Abstract
HAZMAT (hazardous materials) events can cause an influx of patients, including children, directly to the hospital. The ability of health care facilities to care for a large number of casualties including children following a HAZMAT event should be part of all hospitals’ plans. It is critical for hospitals to have the capacity to safely care for casualties while maintaining a safe working environment and preventing secondary contamination. Key components of pediatric decontamination are similar to that of an adult; however, the application is more challenging. Processes vary based on children’s ages and developmental level. Special considerations such as keeping families together, processes for unaccompanied minors, and physiological vulnerabilities should be implemented in the decontamination process. Health care facility guidance, integrating children into disaster plans, communication considerations, specialized equipment, and recommended training are presented.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Allen GM, et al. Principles of disaster planning for the pediatric population. Prehospital Disast Med. 2007;22(6):537–40.
American Academy of Pediatrics. Children and disasters: disaster preparedness to meet children’s needs. 2019. Available from https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Children-and-Disasters/Pages/Decontamination.aspx. Accessed 11 May 2019.
Authority C.E.M.S. Hospital incident command system—job action sheets 2014.
Bowden VR, Greenberg CS. Children and their families: the continuum of care. Philadelphia, PA: Lippincott Williams & Wilkins; 2010.
Chilcott RP, et al. Evaluation of US Federal Guidelines (Primary Response Incident Scene Management [PRISM]) for mass decontamination of casualties during the initial operational response to a chemical incident. Ann Emerg Med. 2019;73(6):671–84.
Chur-Hansen A. Preferences for female and male nurses: the role of age, gender and previous experience–year 2000 compared with 1984. J Adv Nurs. 2002;37(2):192–8.
Cibulsky S, et al. Patient decontamination in a mass chemical exposure incident: National Planning Guidance for Communities. Washington, DC: US Department of Homeland Security and US Department of Health and Human Services; 2014.
Eisenkraft A, et al. What can we learn on medical preparedness from the use of chemical agents against civilians in Syria? Am J Emerg Med. 2014;32(2):186.
Falkenrath RA, Newman RD, Thayer BA. America’s Achilles’ heel: nuclear, biological, and chemical terrorism and covert attack. Cambridge, MA: MIT Press; 1998.
Fire Department Mass Decon. [Internet]. 2011. Available from https://www.foap.com/photos/fire-department-mass-decon-dd4a29f2-46db-4173-856c-d5fbb01a9308. Accessed 30 Sept 2019.
Foresman-Capuzzi J, Eckenrode P. When Mr Yuck meets Mr Bubble: a primer on pediatric decontamination. J Emerg Nursing. 2012;38(5):490–2.
Freyberg CW, et al. Disaster preparedness: hospital decontamination and the pediatric patient—guidelines for hospitals and emergency planners. Prehosp Disaster Med. 2008;23(2):166–73.
Gurwitch RH, et al. When disaster strikes: responding to the needs of children. Prehosp Disast Med. 2004;19(1):21–8.
Harvard School of Public Health. Hospital decontamination self-assessment tool. Commonwealth of Massachusetts Department of Public Health—Office of Emergency Preparedness and Emergency Management. Boston, MA: Harvard School of Public Health; 2014.
Heon D, Foltin GL. Principles of pediatric decontamination. Clin Pediat Emerg Med. 2009;10(3):186–94.
Hick JL, et al. Protective equipment for health care facility decontamination personnel: regulations, risks, and recommendations. Ann Emerg Med. 2003a;42(3):370–80.
Holland MG, Cawthon D. Personal protective equipment and decontamination of adults and children. Emergency Medicine Clinics. 2015;33(1):51–68.
Horton DK, Berkowitz Z, Kaye WE. Secondary contamination of ED personnel from hazardous materials events, 1995–2001. Am J Emerg Med. 2003;21(3):199–204.
Jorgensen AM, Mendoza GJ, Henderson JL. Emergency preparedness and disaster response core competency set for perinatal and neonatal nurses. J Obst Gynecol Neonat Nurs. 2010;39(4):450–67.
Kar N. Psychological impact of disasters on children: review of assessment and interventions. World J Pediatr. 2009;5(1):5–11.
Lynch EL, Thomas TL. Pediatric considerations in chemical exposures: are we prepared? Pediat Emerg Care. 2004;20(3):198–208.
Novak C, Gill P. Pediatric vital signs reference sheet. 2018. Available from http://pedscases.com/pediatric-vital-signs-reference-chart. Accessed 31 May 2019.
Occupational Health and Safety Administration. OSHA best practices for hospital-based first receivers of victims from mass casualty incidents involving the release of hazardous substances. Washington, DC: Occupational Health and Safety Administration; 2005.
Okumura T, et al. Report on 640 victims of the Tokyo subway sarin attack. Ann Emerg Med. 1996;28(2):129–35.
Raber E, et al. How clean is clean enough? Recent developments in response to threats posed by chemical and biological warfare agents. Int J Environ Health Res. 2004;14(1):31–41.
Schreiber M. The PsySTART rapid mental health triage and incident management system. Irvine: Center for Disaster Medical Sciences, University of California; 2010.
Siegel D, Strauss-Riggs K, Needle S. Prioritization of pediatric chemical, biological, radiologic, nuclear, and explosive disaster preparedness education and training needs. Clin Pediatr Emerg Med. 2014;15(4):309–17.
Teague DC. Mass casualties in the Oklahoma City bombing. Clin Orthop Relat Res. 2004;422:77–81.
Timm N, Reeves S. A mass casualty incident involving children and chemical decontamination. Disast Manag Resp. 2007;5(2):49–55.
Toxidrome. (n.d.) Mosby’s medical dictionary 2009.
United States Department of Health and Human Services Security. National disaster recovery framework. 2nd ed. Washington, DC: United States Department of Health and Human Services Security; 2016.
USAMRIID. Medical management of biological casualties handbook. 7th ed. Fort Detrick, MD: USAMRIID; 2011.
Veenema TG, editor. Disaster nursing and emergency preparedness. 4th ed. New York, NY: Springer Publishing Company, LLC; 2019.
Zhao X, Dughly O, Simpson J. Decontamination of the pediatric patient. Curr Opin Pediatr. 2016;28(3):305–9.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Meyer, K. (2020). Decontamination. In: Goodhue, C., Blake, N. (eds) Nursing Management of Pediatric Disaster. Springer, Cham. https://doi.org/10.1007/978-3-030-43428-1_9
Download citation
DOI: https://doi.org/10.1007/978-3-030-43428-1_9
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-43427-4
Online ISBN: 978-3-030-43428-1
eBook Packages: MedicineMedicine (R0)