title: Emergency department external decontamination for hazardous chemical exposure.
abstract: Although external decontamination is an integral aspect of the emergency management of hazardous chemicals exposure, no standard protocol or report of human experience is available. We performed a retrospective review of all patients decontaminated in our emergency department over a 6-y period for hazardous chemicals exposure. Patients were treated by a universal substances protocol in a specially designed decontamination area. Ocular irrigation utilizing 1500 ml of normal saline po was employed in 27 patients. Oral mucosal irrigation utilizing 1500 ml water was employed in 2 patients. All 72 patients received skin and hair decontamination. Skin was washed 3 times with detergent and cornmeal mixture, and water irrigation or shower for 3 min. Hair was shampooed 3 times with mild soap for 3 min. A subset of patients (n = 31) received pre-decontamination and post-decontamination skin swabbing. Swabs were analyzed by a certified analytical chemistry laboratory utilizing gas chromatography/mass spectrometry. Positive pre-decontamination swabs were seen for pesticides and PCBs. All post-decontamination swab analyses were negative, indicating that the method utilized was effective.
authors.affiliation: Department of Emergency Medicine, School of Medicine, University of Louisville, KY 40292.
authors.forename: F W
authors.initials: FW
authors.lastname: Lavoie
authors.forename: T
authors.initials: T
authors.lastname: Coomes
authors.forename: J E
authors.initials: JE
authors.lastname: Cisek
authors.forename: L
authors.initials: L
authors.lastname: Fulkerson
mesh_terms: D002985:Clinical Protocols; D003666:Decontamination / Q000379:methods*; D004636:Emergency Service, Hospital; D004781:Environmental Exposure / Q000517:prevention & control; D015386:Hazardous Substances / Q000506:poisoning*; D006801:Humans; D007629:Kentucky; D010575:Pesticides / Q000032:analysis; D011078:Polychlorinated Biphenyls / Q000032:analysis; D012189:Retrospective Studies
chemical_list: D015386:Hazardous Substances; D010575:Pesticides; D011078:Polychlorinated Biphenyls