On 28 March 1979, the worst nuclear power plant accident in U.S. history occurred in Reactor Two of the Three Mile Island generating station (on the Susquehanna River, near Middletown in southeastern Pennsylvania). Since that time, onsite and offsite guidelines and requirements for emergency preparedness plans covering nuclear power plants have provided a framework for local and state emergency management officials and emergency responders. Throughout the United States, plans for the evacuation, the decontamination (decon), and the sheltering of persons within the emergency planning zones surrounding nuclear generating stations are scheduled regularly and frequently audited by state and federal officials.
Although these plans pre-identify the objectives necessary for a unified response to the release of radioactive material, they usually do not specify the tactics by which the agencies involved are to meet those objectives – many of which require continuous planning and exercising. However, the decontamination of large groups of evacuees may, in certain jurisdictions, involve some unique challenges. The special considerations reviewed below are not specific to radiological incidents but, rather, are among the typical challenges that may face any hazardous materials response team (HMRT), or hospital decon team, when treating and/or decontaminating a patient following a chemical, biological, radiological, nuclear, or high-yield explosive (CBRNE) incident.
The First Priority: Saving Officers
Law enforcement officers (LEOs) are often the first arriving responders at incident scenes, which poses a significant threat for them to unknowingly become contaminated by a hazardous substance. Moreover, because of the increasingly common occurrence of chemical suicide attempts across the country, LEOs may find themselves trying to rescue an unconscious person from an enclosed area, not knowing the chemical threat that might be waiting. Similarly, clandestine labs, both mobile and fixed, present a myriad of other chemical and explosive threats to LEOs. In a radiological emergency scenario, it is possible that a number of LEOs may be among those evacuated from the emergency planning zone who require immediate decon.
In these and certain other scenarios, a LEO who is contaminated will need emergent decontamination, which requires that the HMRT or hospital decon team follow the plans in place for securing and safeguarding any and all weapons. However, it can be safely assumed that many LEOs will not readily surrender their weapons to unknown, or even known, first responders or hospital staff without prior assurance that the weapons will be in the custody of another LEO. Additionally, HMRT and hospital decon staff may not know the procedures required to handle and/or secure weapons – for example, firearms, tasers, and OC (commonly known as “pepper spray”).
To address these and similar issues, a best practice was established in Lehigh County, Pennsylvania, where the county’s Special Operations Team also serves as a regional HMRT and as the Lehigh County Emergency Management Agency’s urban search and rescue team. Working together, those jurisdictions have planned, exercised, and implemented a reasonable and well-articulated policy for the on-scene decon of LEOs. The policy calls for the use of a small team of sworn LEOs from a municipal police department to serve as the support staff of the Special Operations Team. These officers are cross-trained and have been nationally certified to the hazardous materials operations level, which meets the requirements of both the National Fire Protection Association (NFPA-472) and the U.S. Labor Department’s Occupational Safety and Health Administration.
The officers so designated respond with the Lehigh County Special Operations Team and, thanks to their cross-training, are able both to operate in the decon line and to, if and when necessary, take custody of fellow LEOs’ weapons, render them safe, and properly secure them. The support staff also retains and maintains its own small cache of supplies – including Level-B tactical and non-tactical personal protective equipment, self-contained breathing apparatus, and specialized firearm lockboxes. In the event that an officer is in critical medical condition and requires emergency decon, procedures also are in place to secure his or her entire gun belt in a sealed lockbox while the team is administering the expeditious decon needed.
This procedure has been exercised, implemented in actual responses, and evaluated as effective. Because of the diverse number of threats – already present or projected – combined with the all-hazards approach that responders must now follow, integration of the HMRT with local law enforcement is critical for success in the field. Hospital decon teams must consider their operations and policy development for decontaminating any LEO presenting at the Emergency Department who is potentially contaminated.
The same HMRT/LEO partnership also can be expanded from the hazardous materials operations level to include training at the hazardous materials technician level, which would include sampling and the collection of evidence in the “hot zone” of an active crime scene. Although the decon aspect of the LEO support role in the HMRT is in its infancy, it not only has already yielded positive results in Lehigh County but also has shown that there is considerable room for expansion.
Service Animal Decon
Often overlooked is the decon of the special needs population itself, specifically those members with service dogs, which also have to be properly planned for and exercised. Evacuees of the emergency planning zone, or any area affected by a CBRNE event, requiring decontamination may also present to a reception center with their pets. Although most decon efforts primarily focus on human evacuees, plans also must be in place to decontaminate pets when needed.
Service dogs, in particular, must be decontaminated expeditiously and placed back into service to ensure the safety of the humans they serve. Best practices include ensuring that cooperative service animals are decontaminated with their owners, or concurrently with their owner in an animal-specific decon line. Regional teams known as county (or community) animal response teams or state animal response teams are trained to both shelter and care for animals during disasters. Integration of these teams with the local HMRT is critical for the successful and safe decon of animals.
Best practices regarding the use of the county/state animal response teams include outfitting the teams with animal-specific decon supplies, cross-training team members to the hazardous materials operations level, and integrating animal decon into mass evacuation and decon exercises.eally, the animal response team will provide animal crates, muzzles, harnesses, etc., to support and expand the capabilities of the decon operation in place. Additionally, these teams often have members with specialized training in small and large animal handling and care. Frequently, these teams include licensed veterinarians. Using regional resources such as county/state animal response teams is a crucial step toward ensuring an appropriate multidisciplinary approach to decontamination.
Plans originally developed for radiological emergency preparedness often can be adapted for all-hazard uses. The fundamental principles and foundations used to guide the evacuation and/or decon of humans and animals during and after a radiological incident also can be used to develop plans and policies for decon during any CBRNE incident. The keys to a successful multidisciplinary approach are cross-training, frequent exercises, and periodic program reviews. Whether it is a field HMRT or a hospital decon team, the frequent collaboration with partner public and private agencies will almost always help ensure future incident success.
Ryan Hay, RN, BSN, a hazardous materials specialist with the Lehigh County Special Operations Team, serves on both a regional HMRT and on an urban search and rescue team in eastern Pennsylvania. He is also a registered nurse in the Emergency Department of the St. Luke’s University Health Network, where he is involved in emergency preparedness efforts. He continues to work in the field as an active pre-hospital EMS provider and instructor. He also serves as the Pennsylvania coordinator for the National Collegiate EMS Foundation and is co-founder of the DeSales University EMS. He graduated from DeSales University with a BA in political science and national security, and a BS in nursing.