Modelling Mass Casualty Decontamination Systems Informed by Field Exercise Data

Abstract

In the event of a large-scale chemical release in the UK decontamination of ambulant casualties would be undertaken by the Fire and Rescue Service (FRS). The aim of this study was to track the movement of volunteer casualties at two mass decontamination field exercises using passive Radio Frequency Identification tags and detection mats that were placed at pre-defined locations. The exercise data were then used to inform a computer model of the FRS component of the mass decontamination process. Having removed all clothing and having showered, the re-dressing (termed re-robing) of casualties was found to be a bottleneck in the mass decontamination process during both exercises. Computer simulations showed that increasing the capacity of each lane of the re-robe section to accommodate 10 rather than five casualties would be optimal in general, but that a capacity of 15 might be required to accommodate vulnerable individuals. If the duration of the shower was decreased from three minutes to one minute then a per lane re-robe capacity of 20 might be necessary to maximise the throughput of casualties. In conclusion, one practical enhancement to the FRS response may be to provide at least one additional re-robe section per mass decontamination unit.

Chemical, biological, radiological, nuclear and explosive (CBRNe) events

“…Only papers achieved a quality appraisal score of 50% and over; Manley et al (2016). Taylor et al (2004) and Egan and Amlôt (2012).…”

“…detailed examination of decontamination of ambulant causalities byEgan and Amlôt, (2012; 50%) used empirical data to inform a computer model of the Fire and Rescue Service component of the mass decontamination process after a simulated a large-scale chemical release. Movement data were collected with passive Radio Frequency Identification tags at pre-defined locations.…”

Chemical-Biological Terrorism and Its Impact on Children

“…Computer analysis revealed that bottlenecks occurred at specific phases of the process (eg, the redressing or "rerobing" that followed decontamination showers), and subsequent simulations revealed that shortening the duration of showers and adding capacity in the rerobing area could improve throughput of casualties. 77 After exposure to a chemical or biological weapon, children may become covered by toxic material that can produce skin injury or be absorbed, producing systemic toxicity. In the case of infectious material, the contamination of skin could be sufficient to represent a threat to health care professionals as well as the victim.…”

Evidence-Based Patient Decontamination: An Integral Component of Mass Exposure Chemical Incident Planning and Response

“…The decontamination corridor can be a bottleneck delaying evaluation and treatment. 29 The decision to perform mass decontamination is one of the most important decisions made during the emergency response to a large-scale chemical incident. Such a timely decision, likely affecting many other elements in the response, often must be made in a ''fog of war'' with limited information to guide that decision.…”