Chapter 45 – Hazardous Materials Awareness 1

Chapter 45 – Hazardous Materials Awareness

  1. Objectives

Knowledge Objectives /
  1. Define hazardous material and explain the Emergency Medical Responder’s (EMR’s) role during a call involving them.
  2. Describe what the EMR should do if there is reason to believe that there is a hazard at the scene.
  3. Briefly describe the various types of chemical protective clothing.
  4. State the role the EMR should perform until appropriately trained personnel arrive at the scene of a hazardous materials situation.
  5. Discuss methods used to identify hazardous materials.
  6. Discuss the establishment of safety zones at a scene involving hazardous materials.

Attitude Objectives / There are no attitude objectives identified for this lesson.
Skill Objectives / There are no skill objectives identified for this lesson.
  1. Preparation

Corresponding textbook pages: /
  • 706-713

Audiovisual equipment: /
  • Chapter 45 PowerPoint® presentation
  • Computer
  • Multimedia projector

EMS equipment: /
  • Emergency Response Guidebook

Course administration materials: /
  • Attendance sign-in sheet

Research before class: /
  • Review Occupational Safety and Health Administration (OSHA) and National Fire Protection Association (NFPA) hazmat requirements for EMS personnel

  1. Personnel

Primary instructor qualifications: /
  • One EMR instructor knowledgeable in hazardous materials

Assistant instructor qualifications: /
  • None required

  1. Key Terms Presented in This Lesson
  • Chemical Protective Clothing(CPC) Materials designed to protect the skin from exposure to chemicals by either physical or chemical means.
  • Hot Zone An identified safety zone at a hazardous materials incident that contains the hazardous material (contaminant); also known as the exclusion zone.
  • Material Safety Data Sheets (MSDS) Papers required by the Occupational Safety and Health Administration (OSHA) to be kept on site anywhere where chemicals are used. These sheets include the name of the substance, physical properties of the substance, fire and explosion hazard information, and guidelines for emergency first-aid treatment.
  • Warm Zone An identified safety zone at a hazardous materials incident that serves as a controlled area for entry into the hot zone and where most operations take place. It also serves as the decontamination area after exiting the hot zone; also called the contamination reduction zone.

V.Skills Presented in This Lesson

  • There are no skills identified for this lesson.

VI. Lesson Outline

Slide # / Instructor Notes
1 / A.Hazardous Materials Awareness
2 / B.Objectives
3 / C.Hazardous Materials
4
Objective 1 / 1.The National Fire Protection Association (NFPA) defines a hazardous material as “asubstance (solid, liquid, or gas) that, when released, is capable of creating harm to people, the environment, and property.”
a.May be found in incidents involving vehicle crashes, railroads, pipelines, storage containers and buildings, chemical plants, and acts of terrorism
b.Can also be found in the home
5
Objective 2 / 2.Safety is the primary concern.
a.EMRand crew
b.Patient
c.Public
3.Standard operating procedures and protocols must be used.
4.The first phase of dealing with a hazardous materials incident is recognizing that one exists and recognizing the limitations of yourself and your crew.
a.Dealing with hazardous materials requires extensive training and proper equipment.
b.Without the proper equipment, any intervention could put you and your crew at risk.
c.Access to patients must always occur with the proper protective equipment.
1)Standard personal protective equipment may not be sufficient or appropriate for this type of response.
6
Objective 3 / 5.Protective equipment
a.Chemical protective clothing (CPC) is designed to protect the skin from exposure by either physical or chemical means.
b.The Environmental Protection Agency has defined 4 levels of personal protective equipment (PPE).
c.Level A PPE
1)Vapor protective suit that is encapsulated
2)Provides the highest available level of respiratory, skin, and eye protection from solid, liquid, and gaseous chemicals
3)Intended for situations in which the chemical or chemicals have been identified and pose high levels of hazards to the respiratory system, skin, and eyes
4)Typically used by members of the Hazmat(hazardous material) team for entry into the contaminated area (hot zone)
7 / d.Level B PPE
1)Liquid splash protective suit
2)Offers the same level of respiratory protection as Level A, but less skin protection
3)Offers no protection against chemical vapors or gases
4)Worn when the chemical(s) have been identified but do not require a high level of skin protection
a)For example, Level B protection is used when evaluation of the scene identifies that hazards of the chemical involved are associated with liquid but not vapor contact.
8 / e.Level C PPE
1)“Support function protective garment”
2)Provides the same level of skin protection as Level B, but a lower level of respiratory protection
3)Provides liquid splash protection, but no protection against chemical vapors or gases
4)Used when the type of airborne substance is known and contact with chemical(s) will not affect the skin
5)Level C PPE is not acceptable for use in a chemical emergency response.
9 / f.Level D PPE
1)Includes a work uniform, such as firefighter turnout clothing
2)Provides no respiratory protection and minimal skin protection
3)Used when the atmosphere of the involved area contains no known chemical hazards
4)Level D PPE is not acceptable for use in a chemical emergency response.
 No single combination of protective equipment and clothing can protect you from all hazards. Combining PPE ensembles with other types of protective clothing may be appropriate as additional measures for preventing exposure. For example, although CPC alone provides no fire or heat protection, aluminized radiant heat protection worn over CPC will provide limited protection in potential flash fire situations.
A specific PPE ensemble may protect well against some hazards but poorly, or not at all, against others. In many instances, PPE will not provide continuous protection from a particular hazard. In such cases, exposure times should be reduced as necessary and closely monitored. Technical data provided by the PPE manufacturer must be used when determining the most appropriate PPE for the hazards present.
10
Objective 4 / 6.Scene size-up
a.To maximize safety, approach and park uphill and upwind of a hazardous materials scene.
1)In this position, you are less likely to become exposed if the hazardous material becomes airborne or a large spill occurs.
2)Examples of incidents that may involve hazardous materials include:
a)Vehicle crashes (commercial vehicles, pest control vehicles, tankers, cars with alternative fuels, or tractor-trailers)
b)Transportation (railroads or pipelines)
c)Storage (tanks or storage vessels, warehouses, hardware or agricultural stores)
d)Manufacturing operations (such as chemical plants)
e)Acts of terrorism
b.On arrival at the scene, obtain scene control and establish a perimeter.
1)If the call was not initially reported as a hazardous materials incident and you are the first on the scene and suspect hazardous materials involvement, an Emergency Medical Dispatcher (EMD) should be notified so that appropriate measures can be taken.
2)Give dispatch the exact location of the incident or perimeter.
c.If hazardous substances or conditions are suspected, the scene must be secured by qualified personnel wearing appropriate equipment.
1)If you are not qualified and do not have the appropriate equipment, you may need to wait for additional help to arrive before you can attempt entry into the scene.
2)Stage (wait for instructions) a minimum of 2000 feet from a suspected hazardous materials incident.
11 / d.If you have been trained to do so (and are properly equipped), identify and establish safety zones.
e.Initiate the National Incident Management System (NIMS) plan.
1)Designate the Incident Commander and announce the location of the command post.
2)The command post location may be determined by standard operating procedures or other resources.
3)Generally, the command post should not be less than 300 feet away from the scene.
f.In most cases, apparatus should point away from the scene.
g.If possible, attempt to identify the material by locating placards or identification numbers through binoculars while remaining at a safe distance from the area.
12
Objective 5 / 7.Identifying Hazardous Substances
a.The substance involved in an incident can be identified using a number of resources:
1)U.S. Department of Transportation (DOT) Emergency Response Guidebook
2)United Nations (UN) classification numbers
3)NFPA 704 placard system
4)UN/DOT placards
5)Shipping papers
6)Material safety data sheets
EMRs should attend a 24-hour Hazardous Materials First Responder course. If you have not received specific Hazardous Materials training, use the following “rule of thumb.” Assume that any material that has a “colored” placard or four-digit number on it is dangerous to your health and safety and that you must set up a safe zone until trained personnel properly identify the material.
13
Objective 5 / b.DOT regulations
1)The U.S. Department of Transportation (DOT) regulates all aspects of transporting hazardous materials in the United States.
2)These regulations include the design of the container, the type of container used, and the means by which hazardous materials are transported.
3)If dangerous materials are being transported, the DOT requires that a placard be displayed on shipping containers and transport vessels (railroad cars, trucks, and ships).
4)The color of the placard tells the class of the hazardous material.
5)The presence of a four-digit number allows more specific identification.
a)This four-digit number is keyed to the DOT’s Emergency Response Guidebook.
b)This book is a quick reference guide for hazardous materials incidents.
c)Chemicals are listed in the book alphabetically and by their four-digit DOT number.
d)Each chemical is given a reference number that corresponds to a set of instructions and precautions, listed in the back of the book, for dealing with that class of chemical.
14
Objective 5 / c.NFPA’s Standard 704
1)The National Fire Protection Association’s Standard 704 designates a hazardous material’s classification.
2)The NFPA hazard classification system uses diamond-shaped placards divided into quadrants.
3)Different background colors and numbers ranging from 0 to 4 (4 representing an extremely high hazard) are used to indicate the dangers presented by the hazardous material:
a)Blue quadrant – health hazard
b)Red quadrant – flammability hazard
c)Yellow quadrant – reactivity hazard
d)White quadrant – specific hazard (such as radioactivity, water reactivity, biological hazard)
15
Objective 5 / d.Material Safety Data Sheets (MSDSs)
1)MSDSs provide detailed information about the material.
2)This information includes the name and physical properties of the substance, fire and explosion hazard information, and first-aid treatment.
3)The Occupational Safety and Health Administration (OSHA) requires MSDSs to be kept on site anywhere chemicals are used.
4)If MSDSscan be obtained safely, they may be used to identify materials or products.
16
Objective 6 / 8.Establishing safety zones
a.Hazardous materials scenes are divided into zones according to safety.
b.If you have been trained to do so (and are properly equipped), identify and establish safety zones.
c.Hot zone
1)Area of the incident that contains the hazardous material (contaminant)
2)Also known as the exclusion zone
3)Dangerous area
4)Size of the hot zone depends on many factors including:
a)Characteristics of the chemical
b)Amount released (or spilled or escaped)
c)Local weather conditions
d)Local terrain
e)Other chemicals in the area
5)Areas around the contaminant that may be exposed to gases, vapors, mist, dust, or runoff are also part of the hot zone.
6)Only personnel with high-level PPE enter this area. The hot zone is considered contaminated and dangerous until cleared by trained personnel.
17 / d.Warm zone (contamination reduction zone)
1)Controlled areafor entry into the hot zone
2)Area where most operations will take place as a support area for the hot zone
3)Also serves as the decontamination area after exiting the hot zone
4)All personnel in the warm zone must wear appropriate protective equipment.
 If you have not been trained and do not have the appropriate protective gear, you must stay out of the hot and warm zones.
18 / e.Safe zone (cold zone, support zone)
1)Area safe from exposure or the threat of exposure
2)Serves as the staging area for personnel and equipment
3)If there is no risk to you, remove patients to a safe zone.
4)You should not move from this zone or allow anyone else access to the scene from this zone unless they have specialized training and PPE.
5)The Incident Command Post is located in the cold zone.
19 / 9.Approaching the patient
a.Determine if the scene has been secured to allow for your safe approach to the patient.
b.Do not approach unless you are trained and equipped with appropriate PPE for the situation or the scene has been deemed safe by the proper authorities.
1)Much of the information you will need to properly treat the patient may be gathered initially from a distance with the use of binoculars or spotting scopes.
c.Remember to stay uphill and upwind as you approach any patient.
1)Patient care must be performed only by trained personnel wearing the appropriate level of PPE or the patient must have already been decontaminated.
d.Patients who are unable to walk must be removed from the hot zone by trained personnel.
1)This is usually done by fire department and/or hazardous materials personnel.
2)Even if you have been trained and are properly equipped, emergency care in the hot zone must be limited to spinal stabilization, gross airway management (such as opening the airway, suctioning), and hemorrhage control.
3)Emergency care in the hot zone is limited because of the risk of patient or rescuer exposure to hazardous substances or conditions.
e.Address life-threatening problems and gross decontamination before giving emergency care.
1)Gross decontamination means removing all suspected contaminated clothing.
2)Brush off any obvious contaminants.
3)Remove the patient’s jewelry and watch, if present.
4)Cover wounds with a waterproof dressing after decontamination.
5)Perform a primary survey. If spinal stabilization appears necessary, begin it as soon as feasible.
6)Request Advanced Life Support (ALS) personnel if you suspect hazardous material contamination.
7)When treating patients, consider the chemical-specific information received from your PoisonControlCenter and other information resources.
8)In multiple patient situations, begin proper triage procedures according to your local emergency response plan.
20 / 10.Decontamination
a.At every incident involving hazardous materials, there is a possibility that personnel, their equipment, and members of the public will become contaminated.
b.The contaminant poses a threat to the persons contaminated, as well as to other personnel who may subsequently be exposed to contaminated personnel and equipment.
c.Decontamination (decon) by physical and/or chemical processes is done to reduce and prevent the spread of contamination from persons and equipment used at a hazardous materials incident.
d.The process should be directed toward confinement of the contaminant to maintain the safety and health of response personnel, the public, and the environment.
e.Decon should be performed only by trained personnel wearing the appropriate level of PPE.
1)Decontamination is usually performed in the warm zone.
2)Decon procedures should be continued until they are determined or judged no longer necessary.
21 / D.Questions?

VII.Lesson Enhancements

The materials on the following pages are provided to enhance the information presented in this lesson.

  • Chapter Quiz. This quiz was created for you to copy and give to your students. These questions are also available in a computerized test bank on the McGraw-Hill OLC.
  • Chapter Quiz Answers
  • Activities
  • Activity 1. Borrow some toy cars, trucks, buildings, and simulated casualties (or a table-top set-up if one is available locally). You can use game pieces if needed instead of toy people. Label them with injuries. Set up the scenario provided and ask student teams to “respond.”The answers to this exercise will vary according to where you place the vehicles, hazardous materials placards, and where you stage the incident.
  • Activity 2. Word Challenge
  • Activity 3. Instructor Scenarios. Patient scenarios are provided to reinforce the material presented in this lesson. Each scenario contains information about emergency calls involving real patients. Details such as the care given and patient outcome are not included so that you may modify the scenarios as you wish.

Chapter 45 Quiz – Hazardous Materials Awareness

Name ______Date ______

Multiple Choice

In the space provided, identify the letter of the choice that best completes each statement or answers each question.

____1.Where should emergency vehicles be parked at a hazardous materials scene?

a. / 100 feet from the scene
b. / Uphill and upwind from the scene
c. / Downhill and downwind from the scene
d. / As close to the scene as possible

____2.You are responding to a hazardous materials incident in the laboratory at a hospital. What reference source is likely available to help you identify the hazards in this setting?

a. / DOT placards
b. / Material Safety Data Sheets (MSDS)
c. / NFPA 704 diagram
d. / Shipping papers

Short Answer

3.List three examples of chemical protective clothing.

1.

2.

3.

4.When should Level A personal protective equipment be used?

5.List four resources that may be used to identify a hazardous material substance.

1.

2.

3.

4.

Chapter 45 Quiz Answers – Hazardous Materials Awareness

MULTIPLE CHOICE

1.ANS:B

To maximize safety, approach and park uphill and upwind of a hazardous materials scene. In this position, you are less likely to become exposed if the hazardous material becomes airborne or a large spill occurs.

OBJ:Describe what the EMR should do if there is reason to believe that there is a hazard at the scene.

2.ANS:B

Material Safety Data Sheets (MSDS) provide detailed information about the material, including the name and physical properties of the substance, information about fire and explosion hazards, and emergency first-aid treatment. MSDS are required by the Occupational Safety and Health Association (OSHA) to be kept on site anywhere chemicals are used.