Self-Care Decontamination: Psychosocial Supports

April 1, 2014

You are a first responder. You arrive at the scene where there is a crowd of scared, hurting and anxious people who have been contaminated by a toxic chemical. It is 10°C outside. What should you do?

Typically, you would make sure you are safe and you would tell people to move out of the contamination zone and wait for a Hazardous Materials (HazMat) Team to arrive and start the decontamination process. However, research has shown that in many cases it takes a long time for HazMat Teams to arrive and by the time they are set up, many casualties have left the area and have gone to hospitals. Thus, additional persons and places can become contaminated and hospitals go into lock-down, putting others at risk. Casualties, especially children, faced with the “Darth Vader” appearance of HazMat Teams, have reported nightmares, anxiety, and extended trauma as a result of their encounters with HazMat Teams.

The Simulation, Training, and Exercise Collaboratory (SIMTEC) is a four-year research project undertaken by the Justice Institute of British Columbia (JIBC) in collaboration with Royal Roads University and championed by Health Canada. It is funded by the Canadian Safety and Security Program (CSSP), which is led by Defence Research and Development Canada’s Centre for Security Science, in partnership with Public Safety Canada. Originally, SIMTEC researchers were exploring ways to reduce the psychosocial stressors associated with decontamination; however, the project evolved into something much more comprehensive and exciting.

As part of this four-year research project, a simulated functional table-top exercise “Exercise Green Cloud,” was successfully held on October 1, 2013. The exercise tested the ability of responders in Hospital and Community-based Emergency Operations Centres (EOCs) and an Incident Command Post. It also tested the ability of Health Canada’s EOC and the Royal Canadian Mounted Police’s International Integrated National Security Enforcement Team (INSET) to implement Self-Care Decontamination Protocols to a Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNE) event. This exercise was the culmination of months of research, exercise development, and testing by the SIMTEC research team and JIBC support staff.

Researchers noted that there was a real gap in bridging the time between when casualties first needed to be decontaminated and the arrival of HazMat Teams. Accordingly, working with an Expert Working Group of first responders, psychosocial professionals, the BC Coalition for People with Disabilities, and the North Shore Emergency Management Office, a Self-Care Decontamination Protocol was developed. This protocol could be carried out by any trained first responder and would enable casualties to remove most of the contaminants prior to the arrival of HazMat Teams, who could then complete the technical decontamination or showering process.

Researchers also developed messaging and protocols to accommodate at-risk populations, including pregnant women, children, infants, persons who are blind, persons with anxiety disorders, persons in wheelchairs, and many others. Self-care decontamination kits were developed with the help of First Aid Survival Technologies (F.A.S.T.) and used to support the cleaning and disrobing process as well as the post-showering process. Additionally, a prototype “Decon Doll” or action figure was created to help prepare children for the arrival of the HazMat Team members—they could undress the doll prior to the arrival of the Team and recognize that a person was under the personal protective equipment (PPE) and HazMat suits, thus reducing anxiety and fear.

All of this was tested in a cold weather self-care decontamination drill held in North Vancouver in March 2013 with over 35 participants and a number of first response organizations. It was a major success, and using the results of interviews and focus groups with responders and participants, the protocols and kits were further refined, tested in August 2013 in White Rock, and presented at Exercise Green Cloud.

 On January 13/14 2014, HazMat Experts locally, nationally, and internationally were brought together for a two-day workshop to review, critique, and help SIMTEC researchers further refine the protocols used by first responders.

The workshop was a major success and a terrific opportunity to learn from each other. The knowledge and experience shared by experts from Canada, the United States and the United Kingdom provided great insights to improve our protocols and the Research team will be compiling notes and recommendations from the workshop to simplify the directions and further increase the affected populations’ ability to carry out the self-care decontamination kits required steps. On our side, we made our work done with at-risk populations and our findings available to others – all of which will enhance decontamination outcomes for everyone. We anticipate having the changes completed and all of the materials on Exercise Green Cloud available on the SIMTEC website by March 31, 2014.

Laurie Pearce, Ph.D is a Research Chair at the Justice Institute of British Columbia.

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