____ Establishes reporting procedures (Internal / External). 

e. ____ Mans the operations center according to the standing operating 

procedure (SOP). 

f. ____ Continues incident log. 

g. ____ Updates the situation map sketch. 

176 Original



19. ____ Element conducts site closure procedures in accordance with the site 

closure plan. 

Conduct CBRN Assessments 

1. ____ Elements obtains available critical incident data. 

a. ____ Time of the incident. 

b. ____ Weather data. 

c. ____ Signs, symptoms, number, and the current location of the 

casualties. 

d. ____ Type of release or agent (if known). 

e. ____ Other information on known or suspected hazards. 

f. ____ Location of the Incident Command Post. 

g. ____ Location and control measures for hot, warm, and cold zones. 

h. ____ Name of other response agencies on the scene. 

2. ____ Elements evaluates and analyzes the incident data. 

a. ____ Develops site characterization. 

b. ____ Initiates the staff planning process. 

3. ____ Elements collects and analyzes information from internal and external 

resources. 

a. ____ Collects and analyzes information about the entry team(s). 

b. ____ Collects and analyzes information about the medical section. 

c. ____ Collects information about the reach-back agencies. 

d. ____ Analyzes the Incident Command System. 

e. ____ Collects environmental data. 

4. ____ Elements conducts modeling. 

a. ____ Predicts the immediate and downwind hazard area. 

b. ____ Estimates the number of casualties in the hazard area. 

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Table of 

Contents 




Operations 


References 

Appendix B 

Acronym List 

Appendix C 

Glossary 

Appendix D 



Appendix E 

CBR Guide 

Appendix F 


Trees 

Appendix G 

ARNORTH 

Guidance



5. ____ Elements develops the assessment and report results. 

a. ____ Verifies data 

b. ____ Provides results and recommends courses of action to the 

Commander and the Incident Commander by using interim and 

final reports. 

178 Original

(MCD) Guidelines

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