ADD AN EMS SPECIALIST TO YOUR HAZ-MAT TEAM
HAZARDOUS MATERIALS
Hazardous material response teams are good for any community, but team personnel take a tremendous risk.
EMS specialists provide an extra degree of assistance for everyone.
Montgomery County, Md., has the potential for serious incidents involving many dangerous substances. Within the county, there are two interstate highways, a main line of the Chessie System Railroad, five major pipelines, two small plane airports, air traffic to and from nearby major airports, thousands of businesses selling or storing chemicals, and many medical and military facilities. These facilities contain materials including etiologic agents, radioactive materials, explosives, flammable liquids, oxidizers and poisons. In addition, there are mutual-aid agreements with jurisdictions throughout the Washington, D.C., metropolitan area.
The Montgomery County Fire and Rescue Services Hazardous Incident Response Team (HIRT), which became operational on Nov. 1, 1981, has recognized the preceding problem and included six EMS and medical specialists as part of the team. This special EMS group is composed of four paramedics, a registered nurse who is also the EMS officer, and a physician. Other team members include four shift officers, 13 fire fighters, four fire fighter trainees, a supervisor and two coordinators.
HIRT, whose members serve on a volunteer basis, provides support services to the 18 independent fire and rescue departments in the county. The team operates under a rotating shift schedule, with two shifts on standby and two additional shifts on alert at all times.
All applicants for membership on the team must be 18 years old, complete a total NFPA 1001 physical examination, have three years of fire service experience, be a certified NFPA 1001 Fire Fighter III, be a certified State of Maryland EMT-A, and have completed the Montgomery County Fire Academy hazardous materials course.
Having met these requirements, new personnel are assigned to shifts as fire fighter trainees. They assist at incidents in every manner except the handling of the actual hazard. Once the individual has obtained the required knowledge and skill level, the trainee is promoted to team member.
An EMS specialist is assigned to each HIRT shift. This EMS specialist, in addition to the requirements outlined above, must be a Maryland Certified Paramedic (cardiac rescue technicians) or paramedic instructor.
The team is also fortunate to have an emergency department physician who serves as the HIRT medical director. His assignment was approved by the EMS committee of the Montgomery County Medical Society, which provides medical direction to the prehospital advanced lifesupport program in the county. Another of the team’s medical specialists serves as a consultant to the U.S. Surgeon General on emergency medical services and assists the team as a medical advisor and as a paramedic.
In terms of emergency care, the EMS specialist must always be ready to administer treatment with regard to the specific hazards involved. Hazardous materials can produce serious and sometimes unusual injuries such as frostbite, cellular dysfunction, poisoning, paralysis, chemical burns, infections and asphyxiation. Unless countermeasures are taken immediately, permanent injuries or death can occur. For this reason, the HIRT vehicle carries a complete drug kit with many special drugs that are capable of treating unusual symptoms caused by certain hazardous substances.
The HIRT vehicle carries a complete drug kit with many special drugs capable of treating unusual symptoms caused by certain hazardous substances.
The drugs which are carried, based upon the recommendations of the HIRT medical director, include: 50 percent magnesium sulfate, dexamethasone sodium sulfate, amyl nitrite capsules, 0.5 percent tetracaine hydrochloride, 1 percent methylene blue, and 0.9 percent sodium chloride. The EMS compartment also contains a first-aid kit, resuscitator, two cyanide treatment kits, two bottles of eye wash solution, four bottles of normal saline solution and an EMS reference library.
The HIRT uses a surplus mini-pumper that has undergone significant alteration by team members. Modifications have included removal of the tank and pump, addition of a floor, compartment shelves and weather cover, and a complete paint job. The vehicle is stationed at the county’s public service training academy where it is centrally located and close to Interstate 270 and the Chessie System Railroad lines. The responsibility for driving the unit rests with the fire and rescue training staff and designated HIRT members.
In order for the team to be prepared for incidents involving a wide variety of substances and containers, the HIRT vehicle is equipped, in addition to the EMS materials, with a large assortment of specialized protective gear, leak control materials, suppression equipment, monitors and tools. These items have been obtained by means of county government funding, donations from the private sector and the ingenuity of the team members.
The team has also acquired the use of a spill response trailer from the state’s water resources administration. It can be quickly hitched to the HIRT vehicle when needed at the scene of a large spill. The trailer contains various sorbent materials, recovery drums, fencing, nets and thick plastic bags.
Equipment that the team has found to be most useful during its responses include 30 and 60-minute SCBA, particle filter masks, sorbent C, spill control pillows, acid neutralizer, “No-Flash” neutralizer, recovery drums, explosimeters, air sampler monitors, Geiger counters, shovels, brooms, hand tools and reference materials. A complete inventory of the equipment carried is available.
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EMS Functions at Hazardous Materials incidents
Pre-Incident
- Development of safety operation procedures.
- Development of basic and advanced life support protocols specific for hazardous materials incidents.
- Development and maintenance of resource list for medical consultation.
- Development and maintenance of first-aid and medic kits for the HIRT.
- Identification of possible hazardous materials incidents with the potential of major medical problems.
- Development and maintenance of base line (normal) health record system for HIRT members.
- Participate in regular drills and meetings, and assist in the maintenance of equipment.
- Training of HIRT and other fire and rescue personnel on safety procedures, protective gear, decontamination, health hazards and EMS matters related to hazardous materials incidents.
On the Scene
- Serve as health and safety officer for team members.
- Serve as advisor on emergency medical matters to the HIRT officer and incident commander.
- Maintain exposure records. The cumulative effect, even with the use of protective equipment needs to be watched. In addition, concern for future illness, which may be many years developing, needs to be handled. For this reason, an incident exposure record is maintained at the scene showing all of the chemicals to which the individual has been exposed. This information is then transferred to the personnel exposure record and kept in the individual’s permanent file.
- Provide initial emergency care for HIRT members.
- Assist field EMS personnel with providing care for specific health problems.
Post-Incident
- Coordinate decontamination activities.
- Assist with conducting critique of incident.
- Coordinate follow-up care of personnel exposed to hazardous materials.
HAZARDOUS MATERIALS
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During its first nine months of service, HIRT has assisted on 31 incidents involving such materials as pesticides, propane, anhydrous ammonia, hydrochloric acid, sodium hypochlorite, diesel fuel, fuel oil, gasoline, sodium arsenic, cyanide and acetone, The team has also been called upon to assist with determining types and concentrations of suspected toxic vapors.
HIRT members report directly to the scene of an incident from their homes, work or fire stations under their own means of transportation. Alerting of team personnel is done by the county’s emergency operations center with tone-activated pagers. Special arrangements have been made between the HIRT and the employers of the team members so that HIRT personnel can be released to respond to incidents when their shift is on duty. Arrangemehts have also been made with the county police department to allow team members to pass quickly through road blocks. HIRT personnel can be identified by means of their special windshield identification, turnout gear identification tags and wallet-sized picture identification card. These individuals also wear fluorescent vests over their protective gear whenever practicable.
Although the HIRT has the capability to handle most of the incidents, the team is not reluctant to call in outside assistance.
Although team members are experienced and knowledgeable about the handling of hazardous materials, additional training takes place on a regular basis. Team drills are held at least monthly and are usually conducted by the HIRT personnel themselves. This is accomplished by each shift being responsible for various topics which must be researched before providing the instruction. Experts from both the private and public sectors also participate on occasion.
The four shifts also drill separately one or more times per month at the discretion of the shift officer. When funds are available, individuals attend special training courses and conferences.
The officers, coordinators and supervisors hold a monthly meeting to discuss previous incidents and to plan future activities. In addition, the entire team meets once each month to keep everyone informed on new developments and to assign new tasks.
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HIRT participates in many hazardous materials programs, too, in order to keep ideas and techniques flowing to and from the team. Team members give many presentations on handling hazardous material incidents to local, state and national conferences. The team also has plans to cosponsor a seminar on EMS response to hazardous materials emergencies and to participate in a training program for fire department officers from the Washington, D.C., area.
Special arrangements have been made between the HIRT and the employers of the team members so that HIRT personnel can be released to respond to incidents.
Although the HIRT has the capabilities to handle most of the incidents it is called upon to handle, the team is not reluctant to call in outside assistance from competent individuals and organizations. The team maintains a resource manual that lists the local, state and federal agencies that can be contacted for assistance. It also lists the resources available from the private sector, as well as the names and numbers of technical assistance organizations.
The team is always looking to improve its efficiency so that it can better protect the 600,000 citizens of the county. Projects that are currently under way include the acquisition of pre-incident plans for target areas, a skills checklist and decontamination procedures. HIRT has 15 plans so far and is working on many additional ones.
A skills checklist is being developed so that HIRT officers will know the specific capabilities of each team member. This will assist the officer in assigning tasks during incidents.
Individuals desiring a list of the HIRT inventory, the resource manual outline, forms or any further information about the team should contact Chief Warren E. Isman, Director, Department of Fire and Rescue Services, 101 Monroe St., 12th floor, Rockville, Md. 20850.
