(MCD) Guidelines

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Guidelines for Military Mass Casualty Decontamination Operations During a Domestic HAZMAT/Weapon of Mass Destruction Incident Decontamination 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
Guidelines for Military Mass Casualty Decontamination Operations During a Domestic HAZMAT/Weapon of Mass Destruction Incident 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. MCD Principles for 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 USACBRNS Tasks • 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 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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Appendix A - References Guidelines
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Appendix B - Acronym List Guideline
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Establish a Platoon Command Post Gu
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