Chemical Accidents and Disasters: Medical Care Planning

0,23
MB Guidance

94
stron

3522
ID National Board of Health and Welfare

2000
rok

Contents

Foreword..3

Background.7

Examples of accidents and disaster simulations 10

Ammonia ..10

Fires .11

Dioxins (Seveso) 12

Phenol .12

Chlorine .13

Methylisocyanate (Bhopal) ..14

Nerve gases ..15

Nitrogen oxides ..16

Smoke shells 17

General remarks on chemical substances.. 18

Hazardous Substances 19

Industry ..19

Transport 19

Sports installations etc 20

Injury potential ..20

New Threats .21

Special features and requirements in a chemical accident 23

Risk area 23

Decontamination24

Uniform casualty profile and standardised treatment .24

‘Knocked out’ hospital 25

Observation units ..25

Information ..25

Inventory 25

Information .. 26

General ..26

Medical care 27

Labelling and placarding systems, classification, material safety data sheets 32

Decontamination of persons, personal protective equipment . 36

Decontamination of persons 36

Personal protective equipment 37

Responsibility and planning 42

Responsibility and co-ordination in peace time .42

Responsibility and co-ordination during raised alert states .43

Responsibility and planning in the health and medical services 43

Training .45

Organisation. 47

Organisation at the accident scene and in transport .47

Decontamination station/decontamination area .51

Casualty assembly point 53

Health care facilities 54

Follow-up.. 56

Registration ..56

Sampling 56

Effects of exposure, general treatment and triage . 57

Acute effects of exposure..57

Treatment – first aid .60

Triage ..63

Hypochondriac reactions ..65

Particular poisonous substances (including chemical weapons) 66

Chemical weapons 73

Literature .. 82

Appendix 1 ..85

Functional requirements for chemical protection in health care facilities 85

Functional requirements for decontamination stations ..86

The entire hospital should meet the following functional requirements, among others ..88

Other measures ..88

Appendix 2 ..89

Emergency stocks at hospitals 89

Disaster stocks for transport to the scene of the accident ..90

Appendix 3 ..91

Decontamination of casualties from chemical weapons during raised alert states 91