Making your Decontamination Training a success

BY JERRY KNAPP AND ANDREW SAYLOR

This is a success story from start to finish. It tells how a volunteer fire department became an important resource for homeland security and improved its ability to respond to weapons of mass destruction (WMD) and hazardous-materials incidents.

There is no question that firefighters will be the first to respond to a terrorist event. Local firefighters, EMS, and police officers will bear the burden of the initial response to a terror attack. Lives will be lost or saved during this time. Federal and state assistance will arrive, if requested, but will be hours or days away. The terror attack may be a simple explosive device, or it may be a chemical agent, a radiological dispersion device (dirty bomb), or some combination of these devices. We are all familiar with the various mechanisms for death, injury, and damage available for terrorist use.

The common problem we face as firefighters is determining where to start to prepare to respond to a possible terrorist attack. We often think that we must have millions of dollars worth of equipment and thousands of hours of training to even consider responding effectively to these kinds of alarms. Yet, both you and I will respond—whether we are prepared or not. How to prepare is the lingering question. Not preparing is not an option.

Firefighters find them-selves between the prover-bial rock and the hard spot. We can wring our hands and worry and hope it does not happen, or we can take the first steps to preparedness. Remember, hope is not a plan. The rock is simply worry and no action; the hard spot will be responding unprepared. A little knowledge will take away the mystery, and then we will find out the hard spot we all fear is not so “hard” after all.


(1) Two engines are positioned side by side. When possible, the exhaust should be placed to the outboard side of each rig. A water supply is established to one engine, and a 21/2-inch supply line is stretched to the second engine. (Photos by Jerry Knapp unless otherwise noted.)

These photos show the first setup of the emergency decon corridor by trainees during the hands-on portion of the class. Because of high temperature and humidity, we did not insist on full protective equipment. However, such equipment, including SCBA, is essential for safety during an actual event.


(2) Ladders are placed between the rigs to support the hoselines that flow water from above, to ensure a good flow of water over the victims. When possible, keep the pump panels on the outside of the corridor. Make sure the exhaust from the engines is not directed into the corridor.

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WHY PREPARE?

At the 1996 Fire Department Instructors Conference, Fire Department of New York Chief Ray Downey presented a seminar on terrorism response. It was an excellent seminar; most importantly, it had a chilling prophecy. In the very beginning of the presentation, He said something to the effect that it was only a matter of time before the United States suffered a major terrorist attack. He continued with something just as profound. He said, “If you don’t believe it, you might as well leave the training now because you are wasting your time and mine.” Downey was killed saving others’ lives in the September 11, 2001, attack at the World Trade Center.

It is now more than two years since that attack. Many firefighters still do not understand the significance of this attack. These attacks were deliberate and carefully planned. They were brilliant attacks that were so successful that any commander of any army would be proud to be associated with them during a conventional war. Consider the success: Three thousand dead, unlimited press coverage, significant and long-term financial disruption to a variety of industries, damage to the headquarters of the U.S. armed forces, and untold pain inflicted on the enemy (us) at a cost of only 20 lives on their side.

We must remember that these attacks are part of the continuing war on the United States. The goal is to bring down our country and our way of life. The terrorist attacks are the enemies’ way of showing we are vulnerable. They have proven they are capable and cunning foes without regard for killing innocent people. We must be ready when they strike again. Our defense will come through efficient and effective responses to those attacks that cannot be prevented.

Buildings that symbolize the federal government, such as post offices, government buildings, and the like, all may be likely targets. Another terrorist aim is to choose targets with secondary effects. Consider the effect on the airline industry after 9/11. Shopping malls and other buildings important to our economy make good targets in terrorists’ eyes because of the secondary effects. Public transportation is another target that, if attacked, can produce far-reaching secondary effects. The bus bombings in Israel are examples.

Terrorists are also likely to select targets associated with religion. Osama bin Ladin has been quoted as saying it is better to kill an American soldier than to just sit idle. Many radical extremists view Americans as enemies of their religion who must be eliminated. Houses of worship and other gathering places are good targets. The point is clear: Most communities across our country have places or buildings that could serve as targets for terrorists. This war is being fought on our soil, and the fire service will be the first to respond. We must be ready.


(3) The heart of the decon corridor. Water is flowing from each side and from above at nozzle pressures not exceeding 50 psi. Firefighters are encouraged to play the roles of victims for this exercise. It is amazing how disorienting it is to be surrounded by water spray. After being “decontaminated” in the training exercise, firefighters better understand what the victims feel and the directions the victims will need after decontamination.

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(4) The first part of the emergency decontamination corridor system. Additional firefighters are needed to direct victims to undress and enter the decon corridor. These two handlines are pressurized to no more than 50 psi. Automatic nozzles are not used because they flow very limited quantities of water at 50 psi.

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WHERE TO START

If we examine these types of attacks, a common and frequent response requirement is decontamination. It is a very good place to start to prepare. A variety of decontamination procedures are used across our country. The key is that you can use your present fire suppression equipment to establish a good emergency decontamination corridor system.

Generally, decontamination has three categories: emergency decon, technical decon, and mass decon.

  • Emergency decontamination. The physical process of immediately reducing contamination of individuals (civilians or responders) in potentially life-threatening situations with or without formally establishing a decontamination corridor.
  • Technical decontamination. The planned and systematic process of reducing contamination to a level that is as low as reasonably achievable (ALARA). Technical decon operations are normally conducted in support of emergency responder recon and entry operations at a hazardous-materials incident and to handle contaminated patients at medical facilities.
  • Mass decontamination. The process of decontaminating large numbers of people in the least possible time to reduce surface contamination to a safe level. It is typically a gross decon process using water or soap and water solutions to reduce the level of contamination.
  • Medical decontamination. Tom Clappi, the emergency preparedness coordinator for the New York Presbyterian Health Care System, reminds us about another class of decon, medical decon for nonambulatory victims. Clappi explains: “Before treatment and transport can be performed on injured victims who are contaminated, they must be decontaminated to prevent transporting the contamination and the resultant closing of the primary treatment area in the hospital. Nonambulatory victims will require at least three steps: clothing removal, multiple washing/rinsing, and monitoring. This process requires more personnel and different types of equipment—stretchers that do not retain contaminants, decon hoops or a roller system or series of saw horses to hold the stretchers and victims at a height where they can be efficiently worked on by the decon team. This type of decon is not more complex than any other type, but you should plan and train to execute it.”


(5) The commercially available decon is set up in the background. If available, this unit can be set up to provide a more thorough washing of potentially contaminated victims. This inflatable unit has hot and cold running water, air heaters, privacy screens, and shower-quality heads in addition to undress and redress areas.

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(6) The hands-on portion of the training. Members acting as victims enter the first phase of the emergency decon corridor. (Photo by Fred Brennan, News of the Highlands.)

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(7) Trainees are taught to direct victims to keep moving through the system. These victims have come through the preliminary decon and are moving toward the more thorough wash. (Photo by Fred Brennan, News of the Highlands.)

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HIGHLAND FALLS FIRE DEPARTMENT INITIATIVE

The “good, better, best” philosophy is critical to achieving success in preparing your department for terrorism responses. Most departments are not prepared at all. If you establish something, plans, SOPs, and so on, you are better off than before. Once you start your plans, you can and will improve them over time with training, exercises, and after-action reviews. This process will get you to “better.” In time you will get to your best practices. A variety of factors will influence how far you get, but it sure is better than “nowhere!”

The Highland Falls (NY) Fire Department (HFFD) decided to use this philosophy to improve its preparedness posture for homeland defense. Located just outside the U.S. Military Academy (USMA) at West Point, the HFFD is second due for all working fires and emergencies in and around the military academy.

The HFFD agreed to become proficient in mass-decontamination procedures. Personnel enthusiastically accepted the challenge to become better prepared to support the homeland defense mission. The Academy staff met several times with HFFD department officers to discuss the decon plan and to determine exactly the level of capability that could be achieved. The choice was mass decontamination, which would enhance area and county resources. The USMA has developed a basic haz-mat capability; the USMA fire department provides technical decontamination for the haz-mat team. Adding a mass-decon capability that can operate independently is a significant resource to be able to call on when it is needed.

HFFD Chief Andrew Saylor says becoming a decon-capable unit has several advantages: “First, we know that if there is any type of attack or possible attack on the military academy, we will be the first called for help. We know we will respond. It is far better to respond prepared than to try to make it up as you go. That is simply too dangerous.”

He noted also that there is a real potential for serious haz-mat responses in the local area. He cited the presence of a state highway that borders on the town’s western flank and a mainline railroad to the east. Saylor says it is only a question of when the department will use the decon capability. The railroad, he explains, has had some pretty serious derailments just north and south of the town. Considering the terrain and volumes of hazardous materials shipped by rail and highway, a major haz-mat incident is very likely, Saylor says. “We are fortunate in Orange County to have a very good haz-mat team with an excellent mutual-aid component from the Rockland County team. Manpower, however, is always an issue, and we could very easily be a resource for them.”

Another benefit of having the capability to perform mass decon is that it makes it easier to request grant money. Funds are available for equipment that can be used for terrorism response and to provide fire protection to the community.

The Office of Domestic Preparedness (ODP) offers a variety of excellent training courses. Its resources were used to develop the haz-mat team. The ODP has contracted the General Physics Corporation to provide on-site training for responders requesting it. The training is high quality; its instructors are experienced and experts in their field. The training, funded by the ODP, is done at the site of the organization requesting the training and in accordance with the department’s schedule.1


(8) Trainees are taught to explain to victims how they can assist each other. Here, one victim drags another incapacitated victim through the decon corridor. This reduces personnel requirements and prevents rescuers from becoming contaminated. (Photo by Fred Brennan, News of the Highlands.)

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DPETAP PROGRAM COMPONENTS

The Domestic Preparedness Equipment Technical Assistance Program (DPETAP), established through a partnership between the U.S. Army Pine Bluff Arsenal; the Department of Defense Center of Expertise for Chemical/Biological Defensive Equipment, Produc-tion, and Support; and the Office for Domestic Preparedness, is a comprehensive national equipment technical assistance program for emergency responders. The DPETAP provides at no cost to ODP grantees on-site technical assistance and training in operating and maintaining domestic preparedness equipment.

The program also offers the WMD Mass Casualty Personnel Decontamination course. This highly intensive 24-hour course challenges the first responder to establish the emergency decontamination corridor system within the context of a terrorist-related emergency. The decon target audience includes all members of the emergency response community.

Training at HFFD was held Friday evening and all day Saturday and Sunday, to accommodate volunteers’ schedules. All it took on our part to set up the training component was making the phone call and finding a place to hold the classroom and hands-on training. Needless to say, the effort was minimal; the results, however, have been outstanding.

The mass-decon program includes the following topics:

  • Introduction to Terrorism—history and objectives of terrorism.
  • Decontamination Principles—description and definition of mass-casualty decon.
  • Decontamination Procedures and Equipment—methods to reduce contamination of victims.
  • Site plans for mass decontamination.
  • Medical considerations.

Practical exercise and response.

This stand-alone program includes several sections of general training such as detection equipment and terrorist-related weapons. The last eight hours involves hands-on training, conducted at a preselected site. Trainees use their own fire suppression equipment to set up an emergency decontamination corridor system with the instructors’ assistance. The system is then broken down.

After lunch, the class responds as a first-response unit to a hypothetical incident and sets up the system (see photos) and operates it. Actually, doing it takes the mystery out of the process and establishes a very positive mindset for making future improvements. Figure 1 shows the system layout. The instructors also set up the commercially available decon unit they brought with them. This further reinforces the concept of decon and provides a good demonstration of what is available on the market if funding is available.

SOME ADDITIONAL POINTERS

Your decon system must include a few other important concepts. Major Jeff Simpson, a U.S. Army chemical branch officer, notes there are similarities between the battlefield chemical attack and a possible WMD attack in the civilian world: “The most important function is to attempt to identify the agent or at least develop a working determination of the agent based on symptoms, delivery method, [and other factors]. Specific detection equipment will be a real asset. Most haz-mat teams now have these capabilities, especially with the equipment caches being deployed by federal channels.”

He relates the following information as well.

  • Gross contamination is always a priority.
  • If victims are ambulatory, chances are that most of the agent is on their outer clothing. Removing this clothing will often remove most of the contamination. The clothing must be placed in a secure area, away from other people, and ultimately disposed of.
  • For mass decon at the scene, trash cans with lids or trash bags can be used to confine contaminated clothing.
  • Routes for getting contaminated victims into the emergency decon corridor and clean victims and emergency responders out of the decon area must be established. Scene tape, signs, and traffic cones could be used for these purposes. Continue to improve the routes as the incident develops.

REFINING THE SYSTEM

After you have defined and trained with your basic mass decon-tamination system, the next step is to continue to refine it. The following guidelines/recommendations will help ensure your members are appropriately protected and your system is fully mission capable.

  • Team members must wear personal protective equipment, which can range from turnout gear and SCBA to chemical resistant suits and SCBA (level B) to level A for members entering the hot zone to effect rescue.
  • Select a time limit for how long you will allow members to operate near the hot zone and around contaminated people. Then determine how you will get them through decon and whether it will be technical decon brought in by haz-mat units.
  • Determine how your members at the beginning of the corridor will communicate with victims to get them to undress and get into the decon process. SCBA will make it difficult to communicate. Members assigned to direct victims must have voice amplifiers on their SCBA. A public address system could be used from the cold zone, or a speaker on one of the rigs can be used to direct victims.
  • Determine how you will interface with your haz-mat team and EMS. Meet with team leaders to discuss the roles and responsibilities of each unit. Test your plans with full-scale exercises.
  • Determine how you will request people to undress, and to what level. Provide short scripted sentences as part of your plan.
  • How far should they undress? What seems appropriate is to get people to strip down to their underwear. Most of the contamination will be on their outer clothes. Allowing victims to maintain their dignity will make it much easier to get them into and through the decon system.
  • After you have decontaminated people in the middle of the street, provide a means for them to dry and redress. Disposable towels work well and come in case size lots. Redress kits can be as simple as a large plastic trash bag with holes cut in it or commercially available kits.
  • Victims may not want to give up valuables, wallets, pocketbooks, jewelry, handguns, and the like. Give these victims a plastic bag in which they can put these items; they can carry the bags through decon. Clearly, this is not the most effective method of decon, but if items are sealed up in the bag and this process gets contamination off many victims quickly, you may opt for choices like this. The alternative is to spend lots of time arguing with these people. Preplanning and exercising with local police will also help. Under the public law, if the patient presents with an unreasonable threat to public health, he can be forced to decon and give up the possessions.
  • Determine how you will decontaminate nonambulatory victims. Will they be a second priority?
  • The situation will dictate how cooperative people will be and how drastic responders’ actions will have to be. For example, if people are contaminated with a nerve agent and are violently seizing, vomiting, and literally dying in front of numerous other people, compliance with decon instructions will not be a problem. If, however, there is a high degree of doubt in victims’ minds about just how important it is to be decontaminated, it may be difficult to get them to go through.

Don Feldman, an Orange County fire coordinator and active member of the HFFD, observes the following in relation to the training and preparedness process: “In one short training session, we learned enough to get us well down the road to successful response to WMD or haz-mat calls.” He adds that even though the entire department was not at the training, the officers and members who did attend could easily direct other members during an actual response or training event. “This program can really function as a train-the-trainer with excellent results,” he concludes.


“Local responders and haz mat teams will be overwhelmed at emergencies that require mass decontamination,” points out Dan Greeley, Rockland County haz mat team commander.” If several fire departments in each county can become proficient at decontamination, it will be a tremendous asset in saving lives and reducing injuries. Mutual aid among teams must be considered and interdepartmental training/exercises should be held regularly.”

Many people in the fire service may criticize this method of developing your new decon capability. There certainly are pitfalls to establishing part of the system for such a complex response to a haz-mat or WMD emergency. Questions such as the following will be raised: Are we getting into something that will risk members’ lives? Are we really fully prepared? Should we wait until we have all the equipment and training? These and other questions are completely valid. But consider this question: Who in your department will not respond and not do the best they can when people are injured and dying as a result of a haz-mat or WMD event? We are all going to go; let’s be ready.

Special thanks to General Physics Trainers Zach Lay, Ed Ward, Eddie Anderson, and Dennis Casida. This article is dedicated to Chief Ray Downey for advancing the homeland defense initiative long before others could conceive of its importance.

Endnote

1. Gil Wendt, 870-540-2381 or e-mail gwen@genphysics.com or the Web site http://www.gpworldwide.com/.

JERRY KNAPP is a training officer at the Rockland County Fire Training Center in Pomona, New York, and a 28-year veteran firefighter/EMT with the West Haverstraw (NY) Fire Department. He has an associate’s degree in fire protection technology, is a former paramedic, and is the emergency management officer at the United States Military Academy, West Point, New York.

ANDREW SAYLOR is chief of the Highland Falls (NY) Fire Department, where he has served since 1973. He has held a variety of line officer and house positions.

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