Hazardous Materials. HAZMAT Definition (USDOT) Any substance which may pose an unreasonable risk to health and safety of operating or emergency personnel,

Hazardous MaterialsHazardous Materials

HAZMAT Definition HAZMAT Definition (USDOT)(USDOT)

““Any substance which may pose an Any substance which may pose an unreasonable risk to health and unreasonable risk to health and safety of operating or emergency safety of operating or emergency personnel, the public, and/or the personnel, the public, and/or the environment if not properly environment if not properly controlled during handling, storage, controlled during handling, storage, manufacture, processing, manufacture, processing, packaging, use, disposal, or packaging, use, disposal, or transportation.”transportation.”

Requirements and Requirements and StandardsStandards

OSHA: CFR 1940.120OSHA: CFR 1940.120 EPA: 40 CFR 311EPA: 40 CFR 311 NFPA: Standard 473 NFPA: Standard 473

((Standard for Competencies of Standard for Competencies of EMS Personnel Responding to EMS Personnel Responding to Hazardous Materials IncidentsHazardous Materials Incidents))

EMS HAZMAT Training EMS HAZMAT Training LevelsLevels

AwarenessAwareness Level 1Level 1 Level 2Level 2

AwarenessAwareness

All responders who may arrive first All responders who may arrive first on scene and discover hazardous on scene and discover hazardous substancesubstance

EMS, Fire, Law enforcementEMS, Fire, Law enforcement FocusFocus

– Recognition of HAZMAT incidentsRecognition of HAZMAT incidents– Basic identification techniquesBasic identification techniques– Personal protectionPersonal protection

EMS Level IEMS Level I

Patient care in Patient care in cold zonecold zone with with NONO significant 2significant 2oo contamination risk contamination risk

FocusFocus– Hazard assessmentHazard assessment– Assessment, management of Assessment, management of

previouslypreviously contaminated patients contaminated patients

EMS Level IIEMS Level II

Patient care in Patient care in warm zonewarm zone with with significant risk of 2significant risk of 2oo contaminationcontamination

FocusFocus– Personal protectionPersonal protection– Decontamination proceduresDecontamination procedures– Assessment, management Assessment, management duringduring

decondecon

EMT RolesEMT Roles

Size up incidentSize up incident Establish commandEstablish command Activate IMSActivate IMS Isolate & identifyIsolate & identify Treat, transport patientsTreat, transport patients Support HAZMAT team members Support HAZMAT team members

(medical monitoring, rehab)(medical monitoring, rehab)

Incident Size UpIncident Size Up

Size-Up PrioritiesSize-Up Priorities

Safety: Self, crew first!Safety: Self, crew first! Incident stability (Stable vs. Incident stability (Stable vs.

Unstable)Unstable) Property conservationProperty conservation

– Exposures—people, propertyExposures—people, property– Run-offRun-off

Size-Up Special Size-Up Special ConsiderationsConsiderations

Personal risk of exposure, Personal risk of exposure, contaminationcontamination

Delayed product effectsDelayed product effects Scene topographyScene topography Wind directionWind direction Decontamination corridor(s)Decontamination corridor(s) Incident facility location contingency Incident facility location contingency

plansplans

HAZMAT IdentificationHAZMAT Identification

HAZMAT IdentificationHAZMAT Identification

Often most difficult part of Often most difficult part of incidentincident

ALWAYSALWAYS use at least use at least TWOTWO concurring sourcesconcurring sources

HAZMAT ReferencesHAZMAT References

Emergency Emergency Response Response GuidebookGuidebook

Container MarkingsContainer Markings Shipping PapersShipping Papers Material Safety Data Material Safety Data

SheetsSheets Monitors/Chemical Monitors/Chemical

TestsTests

Telephone HotlinesTelephone Hotlines Poison CentersPoison Centers ChemistsChemists ToxicologistsToxicologists Reference BooksReference Books Computer Computer

databasesdatabases

Emergency Response Emergency Response GuidebookGuidebook

U.S., Canada, MexicoU.S., Canada, Mexico Lists >1000 products with placards, Lists >1000 products with placards,

UN numbers, chemical names UN numbers, chemical names Cross references emergency, Cross references emergency,

evacuation proceduresevacuation procedures Medical information is limitedMedical information is limited Multiple chemicals carry the same Multiple chemicals carry the same

numbernumber

CluesClues

Occupancy, locationOccupancy, location Vehicle, container shapeVehicle, container shape Placards, other markingsPlacards, other markings LabelsLabels Scene appearanceScene appearance Other sensory informationOther sensory information

Occupancy/LocationOccupancy/Location

What do you know about the What do you know about the activities at this location?activities at this location?

Are hazardous materials likely to Are hazardous materials likely to be manufactured, stored, used be manufactured, stored, used there?there?

Highway incidents are by Highway incidents are by definition a high risk situation!definition a high risk situation!

Fixed FacilitiesFixed Facilities

ManufacturersManufacturers WarehousesWarehouses Hardware storesHardware stores Agricultural storesAgricultural stores Water treatment Water treatment

plantsplants

Loading docksLoading docks PipelinesPipelines SilosSilos BarnsBarns GreenhousesGreenhouses

Know Your Community!

Vehicle/Container ShapeVehicle/Container Shape

External ring stiffeners frequently are present on vehicles transporting corrosives or poisons.

Vehicle/Container ShapeVehicle/Container Shape

Rounded ends on highway transport vehicles suggest presence of pressurized contents.

Vehicle/Container ShapeVehicle/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.

PlacardsPlacards

DOT (transport vehicles)DOT (transport vehicles) NFPA 704 (fixed facilities)NFPA 704 (fixed facilities)

DOT LabelsDOT Labels

Placed on packages/containersPlaced on packages/containers

DOT Hazard ClassesDOT Hazard Classes

HAZARD CLASSHAZARD CLASS HAZARD TYPEHAZARD TYPE

11 ExplosivesExplosives

22 GasesGases

33 LiquidsLiquids

44 SolidsSolids

55 Oxidizers, organic Oxidizers, organic peroxidesperoxides

66 Poisons, etiologic agentsPoisons, etiologic agents

77 Radioactive materialsRadioactive materials

88 CorrosivesCorrosives

99 Miscellaneous (ORMs)Miscellaneous (ORMs)

UN NumbersUN Numbers

DOT Placard LimitationsDOT Placard Limitations

ALLALL product hazards product hazards NOTNOT indicatedindicated

Incorrect placardsIncorrect placards Absent placardsAbsent placards

DOT Placard LimitationsDOT Placard Limitations

Some products Some products NOTNOT placarded placarded– Rail and motor freight containing <1000 Rail and motor freight containing <1000

pounds of:pounds of:Nonflammable gasesChlorineFluorineLiquid oxygenFlammable gasesFlammable liquids

Combustible liquidsFlammable solidsOxidizers, organic peroxidesPoison BCorrosivesIrritating materials

NFPA 704NFPA 704

Used at fixed facilitiesUsed at fixed facilities

Health

Fire

Reactivity

SpecificHazard

NFPA 704NFPA 704

HEALTH

4 = Too dangerous to enter

3 = Extreme danger—Full protective clothing

2 = Hazardous—Breathing apparatus

1 = Slight hazard

0 = No hazard FIRE

4 = Extremely flammable

3 = Ignites at normal temperatures

2 = Ignites when moderately heated

1 = Must be preheated to burn

0 = Will not burn

NFPA 704NFPA 704

REACTIVITY

4 = May detonate—Evacuate area if fire present

3 = Shock, heat may detonate—Take cover

2 = Violent chemical change possible

1 = Unstable if heated

0 = Normally stable SPECIFIC HAZARD

OX = Oxidizer

ACID = Acid

ALK = Alkali (Base)

COR = Corrosive

W = Use NO Water

Shipping PapersShipping Papers

List specific substancesList specific substances Indicate quantities carriedIndicate quantities carried Operators may not take papers Operators may not take papers

with themwith them Scene may be too unstable to Scene may be too unstable to

retrieveretrieve Papers may be incomplete, Papers may be incomplete,

inaccurateinaccurate

Material Safety Data SheetsMaterial Safety Data Sheets

Present at fixed Present at fixed facilitiesfacilities

Available for Available for ALLALL hazards on sitehazards on site

Cover wide range Cover wide range of common, of common, simple productssimple products

Typically list:Typically list:– Material nameMaterial name– CharacteristicsCharacteristics– ManufacturerManufacturer– Health, fire, Health, fire,

reactivity dangersreactivity dangers– Safe handling Safe handling

considerationsconsiderations– Emergency Emergency

proceduresprocedures

Other Sensory InformationOther Sensory Information

What do you see? Hear? Smell?What do you see? Hear? Smell? Is there a vapor cloud?Is there a vapor cloud? Is there a fire?Is there a fire? Can you hear escape of a pressurized Can you hear escape of a pressurized

product?product? Any unusual odors?Any unusual odors? Are your eyes watering, burning?Are your eyes watering, burning? Are there dead animals, birds, fish Are there dead animals, birds, fish

observable?observable?

CHEMTREC HotlineCHEMTREC Hotline

Chemical Transportation Chemical Transportation Emergency Center (CHEMTREC)Emergency Center (CHEMTREC)

1-800-424-93001-800-424-9300

Sponsored by Chemical Sponsored by Chemical Manufacturer’s Association (CMA)Manufacturer’s Association (CMA)

CHEMTREC ServicesCHEMTREC Services

Emergency response informationEmergency response information Access to manufacturer’s Access to manufacturer’s

representativesrepresentatives Activation of specialized teams to Activation of specialized teams to

deal with chlorine, phosphorus, deal with chlorine, phosphorus, vinyl chloride, HCN, HF, and LPGvinyl chloride, HCN, HF, and LPG

Activation of CHEMNET response Activation of CHEMNET response teamsteams

CHEMTREC LimitationsCHEMTREC Limitations

Communicators Communicators NOTNOT technical technical personnelpersonnel

Will Will NOTNOT interpret data or go beyond interpret data or go beyond what information sheets saywhat information sheets say

Must have product trade or chemical Must have product trade or chemical name to provide assistancename to provide assistance

Cannot provide information on Cannot provide information on effects of mixing of several productseffects of mixing of several products

CHEMTREC Information CHEMTREC Information NeededNeeded

What has happened?What has happened? Where?Where? When?When? Chemical(s) involvedChemical(s) involved Container type Container type

conditioncondition Shipper/originShipper/origin CarrierCarrier

Consignee/destinationConsignee/destination Nature/extent casualtiesNature/extent casualties Nature/extent property Nature/extent property

damagedamage Prevailing weatherPrevailing weather Nature of incident areaNature of incident area Caller name/locationCaller name/location Call-back numberCall-back number

Federal, State, Local Federal, State, Local ResourcesResources

FederalFederal– US EPAUS EPA– Coast GuardCoast Guard

StateState– TNRCCTNRCC– TDHTDH– Railroad CommissionRailroad Commission– Parks & WildlifeParks & Wildlife– Agriculture Agriculture

DepartmentDepartment

LocalLocal– Poison ControlPoison Control– Health Health

DepartmentDepartment– Colleges, Colleges,

UniversitiesUniversities

Protective Equipment and Protective Equipment and Medical MonitoringMedical Monitoring

Protective Equipment Protective Equipment TypesTypes

Level ALevel A Level BLevel B Level CLevel C Level DLevel D

Level ALevel A

Highest level of respiratory/skin Highest level of respiratory/skin protectionprotection

Suit fully encapsulates rescuer, SCBASuit fully encapsulates rescuer, SCBA Used in hot zone with:Used in hot zone with:

– Unknown substancesUnknown substances– Substances with potential for respiratory Substances with potential for respiratory

and skin absorption hazardsand skin absorption hazards

Level ALevel A

Level BLevel B

Full respiratory Full respiratory protectionprotection

Lower skin protection Lower skin protection levellevel

Suit non-Suit non-encapsulating, but encapsulating, but chemically resistantchemically resistant

SCBA worn outside of SCBA worn outside of suitsuit

Typically worn in warm Typically worn in warm zone by decon teamzone by decon team

Level CLevel C

Non-permeable suit, Non-permeable suit, boots, hand, eye boots, hand, eye protectionprotection

Air-purifying Air-purifying respirator with respirator with cartridges for cartridges for specific substancesspecific substances

Worn during Worn during transport of patients transport of patients with 2with 2oo contamination riskcontamination risk

Level DLevel D

Firefighter turnout gearFirefighter turnout gear NOTNOT suitable for HAZMAT suitable for HAZMAT

incidentsincidents

Selection of PPESelection of PPE

Based on chemical involvedBased on chemical involved NONO single suit material is single suit material is

appropriate for all chemicalsappropriate for all chemicals Permeability charts should be Permeability charts should be

consulted to determine consulted to determine breakthrough times for suit breakthrough times for suit materialmaterial

Selection of PPESelection of PPE

Latex gloves are Latex gloves are NOTNOT chemically chemically resistantresistant

Nitrile gloves hive high resistance Nitrile gloves hive high resistance to most chemicalsto most chemicals

Leather boots will absorb Leather boots will absorb chemicals permanentlychemicals permanently

Medical Monitoring & Medical Monitoring & RehabRehab

A primary role of EMSA primary role of EMS Entry team personnel should have Entry team personnel should have

annual physicals with baseline annual physicals with baseline vitals on filevitals on file

Monitoring of crews prior to Monitoring of crews prior to entering and after working within entering and after working within the warm and hot zones.the warm and hot zones.

HAZMAT ZonesHAZMAT ZonesHot Zone

Contamination Present

Appropriate PPE

Limited number of personnel

Everything inside considered contaminatedWarm Zone

Contamination Control Zone

Appropriate PPE

Decon Corridor

Life-Saving Emergency Care

Cold Zone

CP Location

Treatment/Transport Areas

Staging

Medical Monitoring/Rehab

DecontaminationDecontamination

Decon Decision MakingDecon Decision Making

Fast BreakFast Break Long TermLong Term

Fast BreakFast Break

Quick decisions to prevent Quick decisions to prevent rescuer, equipment rescuer, equipment contaminationcontamination

Used on incidents with:Used on incidents with:– Patients who have self-rescuedPatients who have self-rescued– Critical patients out of hot zone Critical patients out of hot zone

needing immediate careneeding immediate care– Unknown materialsUnknown materials– Potentially life-threatening materialsPotentially life-threatening materials

Fast BreakFast Break

Do Do NOTNOT expose yourself expose yourself Contain, isolate patientsContain, isolate patients Remove clothing, if possible by Remove clothing, if possible by

having them undress themselveshaving them undress themselves Wash with large amounts of waterWash with large amounts of water Wrap completely in blankets Wrap completely in blankets

(human burrito)(human burrito)

Fast BreakFast Break

What are the What are the risksrisks associated associated with immediate care?with immediate care?

What are the What are the benefitsbenefits of the of the patient receiving immediate care?patient receiving immediate care?

Transport ConsiderationsTransport Considerations

Patients field decontaminated are only Patients field decontaminated are only semi-decontaminatedsemi-decontaminated

May harbor latent contaminants, may May harbor latent contaminants, may outgas contaminants in body fluidsoutgas contaminants in body fluids

Limit number of ambulances used in Limit number of ambulances used in transporttransport

Remove non-essential equipmentRemove non-essential equipment Wrap patient in plastic sheeting, Wrap patient in plastic sheeting,

blanketsblankets Cover floor with plastic sheetingCover floor with plastic sheeting

Transport ConsiderationsTransport Considerations

Better Dirty and Alive than Clean and Dead!

Transport ConsiderationsTransport Considerations

Do NOT assume your hospitals are equipped to

handle contaminated patients

Transport ConsiderationsTransport Considerations

Preplan transport of contaminated Preplan transport of contaminated patients to hospitalspatients to hospitals– Hospitals may want contaminated Hospitals may want contaminated

patients delivered to location other patients delivered to location other than usual ER entrancethan usual ER entrance

– Hospitals need adequate warning to Hospitals need adequate warning to prepare to receive these patients. prepare to receive these patients. Alert should come when Alert should come when firstfirst EMS unit EMS unit arrives at the scene.arrives at the scene.

WMD & TerrorismWMD & Terrorism

TerrorismTerrorism

A violent act or act dangerous to A violent act or act dangerous to human life, in violation of the human life, in violation of the criminal laws of the U.S. or any criminal laws of the U.S. or any segment to intimidate or coerce a segment to intimidate or coerce a government, the civilian government, the civilian population or any segment population or any segment thereof, in furtherance of political thereof, in furtherance of political or social objectives.or social objectives.

Terrorism TargetsTerrorism Targets

Potential TargetsPotential Targets– Public buildingsPublic buildings– Multinational HQsMultinational HQs– Shopping centersShopping centers– WorkplacesWorkplaces– Public assembly placesPublic assembly places– Places of worshipPlaces of worship– SchoolsSchools

Terrorism TargetsTerrorism Targets

Preplan potential targetsPreplan potential targets Multiple patients with similar signs, Multiple patients with similar signs,

symptoms = High index of suspicionsymptoms = High index of suspicion Consider secondary device, attack riskConsider secondary device, attack risk Think:Think:

– Occupancy or locationOccupancy or location– Type of eventType of event– Timing of eventTiming of event– On-scene warning signsOn-scene warning signs

WMDWMD

BBiologicaliological

NNuclearuclear

IIncendiaryncendiary

CChemicalhemical

EExplosivesxplosives

Protective MeasuresProtective Measures

All forms of protection can be All forms of protection can be defined in terms of:defined in terms of:

TimeTime

DistanceDistance

ShieldingShielding

ConsiderationsConsiderations

Acts of terrorism are criminal acts Acts of terrorism are criminal acts and will fall under the jurisdiction and will fall under the jurisdiction of the FBI.of the FBI.

ICS is pivotal in the successful ICS is pivotal in the successful mitigation of any terrorist act.mitigation of any terrorist act.

Self safety is foremost Self safety is foremost consideration at all times.consideration at all times.