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Comparative Analysis of Showering Protocols for Mass-Casualty Decontamination

Published online by Cambridge University Press:  28 June 2012

Richard Amlôt ,
Joanne Larner ,
Hazem Matar ,
David. R. Jones ,
Holly Carter ,
Elizabeth A. Turner ,
Shirley C. Price  and
Robert P. Chilcott
Richard Amlôt
Affiliation:
Behavioural Sciences Research Team, Centre for Emergency Preparedness and Response, Health Protection Agency, Porton Down, Salisbury, Wiltshire, UK
Joanne Larner
Affiliation:
CBRN & Chemical Toxicology Group, Chemical Hazards and Poisons Division, Health Protection Agency, Porton Down, Salisbury, Wiltshire, UK Division of Biochemical Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
Hazem Matar
Affiliation:
CBRN & Chemical Toxicology Group, Chemical Hazards and Poisons Division, Health Protection Agency, Porton Down, Salisbury, Wiltshire, UK Division of Biochemical Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
David. R. Jones
Affiliation:
CBRN & Chemical Toxicology Group, Chemical Hazards and Poisons Division, Health Protection Agency, Porton Down, Salisbury, Wiltshire, UK Division of Biochemical Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
Holly Carter
Affiliation:
Behavioural Sciences Research Team, Centre for Emergency Preparedness and Response, Health Protection Agency, Porton Down, Salisbury, Wiltshire, UK
Elizabeth A. Turner
Affiliation:
Exercise and Events Team, Centre for Emergency Preparedness and Response, Health Protection Agency, Porton Down, Salisbury, Wiltshire, UK
Shirley C. Price
Affiliation:
Division of Biochemical Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
Robert P. Chilcott*
Affiliation:
CBRN & Chemical Toxicology Group, Chemical Hazards and Poisons Division, Health Protection Agency, Porton Down, Salisbury, Wiltshire, UK
*
CBRN & Chemical Toxicology Group, Chemical Hazards and Poisons Division, Health Protection Agency, Porton Down, Salisbury, Wiltshire, SP4 0JG UK, E-mail: rob.chilcott@hpa.org.uk
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Abstract

A well-established provision for mass-casualty decontamination that incorporates the use of mobile showering units has been developed in the UK. The effectiveness of such decontamination procedures will be critical in minimizing or preventing the contamination of emergency responders and hospital infrastructure. The purpose of this study was to evaluate three empirical strategies designed to optimize existing decontamination procedures: (1) instructions in the form of a pictorial aid prior to decontamination; (2) provision of a washcloth within the showering facility; and (3) an extended showering period. The study was a three-factor, between-participants (or “independent”) design with 90 volunteers. The three factors each had two levels: use of washcloths (washcloth/no washcloth), washing instructions (instructions/no instructions), and shower cycle duration (three minutes/six minutes). The effectiveness of these strategies was quantified by whole-body fluorescence imaging following application of a red fluorophore to multiple, discrete areas of the skin. All five showering procedures were relatively effective in removing the fluorophore “contaminant”, but the use of a cloth (in the absence of instructions) led to a significant (∼20%) improvement in the effectiveness of decontamination over the standard protocol (p <0.05). Current mass-casualty decontamination effectiveness, especially in children, can be optimized by the provision of a washcloth. This simple but effective approach indicates the value of performing controlled volunteer trials for optimizing existing decontamination procedures.

Keywords

decontaminationimagingmass-casualty incidentshowering protocolswashclothvisual aid
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 25 , Issue 5 , October 2010 , pp. 435 - 439
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2010

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