National Urban Search & Rescue Response System National Urban Search & Rescue Response System Operation in the Contaminated Environment Version 4 National Urban Search & Rescue Response System Enhanced Operations In The Contaminated Environment October 2012

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Module 3: Personal Protective Equipment (PPE)

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Upon completion of this module, students will be able to discuss the importance of respiratory protection and recognize medical interventions for exposures. Upon completion of this module, students will be able to discuss the importance of respiratory protection and recognize medical interventions for exposures. Mod 3-3 Terminal Objective

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version Students will be able to recognize 3-1 Students will be able to recognize the importance of wearing the appropriate respiratory protection the importance of wearing the appropriate respiratory protection 3-2 Students will be able to identify levels of respiratory protection and Personal Protective Equipment 3-2 Students will be able to identify levels of respiratory protection and Personal Protective Equipment 3-3 Identify medical interventions available for exposure to hazardous materials/CBRNE 3-3 Identify medical interventions available for exposure to hazardous materials/CBRNE Mod 3-4 Enabling Objectives

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 FEMA US&R CBRNE equipment cache FEMA US&R CBRNE equipment cache Scott respiratory equipment Scott respiratory equipment Chemical Protective Clothing (CPC) Chemical Protective Clothing (CPC) Hazmat related pharmaceuticals Hazmat related pharmaceuticals Communications Equipment Communications Equipment Mod 3-5 Overview

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 World Trade Center Related Cough World Trade Center Related Cough 332 Firefighters 332 Firefighters One Emergency Medical Service Worker One Emergency Medical Service Worker Mod 3-6 MMWR Report September 2002 Morbidity and Mortality Weekly Report Each had four or more weeks of medical leave

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Mod 3-7 Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report September 2002

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 5,000 rescue workers tested 5,000 rescue workers tested ALL had lung impairments ALL had lung impairments Average 10% impairment Average 10% impairment 30% – 40% persistent symptoms 30% – 40% persistent symptoms 1,000 permanent respiratory disability 1,000 permanent respiratory disability Mod FDNY Medical Office Study 9/11 Effects

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 OSHA 29 CFR compliant OSHA 29 CFR compliant Facepiece with Kevlar head piece Facepiece with Kevlar head piece Facepiece allows for: Facepiece allows for: Air Purifying Respirator (APR) Air Purifying Respirator (APR) Powered Air Purifying Respirator (PAPR) Powered Air Purifying Respirator (PAPR) Self Contained Breathing Apparatus (SCBA) Self Contained Breathing Apparatus (SCBA) Mod 3-9 Respiratory Protection Scott AV3000 Sure Seal facepiece

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 N95 Particulate Mask = 10:1 N95 Particulate Mask = 10:1 APR Half-Face = 10:1 APR Half-Face = 10:1 APR Full-Face = 50:1 APR Full-Face = 50:1 PAPR = 1,000:1 PAPR = 1,000:1 SCBA = 10,000:1 SCBA = 10,000:1 A Factor of 1:1 = No respiratory protection in place Mod 3-10 Protection Factors Limiting Factors for Each PPE Must be Understood

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Good particulate protection Good particulate protection High Efficiency Particulate Air (HEPA) Cartridges Only High Efficiency Particulate Air (HEPA) Cartridges Only Easy to change cartridge Easy to change cartridge Eye Protection Required Mod 3-11 Half-facepiece Respirator

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Fits into Scott Full facepiece Fits into Scott Full facepiece CBRN Adapter ( ) allows NATO threaded cartridge CBRN Adapter ( ) allows NATO threaded cartridge NIOSH Approved CBRNE Cartridge NIOSH Approved CBRNE Cartridge Meets/exceeds NIOSH Meets/exceeds NIOSH Adapter ( ) allows the use of 2 quarter turn cartridges Adapter ( ) allows the use of 2 quarter turn cartridges Mod 3-12 APR

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Two - MPC40PF canisters Two - MPC40PF canisters Slight positive pressure Slight positive pressure 10 hour battery life 10 hour battery life Batteries in cache are for deployment Batteries in cache are for deployment Can be used off shelf without charging Can be used off shelf without charging Mod 3-13 PAPR

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 60 minutes carbon cylinder 60 minutes carbon cylinder Each Task Force Each Task Force 30 SCBAs 30 SCBAs 8 Spare Cylinders 8 Spare Cylinders Each HEPP Each HEPP 30 spare cylinders 30 spare cylinders 14 harness assemblies 14 harness assemblies Mod 3-14 SCBA

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Ten per TF Ten per TF Mod 3-15 Communication System

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Physiological (heat stress) Physiological (heat stress) Reduced mobility Reduced mobility Limited vision (poor peripheral vision) Limited vision (poor peripheral vision) Reduced dexterity Reduced dexterity May promote claustrophobia May promote claustrophobia Mod 3-16 Hazards of Working in CPC

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Mechanicalcuts, tears, punctures Mechanicalcuts, tears, punctures Thermalno fire protection Thermalno fire protection Chemicalno ideal suit to protect against all chemicals Chemicalno ideal suit to protect against all chemicals Permeation, penetration, and degradation Permeation, penetration, and degradation Mod 3-17 Damage to CPC

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Selection Application Application Behaviors Behaviors Conditions Conditions Mod 3-18 Damage Protection for CPC Overalls can be used to protect CPC from mechanical damage

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Level A CPC Meets 1994 Class 1 Meets 1994 Class 1 Hazmat Equipment Hazmat Equipment Push Package Push Package (HEPP) Only (HEPP) Only Mod 3-19 Personal Protective Equipment

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Multi Threat Suit Blauer BlauerOR Lion Apparel Lion Apparel Mod 3-20 Personal Protective Equipment NFPA 1994 Class 2

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Level B Requires SCBA Mod 3-21 Personal Protective Equipment

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Level C Mod 3-22 Personal Protective Equipment

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Level D Mod 3-23 Personal Protective Equipment

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Mod 3-24 Personal Protective Equipment AirBoss Overboot Tingley Boots

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Gloves Mod 3-25 Personal Protective Equipment Nitrile Cotton Leather Viton

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Mod 3-26 Hazmat related pharmaceuticals

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Treatment for symptoms of some insecticide and nerve agent exposures Treatment for symptoms of some insecticide and nerve agent exposures Self aid or Buddy aid Self aid or Buddy aid Mod 3-27 Nerve Agent Antidote Kit (NAAK)DuoDote Auto-Injector Includes Atropine 2.1mg and 2-PAM Chloride 600mg

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Indications and Dosing: A single NAAK dose may be given for mild symptoms A single NAAK dose may be given for mild symptoms 2 additional doses may be required forSevere or persistent symptoms 2 additional doses may be required forSevere or persistent symptoms Mod 3-28 DuoDote Auto Injector

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Strange or confused behavior Strange or confused behavior Severe difficulty breathing or copious airway secretions Severe difficulty breathing or copious airway secretions Severe muscular twitching and general weakness Severe muscular twitching and general weakness Urination or defecation (Involuntary) Urination or defecation (Involuntary) Convulsions or unconsciousness Convulsions or unconsciousness Mod 3-29 Severe Nerve Agent Symptoms Severe Nerve Agent Symptoms

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Loss of visual acuity and confusion Loss of visual acuity and confusion Dry mouth and eyes, urinary retention Dry mouth and eyes, urinary retention Headache and abdominal pain Headache and abdominal pain Dangerous hypertension and arrhythmias Dangerous hypertension and arrhythmias Increased temperature and flushing Increased temperature and flushing …All can be severe in some cases Mod 3-30 Side Effects of NAAK

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 One CANA per individual One CANA per individual Should be used for buddy-aid only Should be used for buddy-aid only Mod 3-31 Convulsant Antidote for Nerve Agent (CANA)Diazepam Auto-Injector, Diazepam 10mg

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Inject in large muscle of thigh Inject in large muscle of thigh Area hand width below hip to hand width above knee Area hand width below hip to hand width above knee Hold in place 10 seconds Hold in place 10 seconds Mod 3-32 Injection Site

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Mod 3-33 Site Location

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Thin persons inject in buttocks Thin persons inject in buttocks Avoid nerve and bone Avoid nerve and bone Mod 3-34 Alternate Location

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Mishandling that may result in accidental self-injection Mishandling that may result in accidental self-injection Another danger is unnecessary self- injection. Do not use unless: Another danger is unnecessary self- injection. Do not use unless: You show signs and symptoms, You show signs and symptoms, You know you are exposed, or You know you are exposed, or You are directed You are directed Mod 3-35 Misuse

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Potassium Iodide for thyroid protection during some nuclear emergencies Potassium Iodide for thyroid protection during some nuclear emergencies Daily dose of one tablet given every 24 hours. Must be given prior to exposure Daily dose of one tablet given every 24 hours. Must be given prior to exposure Mod 3-36 Radioactive Iodide Prophylaxis Radioactive Iodide Prophylaxis

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Mod 3-37 Module 3 Activity, Hands-on PPE/CPC and Respiratory Protection

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Mod 3-38 Summary FEMA US&R CBRNE equipment cache FEMA US&R CBRNE equipment cache Scott respiratory equipment Scott respiratory equipment Chemical Protective Clothing (CPC) Chemical Protective Clothing (CPC) Hazmat related pharmaceuticals Hazmat related pharmaceuticals Communications Equipment Communications Equipment

National Urban Search & Rescue Response System Enhanced National Urban Search & Rescue Response System Enhanced Operations in the Contaminated Environment Version 4 Version 1 Review and Examination