CAS RN: 505-60-2

Other Preventive Measures

Hot Zone Responders should be trained and appropriately attired before entering the Hot Zone. If the proper personal protective equipment (PPE) is not available, or if the rescuers have not been trained in its use, call for assistance in accordance with local Emergency Operational Guides (EOG)...
... Patients ... must be decontaminated before being allowed to enter the /Emergency Department/. Decontamination can take place inside the hospital only if there is a decontamination facility with negative air pressure and floor drains to contain contamination. Personnel should wear the same level of protection required in the Hot Zone...
Decontamination procedures should be initiated immediately after exposure. Hypochlorite bleaches were the earliest decontaminants used to detoxify mustard. During World War II, both common bleach [NaOCl-] and superchlorinated bleaches [Ca(OCl-)2] were used. More stable N-chloro compounds, such as chloramine, have been used in more modern personal decontamination systems. In the 1950s, a nonaqueous equipment decontamination solution "DS2" (2% NaOH, 70% diethylenetriamine, 28% ethylene glycol monomethyl ether) was developed in which the conjugate base of the glycol ether reacts rapidly with mustard via double elimination. The currently fielded U.S. ARMY M291 skin decontamination kit contains the decontaminant powder XE-555 resin (Amberguard 555) .
The eyes should be washed immediately with as much water as tolerable, for at least 15 minutes, even if no symptoms are present, since it is known that ocular and dermal symptoms are delayed. Of the many fluids studied for eye irrigation, none has proven more effective than tap water ... Contaminated clothing should be removed and the skin, particularly the groin, axillae, and perineal areas, should be decontaminated. Rapid removal from skin is critical, as sulfur mustard penetrates skin within minutes of exposure. Skin decontamination may be accomplished with copious amounts of water, a 0.5% hypochlorite solution, or a skin decontamination kit.
It has been suggested that removal of sulfur mustard with water alone may be contraindicated as sulfur mustard spreads over more skin surface and increases the area of blistering. Absorbent decontaminants including fuller's earth, calcium chloride powder, or XE-555 resin may be sprinkled onto the exposed skin, allowed to absorb the sulfur mustard, and then washed off with water.
Eyes: Immediately flush with large amounts of tepid water for at least 15 minutes. Do not cover with bandages. Use dark or opaque goggles. Seek medical attention immediately.
To prevent ingestion, do not eat, drink, or smoke during work. Wash hands before eating.
Decontamination of mustard-exposed victims ... should be performed within the first two minutes following the exposure to prevent tissue damage. If not accomplished within the first several minutes, decontamination should still be performed to ensure any residual liquid mustard is removed from the skin or clothes or to ensure any trapped mustard vapor is removed with the clothing. Removing trapped mustard vapor will prevent vapor off-gassing or subsequent cross-contamination of other emergency responders/health care providers or the healthcare facility.
Decontamination of equipment: Use 5% solution of common bleach (sodium hypochlorite) or calcium hypochlorite solution (48 ounces per 5 gallons of water) to decontaminate scissors used in clothing removal, clothes and other items. Decontamination of Environment: ... Common bleach (sodium hypochlorite or NaOCl), superchlorinated bleaches (calcium hypochlorite or Ca(OCl)2) and chloramine can be used.
If material not involved in fire: Keep sparks, flames, and other sources of ignition away. Keep material out of water sources and sewers. Attempt to stop leak if without undue personnel hazard. Use water spray to knock down vapors.
Personnel protection: Avoid breathing vapors. Keep upwind. ... Avoid bodily contact with the material. ... Do not handle broken packages unless wearing appropriate personal protective equipment. Wash away any material which may have contacted the body with copious amounts of water or soap and water.
Evacuation: If fire becomes uncontrollable or container is exposed to direct flame-consider evacuation of one-third (1/3) mile radius. If material leaking (not on fire) consider evacuation from downwind area based on amount of material spilled, location and weather conditions.
SRP: Contaminated protective clothing should be segregated in such a manner so that there is no direct personal contact by personnel who handle, dispose, or clean the clothing. Quality assurance to ascertain the completeness of the cleaning procedures should be implemented before the decontaminated protective clothing is returned for reuse by the workers. Contaminated clothing should not be taken home at end of shift, but should remain at employee's place of work for cleaning.
... Self-aid or buddy-aid for exposure to blister agents includes decontamination of the eyes. When exposure is suspected, time is critical. Unless the individual was wearing a protective mask at the time of the suspected exposure, the assumption must be that the eyes were exposed. ... Remember that time is critical for effective mustard decontamination because blister agents become "fixed" to tissue components within two minutes after deposition. Using the /Military skin decontamination kit/ M291 SDK as soon as possible to remove agent and flushing the eyes with water will do much to prevent or lessen the physical damage from blister agent exposure.
Decontaminable gurneys and back boards should be used if available when managing casualties in a contaminated area. Decontaminable gurneys are made of a monofilament polypropylene fabric that allows drainage of liquids, does not absorb chemical agents, and is easily decontaminated. Fiberglass back boards have been developed specifically for use in HAZMAT incidents. These are nonpermeable and readily decontaminated.
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