TAB H (CBRN CASUALTY PROCEDURES) to APPENDIX 4 (CBRNE OPERATIONS) to Annex J (CBRNE) to 130th MEB (TACSOP)

CHEMICAL CASUALTY PROCEDURES

This card prescribes standard procedures to conduct patient DECON operations and provides an illustration of a dirty casualty collection point (CCP).

  1. Lifesaving measures will be performed on casualties regardless of contamination; care must be taken to ensure that dirty patients and vehicles do not enter clean facilities and reverse. Information on location of DECON sites and clean and dirty routes will be provided by the BDE chemical officer via FBCB2 and FM.
  2. Procedures:
  3. Following a chemical strike, the TF MPL notifies BDE that the TF has chemically contaminated casualties.
  4. In conjunction with the MEB chemical officer, the BDE medical planner and surgeon conducts a weather/terrain analysis and selects a dirty CCP. All TF elements are notified by the battle captain of the activated dirty route and CCP. All non-contaminated vehicles and personnel avoid this route.
  5. The medical platoon leader moves to the CCP and assists assets from BDE and the medical company in establishing the CCP. The CBRNE officer and NCO move to establish an operational DECON site for vehicles and equipment.
  6. Elements from the TF are tasked to provide security and litter details at both the operational DECON site and the CCP.
  7. TF battle captain controls unit movement to and from both locations.
  8. Personnel requirements:
  9. Personnel manning the CCP site are:
  10. 2 soldiers (access control point) – from contaminated unit
  11. 1 medical officer (clean patient treatment) – TF PROFIS doctor or augmented by MED CO
  12. 1 medic (triage area) – contaminated unit
  13. 4-8 litter bearers – from contaminated unit
  14. 4 medics (EMT station) – TF medical platoon or augmented by MED CO
  15. 4 soldiers (clothing removal litter)
  16. 4 soldiers (clothing removal ambulatory)
  17. 4 soldiers (skin DECON litter)
  18. 4 soldiers (skin DECON ambulatory)
  19. 4 soldiers (monitor points)
  20. 4 medics (clean patient treatment)
  21. 4 soldiers (supply dirty site with .5% and 5% hcl solution etc.) total = 44 soldiers *numbers allow for adequate work / rest cycles.
  22. Dirty ambulances with chemical casualties arrive at access point via designated dirty route. Litter bearers (in MOPP 4) download patients and transport them to the triage site where they are prioritized.
  23. Patients undergo clothing removal and subsequent Decontamination of skin. Once all contaminants are removed the patient crosses the “Hot Line” to the clean treatment area where the EMT Team treats the casualty.
  24. Treated patients are evacuated to Level III care or returned to duty (RTD).
  1. Dirty ambulances either return via the dirty route to transport more contaminated casualties or moves to the operational DECON site for equipment/vehicle Decontamination.

  1. In order to conduct detailed patient DECON, prepare patient Decontamination chlorine solutions a. Two concentrations of chlorine solution are required.
  2. A 5% solution is required to Decontaminate:
  3. Gloves
  4. Aprons
  5. Litters
  6. Scissors
  7. The patient’s hood
  8. Other non-skin contact surfaces
  9. 0.5% solution is required to Decontaminate:
  10. The patient’s mask, skin, and splints
  11. Irrigate patient’s wounds
  12. Solution preparation.
  13. Use calcium hypochlorite (HTH) granules (supplied in 6 ounce jars in the patient Decontamination MES) or sodium hypochlorite (household bleach).
  14. Prepare the required concentrations as shown below.

* Use the plastic spoons supplied in your MRE to measure. The amount of HTH to be used is a heaping spoonful

** Do not dilute in water. Household bleach is a 5% solution.

  1. Decontaminate a litter patient:
  2. DECON the patient’s mask and hood.
  3. Remove gross contamination.
  4. Remove LBE and place in a plastic bag; segregate for later Decontamination.
  5. Remove the patient’s CPOG and personnel effects and place in a plastic bag; segregate for later Decontamination.
  6. Remove the patient’s battle dress uniform and place in a contaminated waste bag (or plastic bag if contaminated waste bag not available).
  7. Transfer the patient to a skin Decontamination litter.
  8. Check patient for contamination with CAM. If contamination is determined, patient will return to the skin DECON area.
  9. Decontaminate the patient’s skin.
  10. Check patient for contamination with CAM. If contamination is determined, patient will return to the skin DECON area.
  11. Transfer the patient across the shuffle pit.
  12. Treat any injury, stabilize, and prepare for transport to a clean MTF.
  13. Decontaminate an ambulatory patient:
  14. Remove LBE place in plastic bag; segregate for later Decontamination.
  15. Decontaminate the patients mask and hood, then cut away hood and mask and Decontaminate patient's mask and face.
  16. Remove the gross contamination.
  17. Remove the overgarment.
  18. Transfer patient to skin DECON area.
  19. Check patient for contamination with the CAM. If contamination is present, patient will undergo skin DECON.
  20. Decontaminate the patient’s skin.
  21. Remove bandages.
  22. Check the patient for contamination using the CAM. If contamination is present, the patient will return to the skin DECON area.
  23. Proceed to the shuffle pit to the treatment area.