Hazardous Materials TrainingUnderstanding the ERG

Presented By:

Steven Jones, NREMT-P

• Instructional Guide: – This program is designed to make emergency

medical services personnel more aware of the potential that hazardous materials may be involved in any medical emergency to which they respond and the importance of recognizing the presence of a hazardous material so that they do not become victims. It is assumed that the emergency medical services personnel have the knowledge, skills, and equipment to provide the emergency medical care that may be required.

Training Guidelines in OSHA Regulations (29 CFR 1910.120q)

• NOTE: Hazardous materials training is the only emergency response training that is required by law.

Levels of Training

• First Responder Awareness Level– Recognize potential incident – Call for assistance and standby – Take no further action – Not part of emergency

response• First Responder Operations

Level – Defensive operations - outside

release area – Damning, dyke building,

decontamination assistance – Dispatched as part of initial

response

• Technician Level– Offensive operations– Perform duties if properly

equipped, trained, protected, and with backup personnel

– Usually member of hazmat team

• Specialist Level– Enhanced or specialized

training • Incident Commander Level

– Trained to operations level– Background in ICS – Potential for Involvement

Potential Situations• Responding to an EMS alarm where

hazardous materials may cause the victim to become sick or injured

– Many hazardous materials emergencies are initially dispatched as a person down or person sick

– EMS personnel may be in the area of immediate release before realizing it

– Remember to make sure that the scene is safe

• Attempted suicide– Carbon monoxide – Asphyxiation by gas - may also create an

explosive atmosphere

• Responding to a motor vehicle accident where one of the vehicles involved may be transporting hazardous materials

– Material may have released prior to arrival

– Material may be releasing while approaching the scene

– Material may release while patient care is being provided

• Returning from an alarm and observing a hazardous materials release

• Responding to a civil disturbance where hazardous materials may be used

– Signs and symptoms may not be present upon arrival - delayed reaction

– Potential for secondary release/device

Recognition and Identification

• Containers• Shape and type

– Tank - truck, train, fixed facility – Cylinder – Drum – Bag – Box

• Material used– Metal - aluminum or steel – Glass – Paper or cardboard – Plastic

• Markings– Placards - rail and road transportation only– Placards requirement on any quantity of

poison gas, poison, explosives 1.1, explosives 1.2, explosives 1.3, radioactive materials, and dangerous when wet products being transported

• Placards only required for 1,000 lbs. or more of other products being transported

– Labels - on packages or containers– Signage, stenciling – Color coding - not always reliable indicator – No marking requirement for fixed facilities

• Placards only required for 1,000 lbs. or more of other products being transported

– Labels - on packages or containers– Signage, stenciling – Color coding - not always reliable indicator – No marking requirement for fixed facilities

Recognition and Identification

• Occupancy– Known locations

– Processes or activities

– Senses

– Sight - effects on– Humans

– Animals

– Plants

• Form of material– Solid

– Liquid

– Gas

Recognition and Identification

• Container damaged or stressed

• Clouds

• Runoff

• Sound– Product being released

under pressure

– Relief valve operating

• Smell - should NEVERbe used to detect hazmat presence

• Information from Others– Shipping papers

– Occupant/bystander information

– Dispatch information

Emergency Response Guidebook

• ERG Introduction– First produced in 1980– Updated every 3-4 years – First North American ERG

produced in 1996 - joint effort with Canada and Mexico

– Produced by the U. S. Department of Transportation

• Information applicable to hazardous materials in transport

• Produced as the result of an explosion at a construction site in Kansas City that killed several firefighters

• Designed to provide general information during the first 30 minutes of the incident

ERG Outline

• Inside Cover – Important Shipping

Paper Items

– Placard Example

• Basic guidelines – Resist rushing in

– Approach from upwind

– Stay clear of spills, vapors, fumes, smoke

• Using guide for dangerous goods – Identify material

• Four-digit ID number on placard

• Four-digit number on package or shipping documents

• Product name on shipping document, package, or placard

• Look up three-digit guide

Using the ERG

• White pages – Safety precautions (page

6) – Placard charts (pages 15-

17) – Rail/road identifications

(pages 18-19) – Protective clothing

(pages 364-365) – Chemical/biological

agents (pages 368 370)

– Numerical list – Highlighted products -

indicates special isolation and evacuation information

– Multiple products, same ID number

Using the ERG

• Blue bordered pages – Alphabetical list – Highlighted products -

indicates special isolation and evacuation information

– Correct spelling of product names -different products may have similar spellings but totally different reactions

guides 111-172 – Potential hazards

• Health • Fire/explosion • Public safety • Protective clothing • Evacuation

– Emergency response • Fire • Spill or leak • First aid

Using the ERG

– Isolation distances

– Numeric order

– Small spill/large spill

– Day/night

– Water reactive products

Roles and Responsibilities

• First on scene • Review potential causes of

harm – Thermal– Flame contact– Hot or cold exposure– Radiation– Asphyxiation

• Oxygen deficient environment• Products that displace oxygen

• Chemical• Burns• Reactions• Potential biological dangers

• Mechanical• Projectiles • Sharp edges • Unstable containers

• May be willing to take risk and make quick rescue if required

• Control access to scene and prevent entry

• Keep all personnel a safe distance from the hazard and do not permit any operations to take place which are beyond capabilities (training and equipment)

• Maintain control over all emergency responders and civilians

Roles and Responsibilities

• Attempt to identify the product(s)

• Identification numbers

• Shipping papers

• Placards, labels, or other markings

• Container types or shape

• Type of occupancy

• Knowledgeable individual(s)

• Pre-incident information

• Make necessary notifications

• Fire department

• Law enforcement

• Hazardous materials response personnel

• Public works

• Water and sewer - runoff

Roles and Responsibilities

• Establish operational zones

Roles and Responsibilities

• Hot Zone» Area near release» Perimeter determined initial isolation distances in

Emergency Response Guidebook. May also be determined or adjusted by detecting presence of product using detection devices

» May require specialized clothing and training • Level A - vapor and splash protection with SCBA • Level B - splash protection with SCBA • Level C - splash protection with filter respirator • Level D - work clothing

» Only entry personnel permitted » Size and shape of zone can change with ambient

temperature, wind, and hazard

Roles and Responsibilities

• Warm Zone » Area next out from hot zone

» Area used for contamination reduction - size dependent on space needed

» May require specialized clothing - one level below clothing worn in hot zone

» Decontamination and backup personnel only permitted

Roles and Responsibilities

• Cold Zone» Area outside warm zone

» Area used for staging, incident command, medical support, and apparatus

» No special clothing required

Roles and Responsibilities

• Part of the Initial Response

Roles and Responsibilities

• Remain in the cold zone • Be prepared to receive patients

» Decontamination may be limited to emergency measures such as washing down with booster line and/or clothing removal

» If decontamination is in place and being operated, patients should be decontaminated prior to receipt

» Take necessary measures to reduce contamination to personnel, equipment, and vehicle

» Place victim in contamination control environment (body bag) B. Provide personnel with necessary personal protective clothing based on universal precautions

» May require removal of equipment and supplies not needed at that time

Roles and Responsibilities

• Operating with a hazardous materials team» Process personnel through medical evaluation - generally

required for anyone donning chemical protective clothing

» Process personnel through medical evaluation upon completion of assigned decontamination duties

» Prepare to receive decontaminated victims

» Prepare to receive injured or exposed team members after emergency decontamination

» Isolation of victim until transported or evaluated and released

» May require isolation at treatment facility

Summary

Review:EMS and Hazardous Materials Operations• Relationships • Recognition and Identification • Emergency Response Guidebook • Roles and Responsibilities

Re-motivation: Remember, one of the first things that is addressed in emergency care training is to make sure that the scene is safe so that you do not become a victim. Look as you approach the scene and look at the whole scene as you get closer. Focusing on the patient rather than scene safety can have temporary or permanent results.