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Swift and Low-Cost Surge in Chemical Threat Response: Is It Possible? The Experience of a French Hospital

Published online by Cambridge University Press:  21 February 2018

Albert Brizio*
Affiliation:
Centre Hospitalier de Saint Denis, Hôpital Delafontaine, Service des Urgences-SMUR, Unité du SMUR
Jean-Christophe Hubert
Affiliation:
Centre Hospitalier de Saint Denis, Hôpital Delafontaine, Service des Urgences-SMUR, Unité du SMUR
Brigitte Hennequin
Affiliation:
Centre Hospitalier de Saint Denis, Hôpital Delafontaine, Service des Urgences-SMUR, Unité du SMUR
Jeremy Bouchez
Affiliation:
Centre Hospitalier de Saint Denis, Hôpital Delafontaine, Service des Urgences-SMUR, Unité du SMUR
Marie-Clément Kouka
Affiliation:
Centre Hospitalier de Saint Denis, Hôpital Delafontaine, Service des Urgences-SMUR, Urgences
*
Correspondence and reprint requests to Albert Brizio, MD, 14 Place Etienne Pernet, 75015, Paris, France (e-mail: brizioalbert@hotmail.com).

Abstract

In 2016 France hosted the European football championship. In a context of an increased terrorist threat, Chemical, Bacteriological, Radiological, Nuclear (CBRN) attacks were considered possible. Three days prior to the beginning of the event, the Health Authorities required that a medium sized hospital close to a major potential target, prepare a chemical decontamination centre. Despite a low level of preparedness, little external help, and very few extra resources, an efficient decontamination chain (all premises necessary for the management of contaminated victims: from the entrance gate to the post-decontamination dressing cabins) was set up in 15 days (12 days after the unrealistic deadline). Numerous practical measures allowed three persons in CBRN personal protective equipment (PPE) to manage the whole chain, providing a maximum flow of 24 persons/hour. Volunteers were trained in PPE dressing, undressing and in decontamination procedures. This experience, offers a novel paradigm in managing chemical decontamination, in terms of attitude, and with adaptations to overcome practical constraints. It demonstrates that it is possible to set up a decontamination chain rapidly at very low cost. This provides an attractive option for less advanced countries and in humanitarian contexts. Some additional refinements, enhancements may be considered to further improve results. (Disaster Med Public Health Preparedness. 2018;12:649–656)

Type
Concepts in Disaster Medicine
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2018 

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References

REFERENCES

1. Emploi-Collectivités.fr le site emploi des collectivités territoriales ⦋online⦌. Sceaux, France; Emploi-Collectivités.fr; 2016 ⦋consulted 24 nov 2016⦌. Grille indiciaire de la fonction publique hospitalière. Available: http://www.emploi-collectivites.fr/grille-indiciaire-hospitaliere Google Scholar
2. Centre d’Enseignement des Soins d’Urgence de Paris. Mode d’emploi des Kits de Décontamination d’Urgence (KDUR). Paris : CESU 75; Mai 2016.Google Scholar
3. Chanzy, E. Le risque chimique. Service Mobile d’Urgence et de Réanimation de Saint Denis; 2 juin 2016; Saint Denis, France. Bobigny: SAMU 93; 2016.Google Scholar
4. Lake, W, Divarco, S, Schulze, P, Gougelet, R. Mass Decontamination for Specific Hazards in: Guidelines for mass casualty decontamination during a HAZMAT/weapon of mass destruction incident. Fort Leonard Wood, Missouri: Edgewood Chemical Biological Center; August 2013. Volume II, p. 24.Google Scholar
5. U.S. Department of Homeland Security. Fuller’s Earth in : Guide for the Selection of Chemical, Biological, Radiological, and Nuclear Decontamination Equipment for Emergency First Responders. 2nd Edition. Washington DC: U.S. Department of Homeland Security Preparedness Directorate Office of Grants and Training Systems Support Division; March 2007. Sec 3.1.2.Google Scholar
6. Ciampi, J-P, Rouman, R, Cano, P. Collège PACA de Médecine d’Urgence [online]. Marseille: COPACAMU; 2016 [consulted 20 oct 2016]. Aspects pratiques et risques NRBC:Choix retenus pour la procédure NRBC de l’hôpital Nord APHM. Sec 1.1.2.5.1. Available: http://www.copacamu.org/spip.php?article150.Google Scholar
7. Guidelines for mass casualty decontamination during a hazmat/weapon of mass destruction incident, Edgewood Chemical Biological Center, W. Lake, S. Divarco, Volume I of II, Chap V1.1, 11 August 2013.Google Scholar
8. Balty, I, Guilleux, A, Le Roy, D. Risques chimiques ou biologiques : Retirer sa tenue de protection. en toute sécurité. Cas n°1:Décontamination sous la douche. Dépliant ED 6165. 1ère éd. Paris:Ed INRS; 2013.Google Scholar
9. Missions NRBC des Etablissements de Santé de référence NRBC de de Rennes et de Rouen. Guide de fonctionnement d’une unité de décontamination hospitalière à l’usage des assistants NRBC et des Décontaminateurs de la zone de Défense et de Sécurité Ouest. Version Mars 2013. Rennes; 2013. JORF n°185 du 11 août 2004, p 14277.Google Scholar
10. France. Ministère de la Santé. Décret N° 2005-1764 du 30 décembre 2005 relatif à l’organisation du système de santé en cas de menace sanitaire grave t modifiant le code de la santé publique (dispositions réglementaires). Articles R 3110-4 à R 3110-10. JORF n°304 du 31 décembre 2005, p 20847.Google Scholar
11. France. Ministère de la Santé. Circulaire N°DHOS/CGR/2006/401 du 14 septembre 2006 relative à l’organisation des plans blanc des établissements de santé et des plans blancs élargis. NOR:SASZ200606001 3C.Google Scholar
12. France. Ministère de la Santé. Circulaire DHOS/HFD N° 2002/284 du 3 mai 2002 relative à l’organisation du système hospitalier en cas d’afflux de victimes. NOR:MESH0230349C.Google Scholar