Detection & Monitoring

DECON v2.0 Basic Disaster Life Support 1

Detection & Monitoring

Chapter 2

DECON v 2.0 DETECTION & MONITORING 2

Objectives• List the goals of detection during

Decontamination operations• Discuss general detection principles• Describe detection & monitoring for:

– Chemical events– Biological events– Radiological events


Detection

• Goals of detection during an event:– Determine the possible cause– Determine if decontamination is necessary– Determine risks to workers– Recognizing the need for PPE is vital!

Detection is Awareness !


PELs

• Permissible Exposure Limits– Federal standards for chemical exposure– Different chemicals have different limits– Not all chemicals have established PEL

• 8 hour time weighted average concentration– Higher short term exposure limits (STEL)


IDLH

• Immediately Dangerous to Life and Health– AKA the “Hot Zone”

• Simply walking into the area could cause you to collapse and possibly die

• Unknown releases are IDLH until proven otherwise


IDLH Examples• Confined space entry • Potentially explosive or flammable

situations• Visible vapor clouds

– Dead animals– Collapsed victims

• Hospitals are not IDLH environments


Information Sources

• Placarding– Emergency Response Guide Book

• Shipping papers• Material Safety Data Sheet (MSDS )• Product labeling

– NFPA• NIOSH Handbook• Poison Control Centers


Hazardous Matetials

1. Explosives2. Gases3. Flammable Liquids4. Flammable Solids5. Oxidizing chemicals6. Toxic or infectious substances7. Radioactive8. Corrosives9. Miscellaneous



ERG

• Identifies UN number on placard• Refers to “Guide” with information on

– Health and fire hazards– Protective Equipment needed– Containment & Evacuation– First aid & Emergency response


Shipping Papers

• Required for ANY hazardous material being transported

• Chemical name• Amount (weight or volume)• Hazard Classification


MSDS

• Chemical Name• Hazard Identification• Physical & Chemical

Properties

• Information is NOT reviewed but any agency for completeness


NFPA Labels• Health Hazard• Flammability• Instability

– 0 = Good– 4 = Very Bad

• Special Hazards– Oxidizer– Water Reactive– Radiation


• Chemical Names, synonyms, trade names, • Description of chemical and physical

properties• PEL & IDLH values• Personal Protection Recommendations• Respirator Recommendations• Information on Health Hazards


Poison Control Centers

• In depth information about health effects

• In depth treatment information

• Antidote availability• Toxicologist

Consultation


ChemicalsWide Variety of Dispersal Mechanisms


Chemical Agent Clues • Rapid symptom onset• Multiple victims and civilian panic

• Similar signs and symptoms• Present at same time• History of similar site exposure• Absence of traumatic injuries

• Emergency responders may be affected• A disseminating device may be used• Cloud or vapor release or irritating odor• Animal or insect die-off

• Rapid symptom onset• Multiple victims and civilian panic

• Similar signs and symptoms• Present at same time• History of similar site exposure• Absence of traumatic injuries

• Emergency responders may be affected• A disseminating device may be used• Cloud or vapor release or irritating odor• Animal or insect die-off


Chemical AgentsChemical Agents

Choking Blister Blood Nerve

Phosgene

Chlorine

Mustard

Lewisite

Phosgene Oxime

Cyanide Tabun

Sarin

Soman

VX


Choking (Pulmonary) Chemical Agents

• PHOSGENE

• Odor: newly cut hay

• Symptoms:

Coughing, choking, vomiting

• CHLORINE

• Odor: swimming pool• Symptoms:

Coughing, choking, vomiting


Blister (Vesicant) Chemical Agents

• Mustard• Odor: garlic• Symptom onset: delayed• Symptoms: tearing, eye itching, running nose,

cough, blisters

• Lewisite• Odor: geraniums• Symptom onset: Immediate• Symptoms: tearing, eye itching, running nose,

cough, painful blisters


Blood (Asphyxiant) Chemical Agents

• Cyanide Gas

Odor: Bitter almonds

Symptom Onset: Rapid

Symptoms: Normal skin color, gasping for air, shock & seizures


Nerve Agents(Cholinesterase Inhibitors)

Odor Properties

Tabun & Sarin: None or Fruity Volatile

Soman: None Volatile

VX: None / Sulfur Persistent

Symptom Onset: Rapid to 48hrs

Symptoms: Pinpoint pupils, salivation, runny nose, shortness of breath, chest tightness, nausea, muscle twitching, seizures, coma, death


Nerve Agents Signs and Symptoms

D- defecation

U - urination

M – miosis (pinpoint pupils)

B – BRONCHORRHEA, BRONCHOSPASM

E – emesis (vomiting)

L – lacrimation (watery eyes)

S - salivation

Muscarinic toxidrome


Nerve AgentSigns and Symptoms

• M: Mydriasis (dilated pupils)• T: Tachycardia• W: Weakness• tH: Hypertension• F: Fasciculations (muscle twitching)

Nicotinic toxidrome


Chemical Detection Devices

• Identify unknown chemicals • Determine if situation is safe

– Is concentration in air IDLH?• Monitor patients after decontamination

– Significant clinical effects– Extremely dangerous chemicals– Highly contaminated victims


Chemical Detection Tools

All have limited ranges of substances• Chemical Detection Papers

– Concentrated vapors or liquids

• Air Sampling Devices– Vapors or gasses in low concentration

http://www.emedicine.com/cgi-bin/foxweb.exe/makezoom@/em/makezoom?picture=/websites/emedicine/emerg/images/Large/700APD2000_2.jpg&template=izoom2


Choosing a Detection Device

Agents detectedWhat chemicals can it find?What forms; gas, liquid or vapor?

Sensitivity Can it measure lower than levels necessary for injury?

Interference Does smoke, moisture, or other chemicals prevent accurate results?

Response time Time to analyze & report

Start-up time Time to deploy the device

Alarm capability Audible, visual, or both


Portability Consider weight, size & power source

Durability Amount of abuse the device withstands

Procurement costs Cost per device needed

Operator skill & training

Skill involved in using the device & hours of training

Maintenance Calibration & Replacement parts

Choosing a Detection Device


Biological Agents• Infectious diseases or bacterial toxins• There may not be a “scene”• May be hard to detect

• Long incubation period • Symptoms manifest slowly• Non-specific symptoms

• Infectious diseases or bacterial toxins• There may not be a “scene”• May be hard to detect

• Long incubation period • Symptoms manifest slowly• Non-specific symptoms

Beware of multiple “healthy” people

with similar complaints!

Ebola


Biological Agents “SAFETY”

S: Skin rash with fever • Smallpox

A: Acute Pulmonary Syndrome with fever• Anthrax and plague

F: Flu like syndrome with fever • Tularemia and SARS

E: Excessive Bleeding• Viral hemorrhagic fevers

T: Toxin Effect without fever• Botulism

Y: Your personal and community safety • Depends on recognition


Biological Detection• Mainly clinical diagnosis

– Large numbers of victims– Unusually bad cases– Laboratory confirmation be delayed

• Evidence of a bioterrorism attack:– Witness– Report or threat– Device found


Decon for Bio?• Decontamination is usually not needed

– Patients have usually bathed during incubation

• Exceptions would be known exposures– White powder letters– Spraying over crowds– Etc.

• PPE may still be needed in either case


Radiological Events

• Nuclear weapons will be obvious

• Dirty bombs or simple dispersal devices may not!


DECON v 2.0 DETECTION & MONITORING

External Exposure / Irradiation

s·

····

Local PartialBody

WholeBody

·


Contamination

InternalExternal


Radiation Injury

Chemical Damage

Free Radicals

10-10 Seconds

1. Proteins2. Membrane3. DNA

Cellular Damage

Tissue damage & Loss of organ

function

Hours to years

OrganDamage

Seconds to hours



What to look for …

• Most common presentation is Nausea and Vomiting

• Onset may be delayed• Early symptom onset predicts worse

outcome• Extreme cases may include hair loss,

burns or loss of consciousness


Radiological Detection

Survey Meters• “Geiger Counters”• Detect and measure the

presence of radiation

Dosimeters• Measure your personal

radiation exposure.

Survey meters

Dosimeters

http://www.radetco.net/tld_05_ring.html

http://www.step-sensor.de/EnglVers/Etechdata_pd12i.htm


Rad Victim Monitoring

• Use a survey meter– Be careful not to contaminate probes

• Identify contaminated victims prior to decontamination

• Unlike chemical post decontamination monitoring is needed for all victims– This will be a very slow process


SummaryNow you can:• Define PEL and IDLH• Identify resources to aid in hazard

identification and monitoring• Discuss general detection principles• Describe detection specifics for:

– Chemical events (including “toxidromes”)– Biological events– Radiological events

DECON v2.0 Basic Disaster Life Support 43

Thank you!Questions?

Documents

Detection & Monitoring