title: Evidence-based patient decontamination: an integral component of mass exposure chemical incident planning and response.
abstract: Decontaminating patients who have been exposed to hazardous chemicals can directly benefit the patients' health by saving lives and reducing the severity of toxicity. While the importance of decontaminating patients to prevent the spread of contamination has long been recognized, its role in improving patient health outcomes has not been as widely appreciated. Acute chemical toxicity may manifest rapidly-often minutes to hours after exposure. Patient decontamination and emergency medical treatment must be initiated as early as possible to terminate further exposure and treat the effects of the dose already absorbed. In a mass exposure chemical incident, responders and receivers are faced with the challenges of determining the type of care that each patient needs (including medical treatment, decontamination, and behavioral health support), providing that care within the effective window of time, and protecting themselves from harm. The US Department of Health and Human Services and Department of Homeland Security have led the development of national planning guidance for mass patient decontamination in a chemical incident to help local communities meet these multiple, time-sensitive health demands. This report summarizes the science on which the guidance is based and the principles that form the core of the updated approach.
authors.affiliation: Medical Countermeasure Strategy and Requirements Division, Office of Policy and Planning, Office of the Assistant Secretary for Preparedness and Response, Washington, DC.
authors.forename: Adam D
authors.initials: AD
authors.lastname: Leary
authors.affiliation: National Center for Environmental Health, Centers for Disease Control and Prevention, Washington, DC.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Schwartz
authors.affiliation: US Department of Health and Human Services, Chemical Defense Program, Office of Health Affairs, US Department of Homeland Security, Washington, DC.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Kirk
authors.affiliation: US Department of Health and Human Services, Chemical Defense Program, Office of Health Affairs, US Department of Homeland Security, Washington, DC.
authors.forename: Joselito S
authors.initials: JS
authors.lastname: Ignacio
authors.affiliation: Medical Countermeasure Strategy and Requirements Division, Office of Policy and Planning, Office of the Assistant Secretary for Preparedness and Response, Washington, DC.
authors.forename: Elaine B
authors.initials: EB
authors.lastname: Wencil
authors.affiliation: Medical Countermeasure Strategy and Requirements Division, Office of Policy and Planning, Office of the Assistant Secretary for Preparedness and Response, Washington, DC.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Cibulsky
mesh_terms: D055884:Chemical Hazard Release; D002618:Chemical Warfare; D003666:Decontamination; D004189:Disaster Planning; D004636:Emergency Service, Hospital / Q000458:organization & administration; D055317:Evidence-Based Practice; D006291:Health Policy; D006801:Humans; D054527:Mass Casualty Incidents; D014481:United States