2 HAZMAT Definition (USDOT) “Any substance which may pose an unreasonable risk to health and safety of operating or emergency personnel, the public, and/or the environment if not properly controlled during handling, storage, manufacture, processing, packaging, use, disposal, or transportation.”
3 Requirements and Standards OSHA: CFREPA: 40 CFR 311NFPA: Standard (Standard for Competencies of EMS Personnel Responding to Hazardous Materials Incidents)
4 EMS HAZMAT Training Levels AwarenessLevel 1Level 2
5 AwarenessAll responders who may arrive first on scene and discover hazardous substanceEMS, Fire, Law enforcementFocusRecognition of HAZMAT incidentsBasic identification techniquesPersonal protection
6 EMS Level IPatient care in cold zone with NO significant 2o contamination riskFocusHazard assessmentAssessment, management of previously contaminated patients
7 EMS Level IIPatient care in warm zone with significant risk of 2o contaminationFocusPersonal protectionDecontamination proceduresAssessment, management during decon
8 EMT Roles Size up incident Establish command Activate IMS Isolate & identifyTreat, transport patientsSupport HAZMAT team members (medical monitoring, rehab)
15 Emergency Response Guidebook U.S., Canada, MexicoLists >1000 products with placards, UN numbers, chemical namesCross references emergency, evacuation proceduresMedical information is limitedMultiple chemicals carry the same number
16 Clues Occupancy, location Vehicle, container shape Placards, other markingsLabelsScene appearanceOther sensory information
17 Occupancy/LocationWhat do you know about the activities at this location?Are hazardous materials likely to be manufactured, stored, used there?Highway incidents are by definition a high risk situation!
18 Fixed Facilities Know Your Community! Loading docks Manufacturers WarehousesHardware storesAgricultural storesWater treatment plantsLoading docksPipelinesSilosBarnsGreenhousesKnow Your Community!
19 Vehicle/Container Shape External ring stiffeners frequently are present on vehicles transporting corrosives or poisons.
20 Vehicle/Container Shape Rounded ends on highway transport vehicles suggest presence of pressurized contents.
21 Vehicle/Container Shape Dome covers on rail tank cars suggest that the contents are under pressure.Tank cars with flat ends have been insulated to control product temperature changes.
26 DOT Placard Limitations ALL product hazards NOT indicatedIncorrect placardsAbsent placards
27 DOT Placard Limitations Some products NOT placardedRail and motor freight containing <1000 pounds of:Nonflammable gasesChlorineFluorineLiquid oxygenFlammable gasesFlammable liquidsCombustible liquidsFlammable solidsOxidizers, organic peroxidesPoison BCorrosivesIrritating materials
28 NFPA 704 Used at fixed facilities Health Fire Reactivity Specific Hazard
29 NFPA 704 HEALTH 4 = Too dangerous to enter 3 = Extreme danger—Full protective clothing2 = Hazardous—Breathing apparatus1 = Slight hazard0 = No hazardFIRE4 = Extremely flammable3 = Ignites at normal temperatures2 = Ignites when moderately heated1 = Must be preheated to burn0 = Will not burn
30 NFPA 704 REACTIVITY 4 = May detonate—Evacuate area if fire present 3 = Shock, heat may detonate—Take cover2 = Violent chemical change possible1 = Unstable if heated0 = Normally stableSPECIFIC HAZARDOX = OxidizerACID = AcidALK = Alkali (Base)COR = CorrosiveW = Use NO Water
31 Shipping Papers List specific substances Indicate quantities carried Operators may not take papers with themScene may be too unstable to retrievePapers may be incomplete, inaccurate
34 Material Safety Data Sheets Present at fixed facilitiesAvailable for ALL hazards on siteCover wide range of common, simple productsTypically list:Material nameCharacteristicsManufacturerHealth, fire, reactivity dangersSafe handling considerationsEmergency procedures
35 Other Sensory Information What do you see? Hear? Smell?Is there a vapor cloud?Is there a fire?Can you hear escape of a pressurized product?Any unusual odors?Are your eyes watering, burning?Are there dead animals, birds, fish observable?
36 CHEMTREC Hotline Chemical Transportation Emergency Center (CHEMTREC) Sponsored by Chemical Manufacturer’s Association (CMA)
37 CHEMTREC Services Emergency response information Access to manufacturer’s representativesActivation of specialized teams to deal with chlorine, phosphorus, vinyl chloride, HCN, HF, and LPGActivation of CHEMNET response teams
38 CHEMTREC Limitations Communicators NOT technical personnel Will NOT interpret data or go beyond what information sheets sayMust have product trade or chemical name to provide assistanceCannot provide information on effects of mixing of several products
39 CHEMTREC Information Needed What has happened?Where?When?Chemical(s) involvedContainer type conditionShipper/originCarrierConsignee/destinationNature/extent casualtiesNature/extent property damagePrevailing weatherNature of incident areaCaller name/locationCall-back number
40 Federal, State, Local Resources US EPACoast GuardStateTNRCCTDHRailroad CommissionParks & WildlifeAgriculture DepartmentLocalPoison ControlHealth DepartmentColleges, Universities
42 Protective Equipment Types Level ALevel BLevel CLevel D
43 Level A Highest level of respiratory/skin protection Suit fully encapsulates rescuer, SCBAUsed in hot zone with:Unknown substancesSubstances with potential for respiratory and skin absorption hazards
45 Level B Full respiratory protection Lower skin protection level Suit non-encapsulating, but chemically resistantSCBA worn outside of suitTypically worn in warm zone by decon team
46 Level C Non-permeable suit, boots, hand, eye protection Air-purifying respirator with cartridges for specific substancesWorn during transport of patients with 2o contamination risk
47 Level DFirefighter turnout gearNOT suitable for HAZMAT incidents
48 Selection of PPE Based on chemical involved NO single suit material is appropriate for all chemicalsPermeability charts should be consulted to determine breakthrough times for suit material
49 Selection of PPE Latex gloves are NOT chemically resistant Nitrile gloves hive high resistance to most chemicalsLeather boots will absorb chemicals permanently
50 Medical Monitoring & Rehab A primary role of EMSEntry team personnel should have annual physicals with baseline vitals on fileMonitoring of crews prior to entering and after working within the warm and hot zones.
51 HAZMAT Zones Hot Zone Contamination Present Appropriate PPE Limited number of personnelEverything inside considered contaminatedWarm ZoneContamination Control ZoneAppropriate PPEDecon CorridorLife-Saving Emergency CareCold ZoneCP LocationTreatment/Transport AreasStagingMedical Monitoring/Rehab
54 Fast Break Quick decisions to prevent rescuer, equipment contamination Used on incidents with:Patients who have self-rescuedCritical patients out of hot zone needing immediate careUnknown materialsPotentially life-threatening materials
55 Fast Break Do NOT expose yourself Contain, isolate patients Remove clothing, if possible by having them undress themselvesWash with large amounts of waterWrap completely in blankets (human burrito)
56 Fast Break What are the risks associated with immediate care? What are the benefits of the patient receiving immediate care?
57 Transport Considerations Patients field decontaminated are only semi-decontaminatedMay harbor latent contaminants, may outgas contaminants in body fluidsLimit number of ambulances used in transportRemove non-essential equipmentWrap patient in plastic sheeting, blanketsCover floor with plastic sheeting
58 Transport Considerations Better Dirty and Alive than Clean and Dead!
59 Transport Considerations Do NOT assume your hospitals are equipped to handle contaminated patients
60 Transport Considerations Preplan transport of contaminated patients to hospitalsHospitals may want contaminated patients delivered to location other than usual ER entranceHospitals need adequate warning to prepare to receive these patients. Alert should come when first EMS unit arrives at the scene.
62 TerrorismA violent act or act dangerous to human life, in violation of the criminal laws of the U.S. or any segment to intimidate or coerce a government, the civilian population or any segment thereof, in furtherance of political or social objectives.
63 Terrorism Targets Potential Targets Public buildings Multinational HQs Shopping centersWorkplacesPublic assembly placesPlaces of worshipSchools
64 Terrorism Targets Preplan potential targets Multiple patients with similar signs, symptoms = High index of suspicionConsider secondary device, attack riskThink:Occupancy or locationType of eventTiming of eventOn-scene warning signs
66 All forms of protection can be defined in terms of: Protective MeasuresAll forms of protection can be defined in terms of:TimeDistanceShielding
67 ConsiderationsActs of terrorism are criminal acts and will fall under the jurisdiction of the FBI.ICS is pivotal in the successful mitigation of any terrorist act.Self safety is foremost consideration at all times.