Contaminated Patients in the Hot Zone: A Common Sense Approach
Jeffrey N. Rubin - College of Natural Sciences - Univ of Texas at Austin (SSA Journal Volume 12 Number 2 - Summer 1998 pp. 21 - 24 )
Assessment of potentially contaminated patient in the "Hot Zone" of a hazardous materials incident can be performed with basic skills and knowledge. Advanced assessment and treatment is impractical and adds few advantages. Entry-team personnel with basic CPR and first-aid training should be able to determine whether their operation will be one of rescue or recovery. Safety of response personnel is paramount. Personal protective equipment limits entry-team members by restricting mobility, sight, hearing, touch, and in-zone time. The goal of personnel is not to perform a detailed examination, but to determine the presence of a patent airway and spontaneous cardiorespiratory function. Patients may be assess by the following methods: 1) verbal (of patient is conscious); 2) visual (looking for chest movement, using a mirror or chemical indicator for respirations); 3) tactile (palpating chest for respirations). Patient care in the Hot Zone is restricted to limited immobilization, packaging, supplemental oxygen, and evacuation to decontamination. Every effort should be made to minimize energy expense by entry-team members and to limit their (and the patient's) time in the Hot Zone. Simple triage techniques may be used for multiple patients. Accurate understandable communications are essential for a smooth chain of patient management and personnel safety among industrial response teams, public-safety personnel (EMS, fire, police), and hospital staff. Medical personnel at the scene much ensure proper medical monitoring and decontamination is performed on response personnel as well as patients.