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Evaluation of US Federal Guidelines (Primary Response Incident Scene Management [PRISM]) for Mass Decontamination of Casualties During the Initial Operational Response to a Chemical Incident. / Chilcott, Robert; Larner, Joanne; Durrant, Adam; Hughes, Philip; Mahalingam, Devanya; Rivers, Samantha; Thomas, Elliot; Amer, Nevine; Barrett, Mark; Matar, Hazem; Pinhal, Andreia; Jackson, Toni; McCarthy-Barnett, Kate ; Reppucci, Joseph.

In: Annals of Emergency Medicine, Vol. 73, No. 6, 01.06.2019, p. 671-684.

Research output: Contribution to journalArticlepeer-review

Harvard

Chilcott, R, Larner, J, Durrant, A, Hughes, P, Mahalingam, D, Rivers, S, Thomas, E, Amer, N, Barrett, M, Matar, H, Pinhal, A, Jackson, T, McCarthy-Barnett, K & Reppucci, J 2019, 'Evaluation of US Federal Guidelines (Primary Response Incident Scene Management [PRISM]) for Mass Decontamination of Casualties During the Initial Operational Response to a Chemical Incident', Annals of Emergency Medicine, vol. 73, no. 6, pp. 671-684. https://doi.org/10.1016/j.annemergmed.2018.06.042

APA

Vancouver

Author

Chilcott, Robert ; Larner, Joanne ; Durrant, Adam ; Hughes, Philip ; Mahalingam, Devanya ; Rivers, Samantha ; Thomas, Elliot ; Amer, Nevine ; Barrett, Mark ; Matar, Hazem ; Pinhal, Andreia ; Jackson, Toni ; McCarthy-Barnett, Kate ; Reppucci, Joseph. / Evaluation of US Federal Guidelines (Primary Response Incident Scene Management [PRISM]) for Mass Decontamination of Casualties During the Initial Operational Response to a Chemical Incident. In: Annals of Emergency Medicine. 2019 ; Vol. 73, No. 6. pp. 671-684.

Bibtex

@article{276373d6bf3946d1a24b3b1693666b10,
title = "Evaluation of US Federal Guidelines (Primary Response Incident Scene Management [PRISM]) for Mass Decontamination of Casualties During the Initial Operational Response to a Chemical Incident",
abstract = "Study objective The aim of this study was to evaluate the clinical and operational effectiveness of US federal government guidance (Primary Response Incident Scene Management [PRISM]) for the initial response phase to chemical incidents. Methods The study was performed as a large-scale exercise (Operation DOWNPOUR). Volunteers were dosed with a chemical warfare agent simulant to quantify the efficacy of different iterations of dry, ladder pipe system, or technical decontamination. Results The most effective process was a triple combination of dry, ladder pipe system, and technical decontamination, which attained an average decontamination efficiency of approximately 100% on exposed hair and skin sites. Both wet decontamination processes (ladder pipe system and technical decontamination, alone or in combination with dry decontamination) were also effective (decontamination efficiency >96%). In compliant individuals, dry decontamination was effective (decontamination efficiency approximately 99%), but noncompliance (tentatively attributed to suboptimal communication) resulted in significantly reduced efficacy (decontamination efficiency approximately 70%). At-risk volunteers (because of chronic illness, disability, or language barrier) were 3 to 8 times slower than ambulatory casualties in undergoing dry and ladder pipe system decontamination, a consequence of which may be a reduction in the overall rate at which casualties can be processed. Conclusion The PRISM incident response protocols are fit for purpose for ambulatory casualties. However, a more effective communication strategy is required for first responders (particularly when guiding dry decontamination). There is a clear need to develop more appropriate decontamination procedures for at-risk casualties.",
author = "Robert Chilcott and Joanne Larner and Adam Durrant and Philip Hughes and Devanya Mahalingam and Samantha Rivers and Elliot Thomas and Nevine Amer and Mark Barrett and Hazem Matar and Andreia Pinhal and Toni Jackson and Kate McCarthy-Barnett and Joseph Reppucci",
year = "2019",
month = jun,
day = "1",
doi = "10.1016/j.annemergmed.2018.06.042",
language = "English",
volume = "73",
pages = "671--684",
journal = "Annals of Emergency Medicine",
issn = "0196-0644",
publisher = "Mosby Inc.",
number = "6",

}

RIS

TY - JOUR

T1 - Evaluation of US Federal Guidelines (Primary Response Incident Scene Management [PRISM]) for Mass Decontamination of Casualties During the Initial Operational Response to a Chemical Incident

AU - Chilcott, Robert

AU - Larner, Joanne

AU - Durrant, Adam

AU - Hughes, Philip

AU - Mahalingam, Devanya

AU - Rivers, Samantha

AU - Thomas, Elliot

AU - Amer, Nevine

AU - Barrett, Mark

AU - Matar, Hazem

AU - Pinhal, Andreia

AU - Jackson, Toni

AU - McCarthy-Barnett, Kate

AU - Reppucci, Joseph

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Study objective The aim of this study was to evaluate the clinical and operational effectiveness of US federal government guidance (Primary Response Incident Scene Management [PRISM]) for the initial response phase to chemical incidents. Methods The study was performed as a large-scale exercise (Operation DOWNPOUR). Volunteers were dosed with a chemical warfare agent simulant to quantify the efficacy of different iterations of dry, ladder pipe system, or technical decontamination. Results The most effective process was a triple combination of dry, ladder pipe system, and technical decontamination, which attained an average decontamination efficiency of approximately 100% on exposed hair and skin sites. Both wet decontamination processes (ladder pipe system and technical decontamination, alone or in combination with dry decontamination) were also effective (decontamination efficiency >96%). In compliant individuals, dry decontamination was effective (decontamination efficiency approximately 99%), but noncompliance (tentatively attributed to suboptimal communication) resulted in significantly reduced efficacy (decontamination efficiency approximately 70%). At-risk volunteers (because of chronic illness, disability, or language barrier) were 3 to 8 times slower than ambulatory casualties in undergoing dry and ladder pipe system decontamination, a consequence of which may be a reduction in the overall rate at which casualties can be processed. Conclusion The PRISM incident response protocols are fit for purpose for ambulatory casualties. However, a more effective communication strategy is required for first responders (particularly when guiding dry decontamination). There is a clear need to develop more appropriate decontamination procedures for at-risk casualties.

AB - Study objective The aim of this study was to evaluate the clinical and operational effectiveness of US federal government guidance (Primary Response Incident Scene Management [PRISM]) for the initial response phase to chemical incidents. Methods The study was performed as a large-scale exercise (Operation DOWNPOUR). Volunteers were dosed with a chemical warfare agent simulant to quantify the efficacy of different iterations of dry, ladder pipe system, or technical decontamination. Results The most effective process was a triple combination of dry, ladder pipe system, and technical decontamination, which attained an average decontamination efficiency of approximately 100% on exposed hair and skin sites. Both wet decontamination processes (ladder pipe system and technical decontamination, alone or in combination with dry decontamination) were also effective (decontamination efficiency >96%). In compliant individuals, dry decontamination was effective (decontamination efficiency approximately 99%), but noncompliance (tentatively attributed to suboptimal communication) resulted in significantly reduced efficacy (decontamination efficiency approximately 70%). At-risk volunteers (because of chronic illness, disability, or language barrier) were 3 to 8 times slower than ambulatory casualties in undergoing dry and ladder pipe system decontamination, a consequence of which may be a reduction in the overall rate at which casualties can be processed. Conclusion The PRISM incident response protocols are fit for purpose for ambulatory casualties. However, a more effective communication strategy is required for first responders (particularly when guiding dry decontamination). There is a clear need to develop more appropriate decontamination procedures for at-risk casualties.

UR - http://www.scopus.com/inward/record.url?scp=85052502032&partnerID=8YFLogxK

U2 - 10.1016/j.annemergmed.2018.06.042

DO - 10.1016/j.annemergmed.2018.06.042

M3 - Article

VL - 73

SP - 671

EP - 684

JO - Annals of Emergency Medicine

JF - Annals of Emergency Medicine

SN - 0196-0644

IS - 6

ER -