CAUTION
Remember, personnel must assume MOPP Level 4 before beginning any decontamination process or risk becoming a casualty themselves.
- Hospital staff always mask themselves first, then assist patients in masking. On minimal care wards, most patients can put on their masks. For those who cannot, other patients can assist them after putting on their own masks. On the intermediate care wards, some patients will be able to put on their masks, but many will require assistance. Intensive care and emergency room staff will have to assist their patients in masking.
- Many patients with head and neck wounds or who are on life-support devices will be unable to wear their individual protective masks; these patients must be placed in a PPW. While the PPW has two ports for intravenous or blood infusion lines, the staff may have to adapt for other devices (Foley catheters, traction devices, and cardiac monitor) by using tape and other means to seal the gaps created in the seal around the edge of the PPW. Patients requiring assisted ventilation are at extreme risk, unless their air supply is protected. The sequence of protecting everyone is mask yourself first; assist those patients who can wear their protective masks; and then place patients in the PPW.
(d) Materiel protection. Protection of materiel, especially expendable supplies, requires covers and barriers. All materiel not required for immediate use is kept in shipping containers, medical chests, or under cover (tentage, plastic sheeting, and tarpaulin) for protection against particulate or liquid hazard. Protection against vapor hazard may require multiple barriers through which the vapor must penetrate. For example, intravenous solutions are in their individual plastic bags, in the cardboard shipping box, on a covered pallet, in a hard-walled shelter; such as a military-owned demountable container (MILVAN). This presents four barriers against the vapor hazard. These principles should be used to the maximum extent practical.
4-3. Decontamination
a. Decontamination of nuclear-contaminated personnel, equipment, and the operational site is as follows:
(1) Monitoring equipment is used to detect contamination; the contamination is then removed by brushing or scraping with brooms, brushes, or tree branches. Flushing hard surface contaminated areas with water is also effective in removing nuclear contamination. However, there remains a problem of containing and removing the contaminated water. The best method of containment is to trench the area into a sump for collection of the contamination. This will reduce the area of contamination; however, the level of concentrated radiation may be such that there is an increased hazard to personnel. The collection area must be clearly marked using the standard nuclear hazard signs.
(2) Nuclear contamination of the site may require relocating the hospital. Scraping 1 or 2 inches of topsoil from the area, or covering the area with 1 or 2 inches of uncontaminated dirt will not be practical. A need to relocate the hospital will depend upon the degree of contamination; the amount of decontamination possible and the projected stay before a normal move in support of operations. If the hospital is immersed in a high level of radioactivity, the best option may be to abandon it for 48 to 72 hours. After this period the area should be checked and if the radioactivity has decayed sufficiently the hospital may be reoccupied and continue operations or moved to a clean area. The command OEG must be followed if reoccupying or moving the facility.
b. Suspect biological agents should be removed from equipment as quickly as possible, In the absence of agent-specific guidance, clean exposed surfaces using a 5 percent hypochlorite solution or copious quantities of soap and water (preferably hot). Liberally apply the hot, soapy water and scrub all surfaces with a brush. Then rinse the surfaces with hot water. As previously discussed, the soapy water used is contaminated and must be controlled and removed to a safe area. Supertropical bleach (STB) and decontaminating solution Number 2 (DS2, US Army) are effective against most known biological agents because of their caustic nature. If anthrax (or other spore formers) is suspected, repeat the entire decontamination process again to remove the spores. Other standard biological decontamination agents are described in FM 3-5.