Haz Mat Awareness / ERG Exercise
Your Clues to Potential Hazardous Materials Release
When any of these clues are present, “THINK HAZ MAT”!
- More than one patient with similar complaint at the same location at the same time or on the same day.
- Anytime you encounter a patient with eye, skin or respiratory irritation in a factory or on a farm. A farmer could easily become contaminated by organo-phosphates hours after spraying or working in a freshly sprayed area.
- Fire. Hazardous Materials may be involved in the fire or released by the burning process. Common household items such as foam rubber and carpeting can release lethal gases when burning.
- Any MVA involving a truck of any kind. When you hear your co-workers going to a call that sounds like a hazardous materials situation; remind them to “THINK HAZ MAT”.
When you hear your co-workers going to a call that sounds like a hazardous materials remind them to “THINK HAZ MAT”.
When You “THINK HAZ MAT”
Stage away or approach slowly, looking for evidence of haz mat. If you see multiple people down, a plume of vapor or smoke, THINK HAZ MAT.
- Protect yourself! Just because the fire department is on the scene doesn’t mean it’s safe for you. Do not depend on anyone to protect you; take care of yourself! THINK HAZ MAT!
- Stay away from scenes involving hazardous materials. We don’t have the proper PPE (personal protective equipment) to protect us from haz mat. THINK HAZ MAT! STAY AWAY!
- Use the Emergency Response Guidebook (ERG) to establish safe distances. Use the distances listed under “public safety” on the guide pages to determine your limits. NEVER enter a “hot zone” or “warm zone” unless you are specifically trained and equipped to do so. If the fire department says it’s OK for you to enter the hot zone; it is not and it never will be unless you are properly certified!
Incident Command
An Incident Command System shall and must be implemented at any Haz Mat incident. If you are first on the scene, establish command and maintain it until you are properly relieved. Consult the online ICS Classes; I-100 and I-200 at the FEMA Education and Training website for your ICS education.
Patient Care
We don’t accept patients from a haz mat incident until they have been decontaminated. A contaminated patient will contaminate the ambulance, the ER and YOU! Several fire departments in the county and the SMAT team can decon patients for you. Only personnel specifically trained can participate in decon activities. If you are not properly trained to decon; don’t do it.
Wear full PPE (all available pieces) when treating a patient from a haz mat scene; even if they have been decontaminated. Use a gown, face mask, gloves, etc. Change all of this to a fresh set between patients.
If a situation develops where a patient must be transported that has not been decontaminated, have fire personnel with the proper PPE accompany and treat the patient. You may only use the higher levels of PPE (air packs, level B or better suits, etc) if you have been specifically trained to do so. If you haven’t been trained on the proper use of PPE needed for the situation; don’t get involved. Allow the properly prepared personnel to do it.
Alert the ER early on! The ER must make special preparations for your patient and may elect to decon the patient outside or in a special room. DO NOT enter the ER until directed to do so by the charge nurse. This applies even if the patient has been deconned at the scene. Do NOT enter the ER until directed to do so by the charge nurse.
Use resources available to you for reference. Think about electronic resources that might available on your laptop or PDA. EOC has resources available too they can read to you or send via MCT. Other resources include the MSDS (Material Safety Data Sheet) and Chemtrec at 800-424-9300. We have MSDS sheets for all our medications and other substances on file in the EMS Supervisor’s Office. Realize that patients who have been deconned with water at the scene may develop hypothermia. You should be particularly watchful for, and treat it aggressively even in mild temperatures. We have local experience with causing hypothermia by using cold water to decon at 75 degrees outdoor temperature! Expect anyone who has been sprayed with water to require re-warming.
The Basics of Hazardous Materials
Hazardous Materials are everywhere. Hazardous Materials are a part of our everyday world. From interstate highways to high school chemistry labs, haz mat is everywhere. For the most part, there are no problems; until something goes wrong.
Hazardous Materials can cause problems by burning, reacting with water or heat or cold or reacting with other materials. The results can be explosions, poisonous gasses and liquids, fire, corrosive vapor or liquid or radioactivity.
There is no way we can cover all the things that all materials may interact with or how they may react. For that refer to your ERG (Emergency Response Guidebook) and other resources previously discussed. Since you don’t know what might happen; stay away from hazardous materials involved in any incident that is not stable in your opinion.
Placards and Signs
Placards are required on vehicles and containers that have a certain quantity of hazardous materials inside. It is very possible that a vehicle or container may have hazardous materials inside in a quantity that doesn’t require a placard! Just because there’s not a placard, don’t assume there’s not a hazardous material inside!
ERG Basics
The pages in the ERG are color-coded; white pages give you general information and orientation to the book. Yellow pages allow you look up materials by ID number; the number on the placard. The blue pages allow you look up materials by name (in alphabetical order). The orange pages are the guide pages and the green pages are perhaps the most important. When you find an entry in the yellow or green pages which is highlighted; turn immediately to the green pages and look up the number there.
Highlighted entries; an entry which is highlighted requires an immediate evacuation! How far? Look up the ID number in the green pages. Let’s start with id #1975. Look it up in the yellow pages; it’s highlighted, right? It sure is! Flip back to the green pages and look up that same number; 1975.
- Notice the broad columns; “small spills” and “large spills”. “Small” is 55 gallons or less. Large is more than 55 gallons.
- Notice the first column in each broad column is “first ISOLATE in all directions”. There’s an isolation distance for small and another for large spills.
- The “first ISOLATE in all directions” means everyone within that distance should evacuate immediately. This means you! Get that far away and further!
- The “then protect downwind” means that people downwind of the spill should be evacuated or sheltered in place. We don’t have the knowledge to decide that; let the experts decide it. But if you’re first on-scene be sure to report everything you know to dispatch right away.
Click here for a picture and explanation of the green pages.
Now that we’ve explored the green pages, let’s go back to id 1975 in the yellow pages. The yellow pages tell us to use guide page 124. Flip to the orange pages “Guide 124”. This particular guide page has “Health” listed first, meaning there is more danger from poisoning than fire with this particular material. Review the headings on both pages and the information contained there-under. There’s very little medical treatment information. Use other sources such as poison control or electronic resources available at EOC or the ER to get patient intervention information. Click here for a screen shot of Guide 124.
Placards on Buildings
The NFPA 704 is required on buildings that are housing certain quantities of hazardous materials. The diamond-shaped placard is color coded. The specific ratings are explained below, but a good rule of thumb is “0 is no risk, 4 is the worst”. Roll over the image below to and chose the print icon on the left to print the placard image.
Blue/Health
4. Very short exposure could cause death or major residual injury. (e.g., hydrogen cyanide)
3. Short exposure could cause serious temporary or residual injury. (e.g., chlorine gas)
2. Intense or continued but not chronic exposure could cause temporary incapacitation or possible residual injury. (e.g., Ammonium chloride)
1. Exposure would cause irritation but only minor residual injury. (e.g., turpentine)
0. Exposure under fire conditions would offer no hazard beyond that of ordinary combustible material. (e.g., peanut oil)
Red/Flammability
4. Will rapidly or completely vaporize at normal atmospheric pressure and temperature, or that are readily dispersed in air and will burn readily. (e.g., propane)
3. Liquids and solids that can be ignited under almost all ambient temperature conditions. (e.g., gasoline)
2. Must be moderately heated or exposed to relatively high ambient temperature before ignition can occur. (e.g. diesel fuel)
1. Must be pre-heated before ignition can occur. (e.g., canola oil)
0. Will not burn. (e.g., water)
Yellow/Reactivity
4. Readily capable of detonation or explosive decomposition at normal temperatures and pressures. (e.g., TNT)
3. Capable of detonation or explosive decomposition but requires a strong initiating source, must be heated under confinement before initiation, or reacts explosively with water. (e.g., fluorine)
2. Undergoes violent chemical change at elevated temperatures and pressures, reacts violently with water, or may form explosive mixtures with water. (e.g., calcium)
1. Normally stable, but can become unstable at elevated temperatures and pressures. (e.g., phosphorus)
0. Normally stable, even under fire exposure conditions, and is not reactive with water. (e.g., liquid nitrogen)
White/Special
The white "special notice" area can contain several symbols:
'W' - reacts with water in an unusual or dangerous manner
'OX' - oxidizer
'COR' - corrosive; strong acid or base o 'ACID' and 'ALK' to be more specific.
'BIO' - Biohazard
The radioactive trefoil (
) - is radioactive Note: Only 'W' and 'OX' are officially part of the NFPA 704 standard, but other self-explanatory symbols are occasionally used in an unofficial manner.