(MCD) Guidelines

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