Background

Hazardous material decontamination commonly referred to as hazmat decontamination is a vital step that aims at reducing the impact of hazardous materials on persons. 

The background of Hazmat decontamination on patients stems from the necessity to safeguard the affected individuals and the medical professionals who are providing their treatment. 

Hazmat incidents can be accidental and can happen in industries, transportation, or can be acts of terrorism. In such circumstances, the body gets contaminated on the skin, clothing or other mucous material cause health risks to the person. 

Decontamination is characterized by a rigorous, step-by-step, and efficient strategy to eliminate toxic substances from the patient, including their garments. It usually occurs in decontamination zones that are fitted with requisite tools and procedures aimed at cleaning contaminated tools. As a result, this process fulfils several functions, such as protection against the contamination of the areas not infected by the pathogens, reduction of the potential secondary infection, and safeguarding the personnel caring for the patients. 

Hazmat decontamination on patients can therefore be defined as a system which requires the input of emergency personnel, clinical practitioners, and personnel with specific knowledge of hazardous materials. It entails compliance with wearing of, PPE, and early response to curtail the effects of materials considered as hazardous. 

Indications

• Chemical Spills or Releases: People coming in contact or development with toxic substances in case of some industrial occurrences, or transportation mishaps, or in cases of chemical contamination may require detoxification. 
• Industrial Accidents: The people who are employed in industrial settings or in an occupational incident that involves the use or liberation of dangerous substances may require decontamination to protect them from any further harm. 
• Biological Incidents: For biological incidents, which expose people to dangerous biological materials, decontamination helps to minimize the extent of spread of the agent among people including the patient and the providers. 
• Radiological Events: In cases dealing with radiological occurrences involving radioactive substances, the involved persons must be decontaminated to reduce the overall radiation dose and also curtail the spread of the contaminated material. 
• Intentional Acts (Terrorism): When hazardous substances are intentionally release into buildings with the intent of terrorism, then public requires to be decontaminated to cancel out the effects of hazardous substances. 

Contraindications

• Life-Threatening Emergencies: In some cases that involve life-threatening emergencies, where the time to be used in decontamination endangers the life of the affected person, then decontamination maybe performed after stabilization. 
• Severe Trauma or Critical Condition: Patients with serious injuries or life-threatening illnesses should not be decontaminated because the procedure may harm them further. 
• Cardiopulmonary Instability: Patients with severe unstable cardiovascular or pulmonary status or respiratory distress can hardly endure the decontamination processes involving exposure to water or other decontaminants. 
• Limited Resources: When one tries to decontaminate the patient in areas that lack the necessary equipment or personnel to perform safe decontamination, then it exposes the patient to more dangers. 
• Lack of Personal Protective Equipment (PPE): This implies that when people carrying out decontamination do not put on the right protective gear, then it might be relatively unproductive to expose them to hazardous material during the decontamination process. 
• Unknown Hazardous Material: Delaying decontamination until the hazardous item can be identified may be essential if the identity of the material is unknown and the hazards involved with decontamination outweigh any possible advantages.  
• Decontamination Ineffectiveness: Sometimes decontamination is not completely successful or even partially successful that is if the hazardous material is relatively penetrating and difficult to clean. 

Outcomes

Equipment

Decontamination Shower Systems 

Water Supply 

Decontamination Agents 

Eye Wash Stations 

Stretchers or Gurneys 

Patient Preparation

• Undressing Area: Designate a separate area for individuals to undress before entering the decontamination zone. This area should be provided with waste disposal bins for the affected clothes. 
• Showering Area: Locate the showering sector in a way that people can be thoroughly rinsed. Make sure they are providing adequate amount of water to wash off contaminants on the skin and cloths. 
• Medical Monitoring: Make medical staff present to check people’s health during and after decontamination. For those who already have health issues, this is especially crucial. 
• Privacy Considerations: Use methods that will uphold a privacy and dignity while completing the decontamination process. Cover people when they are changing their clothes or showers to reduce the chances of touch. 
• Assistance for Special Populations: Help youngsters, people with mobility impairments, and other specific groups so they may participate in the decontamination process safely and effectively. 

Technique

The decontamination that is associated with hazmat is a process that is specifically structured and followed to eliminate a material or substance that has been deemed dangerous from a person who has had contact with it or has been affected by it in one way or the other. 

• Initial Assessment: First examination of the exposed persons includes a survey of the hazardous material to which the affected persons were exposed and the degree of exposure to the hazardous substance and possible health effects. Set up a buffer zone that will help avoid more people from being infected. 
• Personal Protective Equipment (PPE): Make sure that the personnel involved in decontamination are well protected since this will involve handling chemicals, thereby using personal protective clothing and equipment that the individuals will need to wear goggles, chemical suit and gloves, respiratory protection. These aim to ensure that the decontamination personnel do not suffer from exposure to diseases or toxic substances. 
• Undressing Area: Provide a particular place where one must change, take off the garments that have come into contact with hazardous substances. Contaminated clothing is carefully placed in designated waste containers.  
• Showering: They must move people straight to the showering zone and wash them with water very thoroughly. Employ decontaminants like the soaps or detergents during the washing process since they increase the washing effectiveness on the skin and hair. 
• Water Flow: Make sure that the water flow rate and its availability are enough and smooth to wash all these hazardous substances. For this purpose, portable showers or fixed installations providing sufficient water must be employed. 
• Eye Wash Stations: Provide eye washing facilities for anybody who could have come into contact with potentially harmful substances. Even for cases of eye exposure, adequate rinsing with water is recommended as a method of handling the problem. 
• Assistance for Special Populations: Ensure that people with some difficulties in locomotion such as disability, elder people or with children accompany them through the decontamination process safely and actively. 
• Medical Monitoring: Ensure health care givers are on stand-by to attend to the health conditions of people after they have undergone decontamination. For such reasons, it is significant that one should adhere to the precautionary measures especially if one has other health conditions or has sign of exposure to the virus. 
• Drying and Redressing: The people are then offered with clean towel and garments after taking a thorough washing with water. Drying and redressing is done away from the patient to avoid cross-contamination of infections since the patient’s area is already contaminated. 
• Post-Decontamination Assessment: Perform post-decontamination survey to evaluate ability of the people to be without the contaminants. Patients should be followed up for similar signs and symptoms of continued exposure or health complications.

  Hazmat decontamination 

Complications

Cross-Contamination: 

Ineffective decontamination methods can disperse pollutants to uncontaminated regions or people. 

Insufficient demarcation between areas polluted and uncontaminated. 

Equipment Failure: 

Inadequate functioning of decontamination showers, sprayers, or protective gears come in the way. 

Lack of or failure of functioning decontamination equipment or adequate stock of decontamination material. 

Human Error: 

Lack of preparation or confusion as to processes and procedures. 

Stress and exhaustion might cause errors or hasty decisions. 

Resource Limitations: 

Lack of people or capacity to perform the much larger scale of decontamination necessary. 

Inadequate availability or accessibility of required decontamination centers or specific apparatus. 

Waste Disposal: 

Disposing of the contaminated waste materials and the wastewater in a way that does not pollute the environment. 

Government regulations and the expenses related to the transportation and disposal of harmful substances. 

References

Toxic Exposure Hazardous Materials – StatPearls – NCBI Bookshelf (nih.gov)

References

Toxic Exposure Hazardous Materials – StatPearls – NCBI Bookshelf (nih.gov)