• http://www.youtube.com/watch? v=NSAXkp9cqbk
Jan 04, 2016
• http://www.youtube.com/watch?v=NSAXkp9cqbk
DeconTag, You’re It!!!!
Brent Cox MS, CHEP, HAZMAT Tech
Why Be Concerned at all?
• Regulatory Agencies• Hospital Impact
TJC• EC 1.4 – Healthcare facility must be prepared
to decontaminate patients and have regular drills and exercises conducted to test preparedness. – An Incident Management system is required– Hazard vulnerability analysis conducted
OSHA
• First Responder Requirements• Published Best Practices for First Receivers
General Duty ClauseSec. 5. Duties(a) Each employer
(1) Shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees;
Equipment 29 CFR 1910.134
• Must be adequate for the type and exposure levels one can reasonably anticipate.– OSHA – Level C is adequate for medical centers.
Medial evaluations29 CFR 1910. 120 (f)
review with employee health to best implement.
it is debatable of where hospital decon teams fall as they do not meet the definition of a decontamination team.
Equipment 29 CFR 1910.134
• Equipment must be inspected and maintained• Respiratory equipment is routinely integrated
into medical surveillance program. – Infection control or employee health
Incident Command• TJC and OSHA• Using HEICS– Falls under operations– Separate Branch (HAZMAT)– On site
• HAZMAT Commander (OSIC)• Safety Officer• Medical Officer • Triage Officer
So who’s it?
• Fire Departments Role
So who’s it?
• Hospitals Role
So who’s it?
• Working Together
Building a Team
• What is a Decon Team– Call it…
• How many people?– American Hospital Association recommends
for a 48 hour response time:Recommends 50 clinicians for metropolitan medical centers
20 at non-metropolitan healthcare facilities
Small facilities should aim for a two person team 24/7.
Building a Team• Who do we use?– Nurses• Floor - ER• Home health
– Engineering/Maintenance - Respiratory– Medical Records -Environmentalist– Security - Admissions– PCT’s - Education– Physical Therapy
Building a Team
Team Issues• Turn over• So many needs, so few people.
Team Considerations• Turn over rate• Availability• Normal Job Function• Desire vs. Ability
Training
No Set Standards or Requirements for
First Receivers
• Meet TJC requirements• Meet OSHA requirements– First Responder Requirements
AwarenessOperations
Training
How often and long should we train?• Research being conducted.
Training
What content should be covered?
State Wide Need
• No one is alone– Critical access – Level 1 Trauma
• So what options do we have– Work alone and hope for the best– Develop Regional and State Teams
State Wide Need
• How would Regional Teams help?– When and When Not– How effective?
• Where to begin?
Conclusion
Tag, You’re It!!Where do we go from here?