(MCD) Guidelines

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Guidelines for Military Mass Casualty Decontamination Operations During a Domestic HAZMAT/Weapon of Mass Destruction Incident 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
Guidelines for Military Mass Casualty Decontamination Operations During a Domestic HAZMAT/Weapon of Mass Destruction Incident 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 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
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