FM 3-11.5 MULTISERVICE TACTICS, TECHNIQUES, AND PROCEDURES FOR CHEMICAL, BIOLOGICAL, RADIOLOGICAL, AND NUCLEAR DECONTAMINATION (April 2006) - page 5

 

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FM 3-11.5 MULTISERVICE TACTICS, TECHNIQUES, AND PROCEDURES FOR CHEMICAL, BIOLOGICAL, RADIOLOGICAL, AND NUCLEAR DECONTAMINATION (April 2006) - page 5

 

 

(1)
Chemical. Ship and personnel decontamination procedures will commence
as soon as possible. In practice, decontamination is any process that eliminates or
substantially reduces the hazards of contaminated surfaces or objects. It includes the
physical removal of an agent by wash down, the chemical destruction or neutralization of
an agent, or weathering.
(a) Operational Recovery. The restoration of shipboard operations after a
chemical attack will be very labor-intensive. Mission intensity is the primary factor in
determining personnel availability. Specific priorities must be established based on
operational need. As intensity subsides, the priority can shift to more general
decontamination activities.
(b) Survey. Once the CW attack has ended and the ship or force is
believed to be clear of the agent cloud, survey or monitoring teams will conduct a survey of
the entire ship. Vital areas such as ventilation intakes must be free of liquid contamination
before commencing purge ship procedures. The contaminated areas must be identified and
isolated.
(c)
Personnel Protection. Personnel protection will gradually be reduced
as practical, consistent with shipboard CW hazards and the probability of a subsequent
attack. The protective mask is not removed for showering, but is worn until verification
that no vapor hazards exist aboard ship and all clear is announced ship-wide. Personnel
protective measures during decontamination operations are straightforward. Personnel
directly involved in the operations must be masked, wearing CBR IPE and foul-weather
clothing with all closures fully sealed. Personnel downwind of the operation must remain
masked and continue wearing chemical protective clothing.
(d) Personnel Decontamination. Personnel CCAs used aboard the ship
are installed or expedient. Installed stations are spaces that by functional design, location,
and installed equipment are designated for personnel decontamination. Expedient stations
are designated spaces in which the use of improvised procedures and equipment is
necessary to meet the practical demands of the situation. It may be necessary to operate
several decontamination stations simultaneously if risk to personnel is deemed greater
than the current operational requirements. It is desirable to have personnel
decontamination facilities capable of processing at least half of the exposed topside
personnel at any given time. Refer to NSTM 470 for a detailed description of the
decontamination area setup and procedures. Refer to NAVAIR 00-80T-121 for the
modifications to standard shipboard contaminated doffing procedures that apply to
aircrews.
(e) Surface and Equipment Decontamination. Using the CMWDS and
fire hoses are the countermeasures available for general, overall decontamination of the
ship’s exterior surfaces. Agent depositions remaining after wash down and fire hosing
include absorbed and surface depositions. CW agents absorbed into the paint, deck
coatings, etc., can usually be left to evaporation and the weathering effects of the
environment. Decontamination may still be required after wash down with fire hoses, and
splash or spray of contaminant-bearing water can be a hazard to the decontamination
personnel or to anyone downwind of the hosing operation.
(f)
Interior Decontamination. In the event that interior decontamination
is required, the standard decontaminant available on USN ships is calcium hypochlorite
mixed with detergent in an aqueous solution. Steaming is an effective alternative means of
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IX-3
decontaminating a ship’s interior; however, it is recommended that this procedure be
conducted at a shipyard. Steaming, which displaces all air from the contaminated
compartment, allows the compartment surfaces to be heated to a maximum temperature of
approximately 212°F. Agent vapor may discharge from a steamed compartment
unchanged, but mixed with the exhaust steam. This could result in a hazard to personnel.
Interior decontamination must include ventilation blowers. Blower vanes and the
surrounding housing can be expected to be heavily contaminated and must be
decontaminated to avoid reevaporation or blow-off hazard to the compartments served.
(g) Final Recovery. Personnel must take precautions to prevent skin
contact with decontaminated surfaces, because of the possibility of CW agents desorbing
from paint and other coverings. Personnel engaged in decontamination must continue to
maintain the maximum levels of protection. Personnel in well-ventilated spaces do not
require protection after gross decontamination and purging of the residual vapors has
removed vapor hazards. Personnel should exercise caution when working in poorly
ventilated spaces.
(2)
Biological. The decontamination of vital spaces should be accomplished as
soon as possible. It is important to identify the personnel who may have been exposed to
the threat. The available shipboard decontaminants should include calcium hypochlorite,
topical disinfectants, soap and water, and laundry bleach. The objective following an attack
is to ensure that the ship can continue its mission without an excessive risk to the
personnel following an attack. Damage control personnel may need to assist with the
following:
(a) Ship Decontamination. Follow the standard decontamination
procedures using an approved method such as steaming, using decontamination solution,
swabbing, and spraying. The DCA must establish a priority list prior to beginning the ship
decontamination and concentrate on vital stations and crew living spaces. Industrial
facilities may be required for the final decontamination process, depending upon the type
and concentration of the agent. After the decontamination is complete and the ship has
exited the affected area, the greatest threat of infection will be from contact with exposed
individuals. Once infected individuals have been identified (a process that could take
several days), they should be isolated from the rest of the crew.
(b) Detection. The decontamination of BW agents is complicated by the
fact that portable monitoring equipment is extremely limited. The decontamination may
consist of a general scrub-down, concentrating initially on vital or known areas of
contamination. Areas of known contamination are identified by the observation of BW
agent clouds or the detonation of munitions containing BW agents.
(3)
Radiological. Radiological hazards can last a long time and can range in
severity from instantaneous casualties to a health hazard that is long-term but of no
immediate operational significance. Radiological countermeasures cannot be applied in the
same sequence in all situations. Command consideration of the tactical situation and the
degree of radiological involvement will influence decisions regarding the countermeasures
to be used (when they are used and how long they will remain in effect). When a ship is
under attack, the commander must first defend the ship from the attack. If the attack is
intense, all radiological countermeasures must wait until the requirements for the essential
defense of the ship have subsided.
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(a) Operational Recovery. The operational recovery phase of a major
radiological involvement starts when emergency actions are discontinued. Maintaining the
level of operational capability required to satisfy the existing tactical situation must be the
primary objective of this phase. It also needs to include reducing the radiation hazards and
repairing the damage. This phase extends over the period of time of decreasing shipboard
radiation when vital stations can be operated for limited periods of time without producing
casualties. Ship maneuvering, personnel shelter, crew rotation and reduction, and early
ship decontamination are applicable countermeasures. In this phase, the command may
have to accept some casualties to maintain the required offensive or defensive capability of
the ship. Setting the appropriate material condition to secure the ship is essential. When
ordered, the closure of fittings will never be given priority over the movement of personnel
to sheltered locations. Ventilation ducts, boilers, and air passages should also be checked
for the accumulation of contaminants. The contamination of saltwater systems does not
present an immediate hazard.
(b) Personnel Decontamination. The adequate decontamination of
personnel can be accomplished using decontamination stations, designated washrooms, or
showers. Personnel decontamination stations should be located within the ship to afford
personnel the best shielding from radiation. The detection of contaminated personnel with
a radiac meter is difficult when the intensity of penetrating radiation from other sources is
high.
(c)
Ship Decontamination. The DCA shall develop a decontamination
prioritization list for the vital watch stations. Hosing and manual scrubbing are the most
effective decontamination measures suitable for use at sea. Saltwater is the basic material
for decontamination of a ship at sea. The institution of decontamination procedures will
commence after fallout has ceased and when the tactical and radiological situations permit.
A monitoring team shall make a rapid survey of selected topside locations and report the
results to aid in the decision to order decontamination.
(d) Final Recovery. The final recovery phase of a major radiological
involvement starts after the intensity of radiation has dropped to a level that no longer
presents a radiological threat. Minimizing the long-term hazard to the health of the crew is
the objective of this phase. Shipboard decontamination and contamination control are
applicable measures. The time of cessation can be determined from the plot of intensity
versus the time readings plotted by the DCC. When the readings continue to decrease at a
steady rate, the assumption can be made that fallout has ceased. When the topside
radiation levels are below 5 rads/hour, the period of operationally significant radiological
involvement is concluded.
3.
Recovery Chemical, Biological, Radiological, and Nuclear Decontamination
Recovery operations are principally intended for the expeditionary strike group (ESG)
commanders, amphibious squadron commanders, landing force commanders, embarked
units, and staffs performing the recovery operations. When tailored, these principles can
also be applied by any size Marine air-ground task force (MAGTF) (e.g., a single-ship
MAGTF or an expeditionary strike force or amphibious task force) or by ships responding to
a CBRN attack. See Tactics, Techniques, and Procedures for Recovery Operations in a
Chemical, Biological, Radiological, and Nuclear (CBRN) Environment for detailed
information on CBRN recovery operations.
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Recovery operations encompass those operations in which military forces and civilian
personnel (to include casualties), equipment, and supplies move from naval ships (e.g.,
ashore or on another vessel) onto amphibious shipping. These operations may include—
Preplanned amphibious withdrawal of forces subsequent to operations ashore.
Noncombatant or other evacuations.
Recovery of personnel and equipment.
Movement of forces and equipment from shore-to-sea as part of ongoing tactical,
humanitarian, or logistical operations.
Operations undertaken to investigate the nature of materials being transported
on a vessel at sea using a ship’s boarding party or specialized landing force team.
This section addresses the decontamination procedures required to support
retrograding forces, to include their equipment, DOD essential civilians and contractors,
and civilians under the protection of an expeditionary force. Paramount to the discussions
of recovery operations in a CBRN environment is an understanding that these operations
will place extreme demands on a ship’s freshwater system to support the effort.
Accordingly, commanders at all levels shall institute procedures to conserve water and
order that excess water be stored in advance of known or suspected CBRN operations. In
completing the requirements for decontaminating personnel and equipment, commanders
are not authorized to alter a ship’s basic design to reconfigure a space or create accesses;
conversely, they may modify the use of a space (e.g., establish an isolation ward).
a.
Procedures.
(1)
Decontamination Procedures.
(a) Decontamination procedures are generally personnel- and
labor-intensive operations. They are largely dependent upon the use of chemical solutions
to rid surfaces of contaminants and upon time to complete weathering or decay in order to
achieve a state of cleanliness that enables the personnel to perform their assigned duties
without the added burden of wearing IPE. The amount of space available to complete the
procedures will generally be determined by the class of ship. Commanders of cruisers,
destroyers, frigates, and smaller-sized ships should anticipate using their flight deck or
fantail areas to support decontamination procedures.
(b) A solution of calcium hypochlorite, detergent, or other soap is used in
scrubbing and swabbing. Normally, a 9 percent solution in seawater is used, but a 3 or 5
percent solution can be mixed if calcium hypochlorite is in short supply. Directions for
mixing solutions of various strengths are provided in Table 470-7-2 of NSTM 470. If
calcium hypochlorite is unavailable, laundry bleach can be used as a substitute. The
pattern of swabbing is top to bottom, front to back. The minimum amount of
decontamination solution that will adequately cleanse the area should be used. Brisk
rubbing and scrubbing should be used to mix the agent thoroughly with the oxidizer so that
chemical neutralization can proceed more quickly. After an area is scrubbed and swabbed
with the calcium hypochlorite solution or a detergent solution, the area shall be rinsed with
seawater or freshwater while continuing to scrub and swab as necessary to remove any
residue.
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CAUTION
Attention must be given when mixing the solution. The
tendency is to make a 10 percent solution. Above 9
percent, the solution becomes caustic and it can
degrade or destroy equipment and materials. Calcium
hypochlorite is not recommended for use on aircraft.
(c)
If calcium hypochlorite is not available and detergent must be used
alone, scrubbing and swabbing will only result in the physical removal of the agent, not
detoxification. The detergent assists in bringing the agent into solution. The resulting
solution contains toxic agents and shall be washed overboard by fire hosing. In areas where
fire hosing is not possible, rinse the area with buckets of clean freshwater or seawater and
scrub and swab as necessary to remove the toxic solutions.
(d) Harsh detergents and oxidizers cannot be used to decontaminate
electronic systems and aircraft without risking damage to the equipment. Instead, only the
materials normally used in maintenance and corrosion control on such systems and aircraft
shall be used. Care shall be exercised to avoid contact with the runoff or other residue as
the toxic properties of the agent are not changed by physical removal methods. The residue
or runoff is still toxic.
(2)
Decontamination Coordination.
(a) Forces who are retrograding to a ship or directing the movement of
contaminated personnel and equipment to a ship shall attempt to reduce the extent of
contamination to the lowest possible amount (consistent with the threat and nature of the
operation) before embarking the ship. They shall also make every effort to inform and
update the receiving platform of the nature of any known or suspected contamination and
the degree of decontamination procedures performed.
(b) Commanding officers support and assist in the decontamination of
ground forces by ensuring that suitable locations, equipment, and properly trained
decontamination teams are on station. Furthermore, they are ultimately responsible for
ensuring that recovered personnel have completed the required decontamination
procedures before allowing them access to interior spaces. They have the authority to
decide what equipment shall be discarded; however, they will coordinate with the
commander of troops and the commanders of carrier air wings (CAW), MAGTF, and
MAGTF air combat elements (ACEs) to determine the final disposition of recovered landing
force vehicles, aircraft, supplies, and equipment.
(c)
If the ship is basically clear of contaminants, only the flight deck or
well deck are contaminated, and operations must continue, the commanders will work front
to back in clearing the hazard and establish a pool of decontaminated craft to assume
transport duties for the unaffected personnel and equipment. In some instances, it may be
advisable to transfer the unaffected or decontaminated craft to a clean ship to maintain the
ability to move both unaffected and contaminated personnel and equipment. In order to
minimize the need to repeat decontamination procedures, as long as a need exists to move
contaminated personnel, then contaminated or previously contaminated craft will be used
to move these individuals and their equipment.
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(3)
CCA. The establishment of CCAs is critical to the effectiveness of any
decontamination effort. The CCA serves as the focal and initial entry point for any effort to
bring personnel into the interior of the ship. In well decks, the CCA should be set up as far
back as possible, to include on the stern gate if sea states permit and the effort is to support
personnel returning in combat rubber raiding craft (CRRCs) or like craft. Similarly, CCAs
that are established in hangar bays should be positioned as near an elevator as possible.
Containment pits should be set out to capture contaminated water, which will help reduce
decontamination efforts that will be required for the deck. The collected water is drained
through fire hoses rigged to discharge overboard.
NOTE: Since the hoses will become contaminated and require disposal, ships
should maintain a pool of old fire hoses that can be expended under such
circumstances.
(4)
Decontamination Showers. Aside from the obvious advantage showers
afford for removing contaminants from personnel, showers provide two added benefits.
They give cooling to individuals suffering from the effects of heat stress and they offer a
psychological boost from the feeling of removing the contamination. After showering,
personnel should be advised to keep previously exposed portions of their body uncovered as
long as possible since clothing will block or reduce the weathering effect. Additionally,
wearing clothing on previously exposed skin can drive any residue further into the skin.
Ships have the following five basic options for providing showers for personnel:
(a) Established Decontamination Showers. Showers offer the best facility
to complete personal decontamination. The ship’s decontamination teams can monitor
personnel through view ports, and contaminated personnel can be guided in completing the
required procedures. However, their location within the ship is not always conducive to
providing returning forces an area close to their entry point onto the ship or the CCA,
which can lead to increased chances for spreading contaminants or offer challenges for
providing safety.
(b) Locally Manufactured Showers. Locally manufactured showers offer
the flexibility to meet the design variations within classes of ships, assist in overcoming
shortfalls in decontamination station locations and quantities, and complement locally
developed plans to process individuals with varying needs. They are dependent upon an
undefined quantity of stock material that may or may not be available on the ship to
complete such a structure (e.g., spare shower heads, various sized piping and fittings,
flexible hose, and fabric to cover the structure to create some semblance of privacy and
control the contaminated water residue/spray). Accordingly, locally manufactured showers
should be planned in advance. Efforts should be made prior to deploying or entering a
CBRN-contaminated area to procure the needed supplies so that multiple units are
manufactured and contingency operations are properly supported.
(c)
Portable Shower Tents. Portable shower tents offer flexibility for
decontaminating a large force or group of civilians. Easy to erect, these portable and self-
contained units include all the piping and wastewater containment capability required to
complement a CCA. Ships would need to rig a source of freshwater or saltwater and a
drainage hose over the side. Consider if the water should be heated and how to heat it if no
access to hot, freshwater exists.
(d) Field Showers from Embarked Units. Field showers, designed and
utilized by forces ashore, offer yet another option to meet the challenge of decontaminating
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4 April 2006
a large number of personnel. This equipment would most likely be sent to the field in
support of the landing force or naval support elements and would be an essential part of the
effort to complete their decontamination prior to retrograding to the ship. The ship’s use of
such equipment would require that an MOU be established in advance of such operations.
(e) Fire Hoses. Rigging fire hoses to create a makeshift shower could
serve as a minimal resource for providing a shower to retrograding personnel. Like the
field and portable showers, some consideration would have to be made for heating the
water. Likewise, personnel manning such stations could be jeopardized by experiencing
hypothermia or increased incidences of dehydration and heat stress from wearing
wet-weather gear to protect their CBRN suits.
(5)
Wash and Gear-Removal Stations. Ships may rig any number of CCAs to
enable personnel to ready themselves for being certified safe for entering the interior of the
ship. Stations will range from areas where individuals can initially attempt to
decontaminate their personal gear and small arms, or to areas that serve as a collection
point for these items, to ultimately providing sites where they can doff their IPE before
proceeding to the shower. If a ship establishes a CCA in the well deck or the hangar bay
and does not have a portable decontamination shower or a locally manufactured shower in
close proximity, a process shall be adopted for moving personnel from the CCA to the
shower wherein the personnel are afforded some measure of privacy (e.g., ships can rig
screening curtains along the route or provide individuals with disposable garments). The
principal decontamination solution for personal gear and equipment will be calcium
hypochlorite. Calcium hypochlorite solutions and the synonymous HTH solution are
prepared in accordance with NSTM 470 by personnel wearing facial shielding, aprons,
rubber gloves, and CBR protective gear. Additional guidance for the construction of shuffle
pits (boot wash), mask lens wash, scissors wash, etc. is provided within Recovery Operations
in a Chemical, Biological, Radiological, and Nuclear (CBRN) Environment.
CAUTION
Do not use saltwater for the mask lens wash
because it may scratch the mask lens.
(6)
Shipboard Decontamination of Personnel. The decontamination of
retrograding personnel shall follow the established procedures for decontaminating
shipboard personnel. Personnel shall be routed to a CCA where the initial decontamination
procedures are conducted. Upon completion of the tasks directed at the CCA, personnel
shall be routed to a decontamination shower facility. Contaminated personnel should be
given step-by-step procedures, read aloud to them where possible, by members of the ship’s
decontamination station teams. For situations in which escort ships within an ESG or
carrier strike group (CSG) are tasked to receive contaminated personnel, ships shall follow
the established procedures (see NTSM 470) consistent with decontaminating scrubber or
survey teams. However, in order to support the embarkation, it is necessary to establish a
CCA in the vicinity of the fantail, for personnel retrograding by small craft; or in the
vicinity of the flight deck, if the movement is by helicopter. Personnel will not retrograde to
a submarine.
(7)
Casualty Treatment/Patient Decontamination. As with shore forces,
casualty decontamination should be performed separately from noncasualty
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IX-9
decontamination. A medical staging area or mass casualty area should be placed near the
decontamination area, but far enough away so that personnel will not be affected by any
contaminant. Refer to NTTP 3-20.31, NSTM 470 and FM 4-02.7.
(8)
Decontamination of Other Forces/Special Decontamination Personnel.
Some modifications to the shipboard personnel decontamination process may be necessary
to accommodate the differences between shipboard protective clothing and equipment and
the corresponding items used by other organizations. Shipboard decontamination station
personnel need to be aware of the differences. Multiservice Tactics, Techniques, and
Procedures for Nuclear, Biological, and Chemical Protection describes Army protective
clothing and equipment that may also be worn by USMC and USN beachmasters and
construction personnel. The following items differ from the shipboard counterparts as
indicated:
The BDO is a two-piece ensemble with slide fastener closures used by
ground forces. It cannot be decontaminated. The newer JSLIST suit is similar.
The USA M-40 series masks are worn by ground forces with a hood that
extends downward over the shoulders. The hood is not part of the overgarment.
Green or black vinyl overshoes are used with the BDO. They are worn over
combat boots for chemical protection and can be decontaminated and recovered.
The USA has a suit, contamination avoidance, liquid protection (SCALP)
that may be worn over the BDO for up to 1 hour for protection from gross liquid
decontamination. The SCALP is a lightweight, disposable suit consisting of a jacket,
trousers, and footwear covers.
USA aircrew members may wear the aircrew uniform integrated for the
battlefield, a two-piece uniform with hook-and-pile closures. In addition to providing CBRN
protection, it also provides flame protection; it replaces the standard flight suit and the
BDO.
The chemical protective gloves used by these personnel are similar to the
shipboard item.
The features that differentiate the protective equipment and ALSS used by USN and
USMC aircrews are specifically detailed in NAVAIR 00-80T-121 and include the following:
The A/P22-14 (V) 1-4 aircrew respirators are designed to be compatible with
the standard aircrew helmet.
Blown, filtered air is provided to the mask by a battery-powered pusher fan
that is affixed to a C2/C2A1 canister. The pusher fan/canister assembly resides in a pocket
attached to the crewman’s survival vest or CBR overvest. CBR respirators used by
fixed-wing aviators have a second filter canister that connects to the aircraft oxygen
systems.
The aircrew CPU consists of an undershirt and trousers. The fabric is
composed of a nonwoven material with encapsulated carbon in a stretchable matrix. It is
worn under the flight suit. The set can be washed once and reused if it is not contaminated.
This undergarment cannot be decontaminated.
A disposable plastic cape can be worn over the flight suit for protection
from liquid agents.
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Chemical protective socks are worn under standard aircrew flight boots;
disposable plastic overboots may be worn over the flight boots.
The chemical protective gloves worn by aircrew personnel are of three
varieties, two of which are similar to the shipboard item. The third is made of a gore-type
material. Nomex™ flyers gloves are worn over the chemical protective gloves.
WARNING
Operational decontamination procedures for
contaminated ground force personnel are not
adequate to allow them entry into the ship.
Personnel must complete the thorough
decontamination procedures before being
permitted to enter the interior spaces.
b.
Flight Deck Operations. Aviation operations in a contaminated environment
create challenges for a ship’s aviation department. The aviation department head and
commanding officer of an embarking aviation unit shall establish MOUs during
predeployment to set policies for such contingencies. They must also arrange for frequent
training to attain mission-essential task list standards will be necessary. Plans must be
developed for conducting extended flight operations, thus necessitating a possible
requirement for additional personnel trained to support flight deck operations. General
statements such as “personnel are not transported after dark” will be negated by
operational and tactical requirements, and such approval can be granted by the MAGTF
commander. One option to meeting these challenges may be to reduce the number of
aircraft operated, with a corresponding reduction in the number of flight deck spots used.
Still, supervisors will need to anticipate a requirement for additional flight deck colored
shirts, additional vests, an increase in the amount of IPE, and foul-weather gear. Some
items may be capable of being laundered, but personnel may be required to don
contaminated equipment over their IPE in the interest of following recognized safety
procedures and to limit the contamination of clean equipment. Recovery operations will
require considerable space to support the collection, separation, weathering, and off-gassing
of equipment, weapons, flight deck jerseys, float coats, ordnance, etc. Likewise, depending
upon environmental conditions, added restrictions may be enacted that limit work periods
to correspond with the heat stress work restrictions.
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IX-11
WARNING
Commands shall not attempt to minimize contamination to aircraft by
stationing personnel with energized fire hoses on the flight deck and
directing the aircraft to hover or pass through a “wall of water,” even if it is
only freshwater that is streamed toward the aircraft. The combination of
rotor wash and the potential for aircraft ingesting water into the air intakes
or damage by too strong a stream of water striking the aircraft present too
great a risk for personal injury or damage to the aircraft.
Because flight operations are normally conducted when winds are off the bow, commanding
officers should endeavor to maintain a wind off the starboard bow to reduce the area
potentially contaminated by a CBRN hazard. Ships should anticipate using their
high-reach equipment and cranes as part of the plan to detect and clean contaminated
areas. The use of the mechanical deck scrubber is not recommended because of its ability to
be decontaminated is highly suspect.
(1)
Moving Aircrews. Because decontaminating the interior of aircraft is
difficult, care must be exercised when moving pilots and aircrew from the interior of the
ship to their aircraft to avoid contaminating the exterior of their individual protective suits
or boots. This can be accomplished through the use of temporary boot covers and the
assistance of the flight deck support personnel. Personnel must remain mindful that
contaminants can be kicked up by jet exhaust and helicopter rotor wash. Flight crews
disembarking from their aircraft will be processed in a manner that is consistent with the
procedures used for troops moving from the aircraft.
(2)
Moving Troops.
(a) Members of the combat cargo division or flight deck crew will guide
retrograding forces from helicopters to the appropriate CCA. If possible, personnel will
remain in the helicopter until the rotor blades have ceased turning. Once the blades have
stopped turning, personnel will be led in a single file to the designated CCA. If rotor blades
must remain engaged, personnel will be directed to move as expeditiously as possible to
clear the helicopter while being led to the appropriate CCA (maintaining a single file). The
use of lights or other markers should be used to identify the path personnel should attempt
to remain within.
(b) For personnel departing the ship on a clean helicopter in a
contaminated environment, there is a similar concern as for the aircrew. The outside of the
helicopter may be contaminated upon landing on the ship. These personnel would
generally have to be encapsulated in their IPE before they could move from the ship’s
interior to embark their assigned helicopter. Ideally, it would be helpful if these troops
could cross the contaminated flight deck and board their externally contaminated helicopter
without contaminating their boots or suits. This would in turn require the use of temporary
coverings for their boots as they crossed the contaminated deck. The use of large numbers
of temporary boot coverings raises concerns about foreign object damage (FOD) to the
engines. For this reason, loading might also need to be done prior to the engine startup,
giving time to recover stray boot covers. Alternatively, troops could walk across the deck
contaminating their boots and then don temporary boot covers as they enter the transport
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4 April 2006
helicopters. This would leave the boots of the vertical assault troops contaminated, which
is less than ideal, but would use the temporary covers to protect the floor of the helicopter.
(c)
It would be best to protect the troops and the transport helicopter
from becoming contaminated. This may require that a pathway be decontaminated on the
deck from catwalks to helicopter spotting areas if the temporary boot covers are not used.
Still another option to consider is the use of a plastic covering to line the floor of the
helicopter. Again, completing such an action will require regard for FOD and a review of
all requirements.
(3)
Loading and Unloading Aviation Ordnance on Aircraft. Aviation ordnance
and ammunition is treated similar to personnel with cargo with regard for minimizing the
spread of contaminants. Returned munitions should not be stored in ship’s magazines until
certified as decontaminated.
(4)
Aircraft Decontamination.
(a) If air and ground crews are careful when operating in a contaminated
environment, cross contamination from the exterior to the interior can be minimized.
In-flight airflow over the aircraft’s smooth skin at typical flight speeds facilitates a higher
rate of evaporation. Still, some agents will migrate into crevices, rivet heads, and joints
and continue to be a hazard. A common area of contamination will also be on the aircraft’s
tires. Thickened agents evaporate slowly and may remain a hazard even after prolonged
flights.
(b) If the interior is determined to be contaminated, flying the aircraft
with the doors open can help reduce the hazard. Procedures for decontamination of naval
aircraft, aircrews and aviation support personnel are provided in NAVAIR 00-80T-121.
Information on emergency reclamation requirements can be found in Aircraft Weapons
Systems Cleaning and Corrosion Control and Organizational/Unit Intermediate
Maintenance for Avionics Cleaning and Corrosion Prevention/Control.
CAUTION
Ships are cautioned that improperly sealed flight
deck lighting can contribute to contaminants
seeping into the interior spaces of the ship.
(c)
If time is available and flight operations are secured, aircraft should
be moved forward to a wash-down spot consisting of a containment pit and a
decontamination team.
NOTE: Ships should try to maintain at least one landing spot of separation
between the recovery landing spots and the wash-down sites.
CAUTION
Do not use steam to decontaminate an aircraft.
Damage to the composite materials used in the
construction of aircraft may result.
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IX-13
(d) An aircraft wash down (i.e., operational decontamination) should be
conducted within 6 hours of becoming contaminated, but it is most effective when conducted
within 1 hour. Some amount of chemical contamination may remain after the aircraft wash
down. The aircrew shall continue to wear their protective masks and rubber gloves for
protection until a thorough decontamination is conducted or until the aircraft has
weathered and the contamination is below detectable levels.
CAUTION
Most of the field-expedient decontaminants
are corrosive and could cause damage to
aircraft materials.
(e) While it is possible to perform a thorough decontamination of
individual aircraft, this can be a tedious and time-consuming activity that will require a
considerable amount of manpower to accomplish.
c.
Well Deck Operations. The requirements for well deck and small boat operations
in a CBRN environment are similar in nature to those of flight deck crews. The ship’s first
lieutenant and DCA, working in conjunction with the ships combat cargo officer, coordinate
policies for manning requirements and decontamination procedures with the embarked
element commanders. Once such operations are directed to occur, the DCA and the ship’s
first lieutenant brief the assigned personnel on the plan of action for the survey and
decontamination procedures, recovery of equipment and personnel, and any offload
requirements. All well deck personnel will require IPE consistent with the threat and their
duties. Once cleared to disembark their craft, personnel will be led to a CCA to initiate
decontamination procedures. Craftmasters shall be advised to maintain loads that were
wet during transit to the ship if contamination is known or suspected to exist. It is the
responsibility of the craftmasters, coxswains and drivers to keep the CBRN defense cell and
well deck control officer advised of the craft’s contamination condition. Depending on a
variety of factors (e.g., tactical situation, sea state, and craft capabilities) craftmasters,
coxswains, and drivers will attempt to decontaminate any known hot spots prior to
recovery. They shall also attempt to complete a survey to verify that the decontamination
is complete. If the craft is unable to be given a wash down, personnel may be brought into
the ship and soaked using the ship’s firefighting sprinklers with the aqueous film-forming
foam (AFFF) secured. Similarly, the craft can be positioned in close proximity to the ship’s
quarter and sprayed by personnel with saltwater fire hoses. Once this is completed, a
report to the ship shall be made citing that the craft is ready to enter the well. If the
environmental conditions permit, and if the procedures exist and can be authorized, a stern
gate or sill marriage is preferred. If the sea state conditions do not permit or if a final
recovery of the craft is expected, the craft should be brought in using the steepest possible
wedge and then be grounded out. All crafts and loads will be rinsed from top to bottom,
front to back. Following the decontamination operations and when the landing craft can be
directed to exit the well, the ship will flood the well deck to further eliminate any hazards.
For the amphibious transport dock (LPD-4) class of ships, energizing the water curtain can
be used to isolate the vehicle storage area from the landing craft air cushion (LCAC) to
spray and rinse the loads. The recovery and decontamination procedures described in the
following paragraphs will be completed for the craft (as applicable).
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(1)
LCAC.
(a) The craftmasters shall maneuver their craft to maximize the exposure
to sea spray. Propeller reversal, with the craft proceeding downwind and across the wind,
is recommended as a minimum. If the craftmaster’s survey confirms that the craft is clean,
direct the craft to proceed into the well. Conversely, if the craft is still contaminated and
the tactical situation and sea state permit, direct the LCAC to go off-cushion astern or
alongside the ship. Have the ship’s well deck crew hose down the craft with saltwater from
the stern or catwalks; avoid hitting the LCAC propellers with a solid stream of water.
WARNING
Spraying water into the moving propellers could produce
catastrophic blade failures presenting hazards to
personnel. Spraying solid streams of water at stopped
propeller blades could result in damage to the propellers
and should be avoided.
(b) If the LCAC is still contaminated and the operational situation
permits, bring the LCAC in using the emergency recovery rig and spot it as far behind as
possible to reduce the likelihood of spreading the contamination within the well deck. With
the crew and troops remaining within the craft, well deck teams will survey the LCAC and
decontaminate the hot spots. If the LCAC went over land to recover or deliver its load,
contaminants will have been absorbed into permeable material, presenting a long-lasting
contact and vapor hazard. At-risk material includes nonskid coverings and the rubber
skirt; a thorough decontamination will likely result in their removal and replacement. It is
possible that the emergency recovery line might become contaminated through contact with
the craft. Following the last evolution, discard the line over the side, ensuring that it does
not create a hazard to navigation. If a replacement line is not available, cut off the affected
portions and reconstruct the line’s features as necessary.
(c)
When bringing a contaminated LCAC into the well deck, every effort
should be taken to clear the well deck and wing walls of all porous materials (e.g., lines, fire
hoses). Porous materials exposed to the contamination should be jettisoned. Personnel who
are exposed to LCAC-generated wind and spray shall don their JSLIST and wet-weather
gear. All well deck and vehicle storage supply ventilation shall be turned on high speed, all
exhaust ventilation shall be secured, and all vent exhaust intake covers shall be covered to
ensure that air is forced toward the rear part of the ship and exits through the stern gate
opening. When sea state and weather permit, it may be necessary to deviate from the
ship’s normal recovery ballast condition in order to minimize the spraying action of the
contamination throughout the well deck and wing walls. In such cases, it will then be
necessary to complete an emergency recovery of the LCAC using the towing rig with the
propellers secured. Ballast the ship to the steepest wedge possible, with the water level at
the sill to a minimum of 5 feet. Recover and shut down the LCAC engines. Activate the
well deck sprinkler system with the AFFF in the recirculating mode, and operate the
system for 2 minutes to wash down any contaminated spray from the craft. Fire hose main
pressure should be at the maximum, and all nozzles should be operational to ensure the
complete designed coverage. The survey and decontamination teams will then conduct
established checks and cleaning procedures that are consistent with the ship’s CBRN
defense bill.
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(2)
Landing Craft, Utility (LCU). The LCU initiates active decontamination
during transit to the ship, including activation of its CMWDS. Upon nearing the ship, the
LCU should be directed to take and maintain its station alongside the ship at the slowest
and safest possible speed. Once alongside, the ship’s force uses additional fire hoses from
the catwalks to concentrate on those areas not fully covered by the LCU system. The LCU
crew is then directed to survey their exterior and report results to the ship; any hot spots
will be further decontaminated. If agents have been left on the craft for over an hour, the
epoxy-based paint may have absorbed them and a thorough decontamination may be
required. The ship’s force and LCU crews should pay particular attention to the crew cabin
ventilation, air conditioning systems, and the large filter units for the engine air intake
system. The crew cabin ventilation system can create a serious vapor hazard by blowing
the agent vapor into an otherwise sealed compartment. When retrieving an LCU, a stern
gate or sill marriage is preferred to minimize the contamination of the ship. Alternatively,
bring the LCU in and ground it out without fully deballasting. With the ramp down, the
ship’s survey team checks the craft for any residual agents and, working with the craft
crew, completes the decontamination. Direct disembarking personnel to proceed to the
CCA to commence personal decontamination and to receive medical attention (if required).
Complete the decontamination of the craft while the well is deballasted, flushing out the
well deck in the process.
NOTE: There is a possibility that the steadying lines will be contaminated.
Following the last evolution, discard the lines over the side, ensuring that they do
not become a hazard to navigation. If replacement lines are not available, cut off
the section which came in contact with the craft and resplice the line’s eye.
(3)
Amphibious assault vehicles (AAVs) essentially complete an external
decontamination as a function of their transit to the ship. To further decontaminate the
craft, position the personnel in the vicinity of the stern and direct them to hose down the
AAV with saltwater prior to signaling it to enter the well. Once in the well, keep the
hatches closed, with the crew and troops still inside, stop the AAV in the center of the well,
and hose it down again with saltwater from fire hoses on both wing walls. Turn the AAV
180 degrees, and hose it again before backing it into a parked position. Keep the planking
wet before and during recovery to avoid or reduce the likelihood of the agent saturating the
wood. The AAV platoon commander will initiate the internal decontamination procedures.
After a survey and the additional decontamination, permit the crew and troops to exit the
vehicle, directing them to the CCA to complete their decontamination and medical
assistance before allowing them into the interior of the ship. Setting “Circle William“
hinders the ship’s ability to ventilate the heavy AAV fumes from some well decks and could
contribute to a buildup of fumes in the well deck and contribute to reduced visibility.
(4)
Landing Craft, Mechanized (LCM). The procedures are the same as for an
LCU, except the craft has no CMWDS and does not use a stern gate or sill marriage.
(5)
CRRC. Contaminated CRRCs should be recovered one at a time. When
environmental conditions permit, the CRRCs and their crews should remain in the rear
section of the well deck during their survey and decontamination. The decontamination
team uses portable showers for the crews. Once an initial rinsing has been completed, the
personnel are directed to proceed to the CCA for decontamination and medical attention (if
required).
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(6)
Other Small Craft. For davit-hoisted small craft (e.g., motor whaleboats,
rigid hull inflatable boats), call the craft alongside for the initial decontamination by the
shipboard fire hose teams; take care not to injure the personnel or swamp the boat. Once
the craft is at the rail, the personnel disembark, are surveyed, and are directed to the CCA
for decontamination and first aid (if required). The craft receives a thorough survey and
decontamination prior to being hoisted aboard and secured. If a determination cannot be
made that the craft is decontaminated, and if weather permits, it may be left at the rail
until further decontamination can be accomplished. The eyes on all of the steadying lines
and the sea painter will be dipped into an HTH solution and then cut off and disposed of
over the side; new eyes on the lines will be made.
d.
Vehicle and Equipment Decontamination Procedures.
(1)
Ships generally lack sufficient equipment to conduct a thorough
decontamination of vehicles; specifically, they do not carry wash racks to facilitate easy
access to the undercarriage of the vehicles. Any effort to embark the contaminated vehicles
and cargo into previously uncontaminated amphibious shipping requires a thorough review
of all the options available to complete the assigned mission (to include a review of the
follow-on mission responsibilities). If the ESG has the option to consolidate the clean cargo
and vehicles before loading the contaminated items, such a course of action shall be
pursued. If wash ramps are not available, ships with a “false beach” offer the best option
for receiving the contaminated vehicles (e.g., LPDs, amphibious assault ships [general
purpose and multipurpose, and cargo variant landing ship docks [LSDs]).
(2)
In order to accomplish the cleaning, ships should ballast, create a steep
wedge, and avoid submerging the false beach. When sea state and wave action in the well
deck permit, create a 3- to 5-foot basin of water in the well deck, attach fording gear to the
vehicles, and slowly drive them for 5 to 10 minutes in the saltwater. Spray with fire hoses,
and use scrubbing teams (as necessary) to decontaminate the unsubmerged areas. Once
the vehicle is determined to be free of contaminants, it will be directed to move further up
on the false beach and receive a freshwater wash down to minimize corrosion potential.
Finally, maintenance personnel should perform the post-saltwater emersion maintenance
tasks.
(3)
Steam cleaning may be considered as an option for decontaminating
vehicles and cargo, but such evolutions are likely to be extremely dangerous and difficult to
accomplish. Steam lancing can produce injuries similar to surgical incisions and the risks
may far outweigh the potential gains that might be made over attempting to complete the
decontamination procedure by creating a pool of water as described above.
e.
Force Reconstitution.
(1)
Reconstitution is generally beyond the capabilities of an ESG. However,
reconstituting and expeditiously returning the force to a full mission readiness standard is
the ultimate goal of any decontamination effort. In some instances this will not be possible
until a considerable period of time has elapsed (e.g., following a nuclear warfare attack).
Should the force be unable to restore itself to a full operational-readiness standard,
assistance from outside commands or agencies will be sought, to include replacing
contaminated personnel and equipment with assets obtained from the rear area commands.
Similarly, in situations where the forces are being maneuvered (i.e., transported) from one
landing force objective to another, forces may only be capable of accomplishing a limited
operational decontamination. If the forces are unable to complete a thorough
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FM 3-11.5/MCWP 3-37.3/NTTP 3-11.26/AFTTP(I) 3-2.60
IX-17
decontamination, the commanders will make every effort to ensure that personnel are
afforded the maximum level of support in assuring their comfort. For example, landing
forces may be required to remain in the well deck or sequestered on the flight deck, but
every effort will be made to afford them with adequate shelter and meals. Commanders
may likewise find it more practical to take advantage of consolidating the forces along the
lines of their levels of contamination and have one or more of the ships serve as
contaminated ships and the remainder as clean ships, thus modifying the landing plan to
align with the modified force disposition.
(2)
The commanders may reduce the protective postures and allow the
unprotected military personnel, DOD essential civilians, and contractors to operate in the
proximity of the formerly contaminated material or equipment. This reduction can be made
after using the currently fielded and available technologies to validate that the
decontamination procedures or weathering have reduced the hazards from material and
equipment to nondetectable levels. The commanders will ensure that the equipment and
personnel are periodically monitored to determine if signs of a return of the contamination
are detected. Should a hazard be identified, commanders will direct that appropriate action
be taken to safeguard affected personnel.
WARNING
Risks to personnel safety increase as residually
contaminated equipment is consolidated and
personnel work around this equipment for
prolonged periods, particularly in areas with
limited air circulation.
(3)
Before initiating the action to recover potentially contaminated equipment
to the CONUS for repair, the commanders should coordinate with the JRA coordinator to
determine if an emergency condition exists and warrants the risks associated with such an
action. Generally, the equipment will not be returned to CONUS until it has been
determined to be clear of contamination, even if such an action results in the requirement
for an extended period of time for weathering. If the equipment cannot be decontaminated,
destruction may be required.
CAUTION
Civil aircraft will not normally be used to transport the
contaminated equipment due to the safety and legal
concerns.
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4 April 2006
Chapter X
PATIENT EVACUATION AND DECONTAMINATION
1.
Background
a.
The evacuation of patients under CBRN conditions forces the unit commander to
consider how he will commit evacuation assets to enter the contaminated area. Generally,
if a supported force is operating in a contaminated area, most or all of the medical
evacuation assets will operate there also. Efforts should be made to keep some ambulances
and aircraft free of contamination. See FM 4-02-7 and FM 8-10.6 for additional
information.
b.
On the modern battlefield, land forces have three basic modes of evacuating
patients (personnel, ground vehicles, and aircraft). Watercrafts may also be used to
conduct patient evacuation for waterborne forces (see MCRP 4-11.1E).
c.
Cumbersome MOPP gear, climate, increased workloads, and fatigue will greatly
reduce the effectiveness of the unit personnel. Using the personnel to physically carry
patients incurs a great deal of inherent stress.
d.
The evacuation of patients must continue even under CBRN conditions. The
medical leader must recognize the constraints that CBRN contamination places on him and
then plan and train to overcome them. These constraints include the need for the allocation
of dirty evacuation vehicles, patient transfer processes from dirty to clean vehicles, the
allocation of personnel and supply resources for PDS operations, and the restricted working
conditions of medical personnel wearing MOPP in ambulances with patients who have not
been thoroughly decontaminated.
e.
When evacuating patients in a CBRN contaminated environment, evacuation
considerations should include the following:
(1)
Evacuation assets could become contaminated in the course of battle.
Optimize the use of contaminated medical and nonmedical resources before employing
uncontaminated resources.
(2)
Once a vehicle enters a contaminated area, it is highly unlikely that it can
be spared long enough to undergo decontamination. This will depend upon the
contaminant, the tempo of the battle, and the resources available for patient evacuation.
Normally, the contaminated vehicles (air, water, and ground) will be confined to
contaminated environments. However, immediate decontamination may be accomplished
to reduce the amount of contamination in the patient transport area.
(3)
Ground ambulances or other assets that are easy to decontaminate and
readily replace should be used versus using air ambulances. However, this does not
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X-1
preclude the use of aircraft in a contaminated environment or the evacuation of
contaminated patients.
(4)
If evacuation personnel are sent into radiologically contaminated areas,
adhere to the operational exposure guide (OEG). Radiation exposure records must be
maintained by the supported unit and made available to the commander, staff, and medical
leader. Based on the OEG, the commander (with the assistance of his medical staff), will
decide which evacuation elements are sent into the contaminated environment.
(5)
The relative positions of the contaminated area, FLOT, threat air defense
systems, and the patient’s medical condition will determine if and where air ambulances
may be used in the evacuation process with minimal air crew exposure. One or more air
ambulances may be restricted to the contaminated areas. When possible, use ground
vehicles to cross the line separating the contaminated and clean areas.
(6)
Patients should receive immediate and patient decontamination at the
operational level and first aid and buddy care prior to being placed on evacuation vehicles.
To reduce the spread of contamination on ground ambulance wheels for vehicles that have
been in the contaminated area, a contamination control line can be established at the edge
of the contaminated area where patients can be transferred from the dirty ambulances to
clean ambulances that do not contain contamination on their wheels. The clean medical
evacuation vehicles would then proceed to a PDS at an MTF. The patients have not been
given patient decontamination at the thorough level at this point. The inside of these clean
vehicles may become contaminated if patients are not provided with immediate
decontamination of their MOPP uniforms to remove most of the contamination. This
necessitates that all ambulance crew members wear MOPP while in the field vehicles to
protect them from possible cross contamination or vapor hazards from agent on patient
MOPP. Another alternative is to determine the specific routes that will be used by dirty
medical evacuation vehicles to get to the PDS at an MTF. The routes used by the dirty
ground vehicles to cross between contaminated and clean areas are considered dirty routes
and are not crossed by clean vehicles. See FM 4-02.7 for the setup of a PDS at an MTF.
(7)
When employing ground ambulances, watercraft, or aircraft in a medical
evacuation, place plastic sheeting under the litters to prevent transferring contaminants
from the patients or litters to the inside of the vehicle. The plastic sheeting can be removed
with the patients, thus removing most of the contamination with it. When plastic sheeting
is not available, placing a blanket under the litter will reduce the amount of agent that
makes contact with the inside of the vehicle.
(8)
The rotor wash of the helicopter or turbulence (e.g., prop blast) from wing
aircraft must always be kept in mind when evacuating patients, especially in a
contaminated environment. The intense winds may disturb contaminants, increasing
vapor hazards at the contaminated landing site. The effects of downwash may be reduced
by allowing the helicopter to land and reduce to flat pitch before patients are brought near
it. Additionally, a helicopter must not land too close to a PDS that is open to the air as it
can disturb dust and contaminants that may be in the area. If the PDS operation is in an
uncontaminated area and contains contaminated runoff (such as in a bladder to hold
contaminated waste), downwash should not be an issue at the PDS.
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(9)
Casualty protection during an evacuation is critical. Casualties who have
been thoroughly decontaminated at a forward MTF and have had their MOPP ensemble
removed must be placed in a patient protective wrap (PPW) or have their MOPP ensemble
replaced if they are to be transported on a dirty aircraft, watercraft, or ground vehicle or
when they are moved across a contaminated area.
(10) Medical evacuation by a fixed-wing aircraft will be severely limited as these
assets are few compared with rotor wing and ground ambulance, and they require
significant time to decontaminate. Some nations may not allow casualties from
contaminated areas to travel through or over their territory. Every effort should be made
to thoroughly decontaminate the casualty by removing the contaminated clothing and
thoroughly washing the patient at an MTF PDS prior to the casualty reaching the staging
area. The patient must undergo a thorough decontamination before entering a fixed-wing
aircraft that is designated as clean.
f.
Operational decontamination of medical evacuation assets should be
accomplished to minimize crew exposure if the mission permits. The unit SOP should
include equipment decontamination procedures.
2.
Patient Decontamination
a.
Contaminated patients potentially create increased hazards to casualty
extraction teams, HSS personnel, MTFs, and materiel. Detailed information on patient
decontamination is found in FM 4-02.7. This section provides an overview of patient
decontamination for the individual services.
b.
Personnel who have undergone a CBRN attack may suffer from the effects of a
CBRN agent, TIM exposure, a conventional wound, psychological stress reactions, or a
combination of these. In addition, some personnel may suffer from heat injuries induced by
extended time spent in MOPP4.
c.
Patient decontamination supports the decontamination process at the
immediate, operational, and thorough levels.
d.
The process of patient decontamination begins at the incident site. The
contaminated service member performs immediate personal decontamination. If the
service member is unable to decontaminate himself due to injury or incapacitation, a buddy
performs this function. The contaminated areas on the MOPP ensemble and the exposed
skin are decontaminated. For liquid chemical contamination, the M291 SDK is useful. If
the M291 SDK is not available, use soap and water or a field-expedient absorbent material
(such as clean, dry earth), ensuring that the skin is not abraded during its use. For vapor
and aerosol contamination, use soap and water. Immediate decontamination is critical to
limit the injury to the contaminated individual. For biological contamination, soap and
water will remove these agents, but may not kill all of them. Radioactive contamination
can also be removed (but not neutralized) with water or soap and water, by simply brushing
dust and debris from the clothing and hair, or vacuuming with a vacuum that is fitted with
a high-efficiency particulate air (HEPA) filter.
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X-3
e.
Every attempt must be made to limit the spread of contaminants onto the
medical evacuation vehicles. As much contamination as possible must be removed from the
patient’s MOPP prior to loading him on the evacuation assets to reduce the contamination
of these assets and the cross contamination of the other patients and crew. Individuals who
are transported to the MTF for care may or may not be contaminated. If feasible,
uncontaminated patients should be protected from cross contamination. Ways to reduce
cross contamination include the following:
Designating areas for the contaminated patients on the ambulance.
Placing the contaminated patients on plastic sheets in the vehicle.
Identifying separate assets for dirty and clean patients who are transported from
the battlefield in MOPP.
Decontaminating the MOPP of all patients who come from the dirty evacuation
assets (ensuring that the MOPP gear is adequately decontaminated reduces cross
contamination inside the dirty vehicle).
f.
The key in patient decontamination at the thorough level is that the proper
decontamination procedures must be followed to limit the spread of contamination so that
MTFs and other patients are not compromised through the incapacitation of medical staff
who are wearing CBRN protective equipment.
g.
Each service follows slightly different procedures for thorough patient
decontamination (based on the service’s mission and equipment). All services follow similar
principles, which include the following:
(1)
Medical personnel supervise the patient decontamination operations.
Augmentees from the supported units are usually required to assist in the decontamination
process and perform patient lifting and washing.
(2)
In the triage area outside the PDS, further decontamination of MOPP is
performed to limit the spread of contamination (while necessary medical care is provided to
stabilize the patient).
(3)
Medical triage officers sort patients, considering the priorities for
treatment, decontamination, and evacuation, based on the patient’s need for care and his
ability to benefit from what is available at that MTF.
(4)
Those who do not require lifesaving procedures at a smaller MTF may
remain in their MOPP4 ensemble on the dirty side of the hot line. There, the patient will
be given patient operational decontamination and medical stabilization and returned to
duty or evacuated to a larger in-theater MTF (where there is adequate staff to provide
patient thorough decontamination to larger numbers of patients).
(5)
Patient decontamination at the thorough level is a comprehensive cleaning
process that must be carried out prior to a patient being allowed inside any MTF. It
involves removing all of the patient’s MOPP and any underclothing that is suspected of
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4 April 2006
being contaminated. Typically, all of the patient’s clothing is removed. The patient’s skin
is then decontaminated. When water resources are limited, only the patient’s mask and
those areas of suspected skin contamination are decontaminated (pay particular attention
to areas where there were breaks in the protective clothing and around wounds). The M291
and soap and water are used for chemical contamination. However, a 0.5 percent
hypochlorite solution is useful if water is limited and the M291 kits are not available. Soap
and water are best for biological and radiological contamination. For all agents, a complete
body wash, using soap and water, can be performed (if adequate resources are available).
(6)
Medical care and triage are provided before, during, and after patient
decontamination to ensure that the patient remains stable enough to survive the procedure.
(7)
Open wounds are irrigated with clean water or saline.
(8)
The least desired alternative for skin decontamination is hypochlorite
solution. If used, only a 0.5 percent hypochlorite solution is used for patient
decontamination. Higher concentrations will irritate and burn the skin and allow some
nerve agents to enter the skin more rapidly. During patient decontamination at the
thorough level, the only place where 5 percent hypochlorite (full strength liquid bleach)
solution is used is to decontaminate plastic mesh litters that are designed to be
decontaminated. The litters are rinsed before reuse. The litter washing process is
performed away from the patient decontamination area.
(9)
All patients who arrive at the PDS wearing protective masks will remain in
their masks during the decontamination process and until they are out of the PDS vapor
hazard area. Medical personnel may remove the patient’s protective mask to intubate the
patient. The resuscitation device, individual, chemical (RDIC) is used if there is a vapor
hazard in the area of treatment.
(10) Patients who are treated outside the MTF should not have their MOPP
removed as long as they do not enter the MTF or a clean area or do not require skin
decontamination.
(11) Contaminated bandages and splints are only removed by trained medical
personnel. The bandages are removed; the skin is decontaminated and only replaced if
bleeding continues. Splints are not removed during the decontamination process; cravat
and other strapping material may be removed one item at a time, the skin decontaminated
and a new cravat placed on the splint. Repeat this process until the entire splint has been
decontaminated.
3.
Army Patient Decontamination Procedures
a.
The Army is a land-based mobile force, which uses patient decontamination
procedures that meet the mission demands. Decontamination equipment is simple, is easy
to relocate and set up, can be used in a limited water environment, and takes up relatively
little storage space.
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b.
Each MTF, from Level I to larger, has a patient decontamination medical
equipment set. Larger facilities, such as Levels III and IV, have more equipment and staff
to handle larger numbers of patients evacuated to them from smaller, forward MTFs.
c.
Smaller, battalion level MTFs are not staffed to perform patient thorough
decontamination and medical treatment. Therefore, patient thorough decontamination
must be performed by nonmedical personnel from the supported units or units located
within the base cluster or in vicinity of the MTF. These individuals are supervised by the
medical personnel. The minimum number of personnel required for basic PDS operation is
16. Larger MTFs will require greater numbers of personnel as they will need to process
greater numbers of patients. Also, additional personnel should be considered to allow for a
work-rest rotation of workers. Personnel are split into two categories. The two categories
are:
Nonmedically trained augmentees to assist with ambulatory decontamination
and litter decontamination.
Medically trained personnel serve as medics at the triage area, dirty side
emergency medical treatment (EMT) areas, litter and ambulatory decontamination areas,
clean side of the hot line, and clean treatment area.
d.
If the MTFs are located near the troop decontamination units, coordination can
be made to colocate medical patient decontamination and nonmedical troop
decontamination side by side to share assets. Brigade is the lowest level that this operation
can be effectively planned. However, decontamination support for other unique operational
organizations (e.g., SOF) may require execution at a lower level. The operation requires
close coordination between the brigade chemical officer, brigade S-4, brigade surgeon, and
medical company commander.
e.
Army patient thorough decontamination involves decontamination procedures
for litter and ambulatory patients. This encompasses a series of specific steps for patient
medical stabilization, the removal of clothing, wash down, and mask removal before entry
into the MTF. Army field decontamination equipment sets provide buckets, sponges, liquid
soap, HTH for a shuffle pit and hypochlorite solution preparation, litters, and litter stands.
f.
Detailed step-by-step instructions for the operation of the Army PDS are found
in FM 4-02.7.
4.
Marine Corps Patient Decontamination Procedures
a.
The Marine Corps is an amphibious mobile force that can conduct patient
thorough decontamination operations on a ship, according to the Navy shipboard
procedures, or on land with procedures similar to those used by the Army. It uses patient
decontamination procedures at the thorough level that meet the mission demands.
Decontamination equipment is simple, is easy to relocate and set up, can be used in a
limited water environment, and takes up relatively little storage space.
b.
The Navy MTFs supporting the Marine Corps are not staffed to perform patient
thorough decontamination and provide medical treatment. Therefore, the patient thorough
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decontamination must be performed by nonmedical personnel from the supported units or
units located within the base cluster or in vicinity of the MTF. These individuals are
supervised by the Navy medical personnel. The minimum number of nonmedical personnel
required for a Level I battalion aid station for patient thorough decontamination is identical
to the requirements for the Army. The requirements include personnel to assist with
ambulatory decontamination, litter decontamination, and hot line management. Navy
medical personal minimal requirements would include medics at the triage area, dirty side
EMT area, litter and ambulatory decontamination areas, and the hot line. Levels II and
larger will require greater numbers of personnel as they will need to process greater
numbers of patients at larger Navy medical facilities supporting Marine Corps units. In
these cases, additional manpower will be needed to ensure appropriate manpower
work-rest rotation.
c.
The Marine Corps land-based patient thorough decontamination involves
decontamination procedures for litter and ambulatory patients. This encompasses a series
of specific steps for patient medical stabilization, the removal of clothing, wash down, and
mask removal before entry into the MTF. The equipment and procedures are almost
identical to those of the Army, with minor differences in the cutting of clothing procedures
for patients.
d.
Detailed, step-by-step instructions for the operation of the Marine Corps
land-based PDS are found in FM 4-02.7.
5.
Navy Patient Decontamination Procedures
a.
The Navy is primarily a sea-based force that can conduct patient thorough
decontamination operations on a ship (according to Navy shipboard procedures) or on land
for land-based Navy MTFs.
b.
Ship-based procedures are unique to the Navy due to the architecture and layout
of the ship. Contaminated litter casualties are typically triaged, stabilized, and
decontaminated above deck and then brought below deck for treatment after they are
decontaminated. Some ships may contain decontamination stations built within the ship
where patients can be processed below deck.
c.
Patient thorough decontamination procedures for land-based Navy MTFs are
similar to those of the Army, depending on the decontamination equipment available.
d.
Detailed, step-by-step instructions for the operation of the Navy land-based PDS
are found in FM 4-02.7.
6.
Air Force Patient Decontamination Procedures
The USAF is deployed as a land-based force that projects air power from a stationary
site that may become contaminated. USAF patient thorough decontamination procedures
are for deployed and CONUS forces in two separate configurations.
a.
In deployed environments, the USAF utilizes expeditionary medical
decontamination teams (EMDTs). These teams, with equipment and procedures, meet the
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mission demands for a stationary land support force that must sustain operations in a
contaminated environment. Patient thorough decontamination is designed to allow the
force to continue limited operations in an environment that becomes contaminated. Patient
decontamination equipment is packaged to be air-transportable, ergonomically designed for
optimal manning, and rugged for sustained use. USAF patient decontamination assets are
only deployed with a chemically protected deployable medical system (CPDEMEDS) 25-bed
medical package or larger. Decontamination equipment includes a Small-Shelter,
Personnel Decontamination System (SSPDS), which is composed of tentage, a water
bladder, a litter roller system, water heaters for handheld soap and water sprayers, and a
runoff wastewater collection system. The SSPDS has lanes for both litter and ambulatory
patients. Environmental control units regulate the temperature inside the SSPDS and
maintain positive air pressure through access doors to the outside so that the unit can
operate with contamination outside. The environmental control units also include air locks
to the CPDEMEDS MTF. The 19-person manpower detail, which makes up one EMDT, is
primarily composed of medical personnel who train together and perform all the
decontamination procedures and medical care involved in the patient decontamination
process. One EMDT can simultaneously process an average of 15 ambulatory and 15
nonambulatory casualties per hour. Detailed step-by-step instructions for the operation of
the EMDT are found in AFI 10-204, with supplemental information found in FM 4-02.7.
b.
Within CONUS, the USAF uses an in-place patient decontamination capability
(IPPDC). This is a nondeployable asset that is designed to provide patient thorough
decontamination at USAF MTFs. It is designed for patients who self-present or are
transported for definitive medical care to the MTF and may have bypassed
decontamination at the incident scene. Equipment includes a decontamination tent that
can be readily deployed. The entire tent setup includes plumbing, with soap and water
sprayers, to decontaminate both litter and ambulatory patients and a roller system for
litter patients. It also has water heaters and a runoff water collection system. The
plumbing must be connected to a fire hydrant or an outside faucet. The IPPDC
decontamination team is typically composed of 12 medical personnel who train as a group.
Detailed, step-by-step instructions for the operation of the IPPDC are found in AFI 10-204,
with supplemental information found in FM 4-02.7. Many CONUS MTFs have similar
nondeployable patient decontamination layouts.
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Chapter XI
DECONTAMINATION IN SUPPORT OF HOMELAND SECURITY
1.
Background
a.
During every incident involving a CBRN release, there is a possibility that the
target could be a military installation, unit, or activity or a civilian site. The targets could
include critical infrastructures or members of the public. The DOD maintains significant
decontamination resources (personnel, equipment, and supplies) that may be used to
support a request for federal assistance. Additionally, service decontamination resources
may likely be used to respond to an incident or accident at a military installation. This
chapter will briefly address how DOD decontamination capabilities could be provided to
support HLS. Additionally, this chapter will address decontamination terms, procedures,
and planning considerations that could be applicable to an incident or accident supporting
HLS.
b.
To prevent, prepare for, respond to, and recover from terrorist attacks, major
disasters, and other emergencies, the United States Government (USG) has established a
comprehensive approach to domestic incident management. The objective of the USG is to
ensure that all levels of the government have the capability to work efficiently and
effectively together. In order for the government to accomplish this mission it developed
the Federal Response Plan and later the NRP.
c.
For additional information refer to Multiservice Tactics, Techniques, and
Procedures for Nuclear, Biological, and Chemical Aspects of Consequence Management.
2.
Federal Assistance
Providing decontamination assistance to non-DOD government organizations requires
detailed coordination.
a.
Local and state governments routinely respond to a wide array of domestic
emergencies without any federal assistance. Some CBRN incidents may not overwhelm
local response capabilities, but may require technical advice and assistance that is not
readily available in local or state agencies. However, a large-scale incident may overwhelm
local and state responders, requiring considerable federal assistance.
b.
Requests for assistance (RFAs) from civil authorities are coordinated through the
processes outlined in the NRP. If local or state authorities submit an RFA, the Federal
Emergency Management Agency (FEMA) develops a mission assignment and tasks the
appropriate primary agency. If the tasked primary agency needs additional assistance, it
may request military support through the on-scene defense coordinating officer or the
Secretary of Defense (SecDef). The military elements capable of providing the necessary
response are then sent to the incident area under the operational control of the defense
coordinating officer (DCO) or JTF (during a CBRN incident) to perform the tasks.
c.
Under DODD 3025-1, imminently serious conditions resulting from a civil
emergency or attack may require immediate action by military commanders or by
responsible officials of other DOD agencies to save lives, prevent human suffering, mitigate
great property damage, or limit the spread of contamination.
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3.
Response to a Homeland Security Incident—Decontamination
Considerations
There are important differences between a HAZMAT incident and a CBRN incident.
Responders must be aware of these differences and take the proper precautions for self-
protection, protection of other responders, and protection of the public during response
actions. See Multiservice Tactics, Techniques, and Procedures for Nuclear, Biological, and
Chemical Aspects of Consequence Management for decontamination considerations that
apply to consequence management operations.
a.
General Considerations.
(1)
With most CBRN material, responders must complete decontamination
swiftly in order to save lives and minimize the number of victims. Although a rapid
response is required because of the speed that many of the toxic chemical agents affect the
body, responders must resist rushing in to assist until the situation is over.
(2)
The number of expected victims is the first major difference between a
standard HAZMAT situation and a CBRN incident. Responders may be required to control,
triage, decontaminate, and track a large number of people at the site of a CBRN incident.
Scene control may involve a large area, a mass victim situation with numerous responders
who want to help, and the press corps seeking information about the incident. A response
of this magnitude will require more personnel and material than may be available;
therefore, detailed contingency planning, training, and exercising is required in advance.
(3)
A terrorist CBRN incident is a federal crime scene. During the
decontamination process, responders must make every effort to preserve evidence for
eventual use in apprehending and prosecuting the perpetrators.
(4)
Runoff control is required to reduce the spread of the hazard. Because of its
potential toxicity, keep decontamination runoff away from sewer drains, groundwater,
streams, and watershed areas. If runoff cannot be controlled, notify the appropriate
agencies (e.g., sewer, water, and environmental).
b.
Purposes of Decontamination. The potential for exponentially increasing panic
and cross contamination after a CBRN release is staggering. Responders who are called
upon to assist in the decontamination process must possess the ability to execute the
decontamination procedures properly; thus, negating the exponential effects and enhancing
victim confidence.
c.
Decontamination Levels.
(1)
Emergency decontamination can occur at any point during a
decontamination operation. Like mass decontamination, it commonly refers to procedures
taken for the rapid reduction of agent from the skin. However, when an emergency arises
during the decontamination process (e.g., the responder runs out of air during a technical
decontamination), quick steps must be taken to alleviate or mitigate the emergency while
also practicing contamination avoidance.
(2)
Mass decontamination is a commonly used term referring to the rapid
reduction of agent from the skin of many contaminated victims. Mass decontamination is
performed as quickly as possible while also practicing contamination avoidance. Other
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terms associated with the mass decontamination process are emergency, gross, and
immediate decontamination.
(3)
Technical decontamination commonly refers to the deliberate
decontamination of responders, equipment, and evidence. Technical decontamination can
also be performed on a mass contaminated populous if conditions allow. Technical
decontamination is performed with the emphasis on neutralization of the agent. Speed is
not a factor. Terms that are commonly associated with technical decontamination are
detailed, thorough, deliberate, definitive, and responder decontamination.
d.
Decontamination Planning Considerations.
(1)
Mass decontamination can take many improvised forms, with the intent
being the rapid removal of the agent.
(a) Government agencies (e.g., OSHA) recommend a high-volume,
low-pressure water system as the default standard for mass decontamination.
(b) High-pressure water systems are discouraged because they may force
contaminants through the clothing and increase contamination on the victim.
(c)
Field-expedient methods, like the ladder-pipe decontamination system
method developed by the Howard County Fire Department for the Baltimore Exercise
(BALTEX) V (an emergency response demonstration in Baltimore, Maryland), proved that a
multiple-apparatus platform allows responders to create a longer corridor for
decontamination that will accommodate a large number of victims.
(d) Commercially available decontamination systems are effective, but
most of these systems are trailer-mounted and require transportation to the incident site,
causing delays. However, if these systems are centrally located and rapidly deployable,
they offer an advantage over other systems because they provide the following:
Heated showers.
Cover.
Systems to control runoff.
(e) The use of chlorinated swimming pools, elevated master nozzles, fog
streams, and public-school shower facilities are other improvised methods that meet the
intent of emergency decontamination. The objective is the rapid and gross removal of most
of the agent involved in the incident.
(2)
Emergency decontamination does not require the use of a decontamination
corridor, although the nature of the corridor lends itself to an organized and effective
decontamination operation.
(3)
Weather conditions and the possible requirement of an indoor
decontamination site (e.g., school gym with showers, car wash, or community center) are
things to keep in mind when choosing a location. Techniques for adjusting water pressure
may also come into play when using hose lines and elevated master streams in the
decontamination process.
(4)
Appropriate personal coverings are provided for persons undergoing
decontamination, using items readily available from the local area, such as disposable
ponchos, coveralls, and salvage covers. Incident logistics coordinators or responders might
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procure blankets, large towels, sheets, and tablecloths from local restaurants, stores,
hospitals, and hotels. Consider providing overhead cover to afford additional consideration
for modesty.
(5)
Establishing a triage, treatment, and transport area in a clean and secure
location that is large enough to accommodate all victims must also be considered. Ensure
that all responders are aware of the signs and symptoms of CBRN exposure. The use of
mechanical ventilation and pharmaceuticals may be required to stabilize victims.
(6)
Decontaminated victims and responders must be treated and transported to
supporting MTFs immediately following the decontamination. Consider mass transit, when
available, to assist in transporting victims.
e.
Safety of Responders.
(1)
The safety of responders is of the utmost importance. All responders with
the potential to encounter contaminated victims or be exposed to contaminated material
must wear protective clothing and respiratory protection equal to or one level below the
level of protection required for the hazard. Responders can assure maximum consideration
for the safety of themselves and victims by instituting and following safety procedures. The
following are the levels of protection given in Department of Labor (DOL) Regulation 29
CFR 1910-120:
(a) Level A.
Positive pressure, full face piece, self-contained breathing apparatus
(SCBA) or positive pressure-supplied air respirator with escape SCBA approved by the
National Institute for Occupational Safety and Health (NIOSH).
Totally encapsulating chemical-protective suit.
Coveralls (optional).
Long underwear (optional).
Gloves, outer and inner, chemical-resistant.
Boots, chemical-resistant, steel toe and shank.
Hard hat (under suit) (optional).
Disposable protective suit, gloves and boots (depending on suit
construction, may be worn over totally encapsulating suit).
(b) Level B.
Positive pressure, full face piece SCBA or positive pressure-supplied
air respirator with escape SCBA (NIOSH-approved).
Hooded chemical-resistant clothing (overalls and long-sleeved jacket,
coveralls, one- or two-piece chemical-splash suit, disposable chemical-resistant overalls).
Coveralls (optional).
Gloves, outer and inner, chemical-resistant.
Boots, chemical-resistant, steel toe and shank.
Boot covers, outer, chemical-resistant (disposable) (optional).
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Hard hat (optional).
Face shield (optional).
(c)
Level C.
Full face piece or half mask, air-purifying respirators
(NIOSH-approved).
Hooded chemical-resistant clothing (overalls, two-piece
chemical-splash suit, disposable chemical-resistant overalls).
Coveralls (optional).
Gloves, outer and inner, chemical-resistant.
Boots, chemical-resistant, steel toe and shank (optional).
Boot covers, outer, chemical-resistant (disposable) (optional).
Hard hat (optional).
Escape mask (optional).
Face shield (optional).
(d) Level D.
Coveralls.
Gloves (optional).
Boots or shoes, chemical-resistant, steel toe and shank.
Boots, outer, chemical-resistant (disposable) (optional).
Safety glasses or chemical-splash goggles.
Hard hat (optional).
Escape mask (optional).
Face shield (optional).
(2)
If the agent is unknown, Level B is the minimum required protection.
Military issue IPE (MOPP ensemble) does not meet OSHA Level C requirements. If
wearing MOPP—
Minimize contact with the victims.
Practice contamination avoidance.
Know the agents and the signs and symptoms of their effects.
Institute the universal safety precautions to better protect operations level
responders from blood-borne pathogens.
NOTE: MOPP gear does not provide adequate protection for many TIM.
f.
Isolation and Organization of Ambulatory Victims.
(1)
Determine the best ways to isolate victims and establish victim control.
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(2)
Explain to victims that they need help. Provide them with instructions
pertaining to what steps need to be taken. This can be done with loudspeakers or public
address systems.
(3)
Evacuate the victims upwind and uphill of the hazard. Separate the
victims who are showing symptoms (symptomatic) from the victims who are not showing
symptoms (asymptomatic). Separate men and women. Collect personal items (e.g., use a
plastic bag and a method of identification, voucher personal articles for later return).
(4)
Provide special consideration to families, small children, the elderly, and
special-needs persons.
g.
Types of Decontaminants.
(1)
While there are numerous types of decontaminants available for use by
responders, they fall into three basic categories:
(a) Miscellaneous (Commercial). Available stockpiles of these
decontaminants may be quickly expended and not readily replaceable. Therefore, it is
important that responders have an understanding of other decontaminants, their sources,
and their uses.
(b) Natural. The use of natural decontaminants will reduce the responder
time and the use of available decontaminants.
(c)
Standard Military. If the military is called in to support the incident,
military decontaminants may be available.
(2)
Decontaminants should be stocked and stored before any incident. They
must be accessible and clearly marked for content. Test decontamination material
routinely for viability (strength). Operations level responder training must stress
decontaminant use, application, and risk (e.g., agent use and contact time for personnel and
equipment).
(3)
When capabilities and resources allow, decontaminants of choice are soap
and water, water, or household bleach if soap and water are limited. Full strength, 5
percent bleach solution from the bottle should only be applied to equipment (15-minute
contact times) and never to skin. It will decontaminate most CB agents. A 5 percent bleach
solution followed by a complete flushing is the maximum bleach concentration used for skin
and clothing (though not exactly matching the recommended percentages, a standard rule
of thumb is 10:1, or 10 parts water to 1 part bleach). Do not apply bleach to a victim’s face.
(4)
Responders may use commercially available materials (such as absorbents)
for the control of liquid contamination at an incident scene and the removal of most gross
chemical contamination from surfaces. Contamination will be transferred to the absorbent
material, which must be treated as contaminated waste and disposed of accordingly. Since
there is no preparation time for absorbent material application, utilize the material as soon
as it arrives at the incident scene.
(5)
Nonaqueous (without water) methods provide a means for contaminant
removal.
(a) The use of dry, gelled, or powdered decontaminating materials to
absorb chemical agents is appropriate (if their use is expedient). Commonly available
absorbents include dirt, flour, baking powder, sawdust, charcoal, ashes, activated carbon,
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alumina, silica gels, and clay materials. Although these absorbents may be an expedient
means of decontamination, their effectiveness has not been determined. In general,
absorbents only remove contamination, they do not always neutralize the agent.
(b) The DOD uses the M291 and M295 SDKs, which employ a
charcoal-based resin absorbent and are available for commercial purchase. However, while
these kits are effective in removing spots of liquid chemical-agent contamination, they may
not be suitable for treating mass casualties. This is due to their potentially limited
availability and the relatively high labor requirements because of the size of the
decontamination pad and the time it takes to clean large amounts of contamination from
the victim.
(6)
The use of natural degradation and ultraviolet (UV) light does not require
responder preparation or application time. UV light kills most biological agents quickly,
but does not kill spores.
h.
Decontamination Corridor.
(1)
Responders must be prepared to conduct emergency
decontamination and to set up a decontamination corridor. To do this, select and
secure a large area upwind and uphill of the hot zone. Provide protection for and be
able to accommodate the decontamination of large numbers of victims. Base an
emergency decontamination operation on speed rather than neatness.
(2)
The sooner one begins and completes the decontamination, the
better, as time will be a critical element. The decontamination process also has the
potential of creating a hazard. Notify the proper authorities downstream if
responders cannot confine the runoff to the incident scene. To reduce this hazard,
responders must do the following:
(a) Control decontamination runoff as best as possible. Know where it is
going, and ensure that it will not flow into clean areas.
(b) Coordinate with local environmental management officials if possible.
Confinement may be critical if radiological materials are involved.
(c)
Establish measures for the decontamination of fatalities. One method
is to establish an additional lane within the decontamination corridor. Consider the
psychological implications of the colocation with living victims and the potential need for
autopsies for evidence as factors in determining where to establish the decontamination
facilities for fatalities.
(3)
After establishing the decontamination corridor, responders must
effectively communicate to the victims what action can be expected as they pass through
the corridor during the decontamination process.
(a) During decontamination, have the victims remove their outer clothing,
down to their undergarments to increase the thoroughness of the decontamination process.
The removal of clothing removes approximately 50 to 80 percent of the contamination.
(b) Additionally, consider implementing the following techniques:
Use bags (such as trash bags, biohazard bags, or other bags of suitable
size and strength) to collect and identify the individual clothing removed from the victims.
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Place the bagged clothing into a sealed container (tagged for
identification) for a more thorough inspection later.
Wet the victims down before removing their individual clothing (if the
hazard is biological or radiological). This will embed the agent on the clothing of the
victims and reduce the potential for the biological or radiological agent to adhere to the
bodies of the victims or becoming reaerosolized.
Blot the agent off (using a pinching motion) to remove the liquid (if the
hazard is a suspected liquid mustard [blister] agent).
i.
Nonambulatory Emergency Decontamination of Patients.
(1)
Emergency cutout and decontamination of the nonambulatory victims at a
WMD terrorist event presents many challenges to the first responders. Responders must
be able to perform cutout procedures efficiently in order to accommodate the numerous
victims that will need immediate medical attention. Precautions must be taken to prevent
the spread of contamination to the responders, team, victims, and uncontaminated ground.
(2)
Minimize responder and victim exposure during the decontamination
process by—
Selecting PPE at a level that protects the responder against the threat
(chemical or biological agent). OSHA guidelines state that the PPE level must be at least
one level below the contaminated responder’s protective level. When the agent is unknown,
OSHA requires PPE Level B. However, PPE Level A protection is recommended for
additional safety pending the agent identification.
Wearing positive pressure SCBA.
Limiting the number of responders that come in physical contact with
victims.
(3)
Consider the following techniques to provide protection when handling
victims:
Use supports to hold the stretchers and backboards off the ground (e.g.,
milk crates or sawhorses).
Keep clothing away from the victim’s face during removal (limits the victim
breathing the agent).
Remove or cut the clothing from head to toe, front to back.
(4)
Do not cut through holes or tears when removing clothing from victims.
These are clues to the event and may prove to be useful evidence.
(5)
Control and monitor all responder’s activities throughout the incident for
accountability and treatment in the event they become contaminated. If responders become
contaminated, they may be required to conduct self-decontamination procedures to assure
their own safety.
j.
Technical Decontamination.
(1)
When setting up the technical decontamination corridor, establish it away
from the emergency decontamination corridor. During the emergency decontamination
process, the emphasis is on speed and CBR agent removal since the victims have no
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protection against the agent. Technical decontamination concentrates more on
completeness and neutralization since the responders are in protective clothing.
(2)
The distance between the stations of the corridor is critical in minimizing
the vapor hazard and cross contamination. The distance is most critical at the last station,
where personnel remove their respiratory protection and move to the cold zone. The
incident commander or HAZMAT technician will establish the distances required between
stations based on the weather conditions, the number of victims, space available, the type of
agent used, and time restraints.
4.
Department of Defense Decontamination Capabilities
See Appendix G for a summary of representative DOD decontamination capabilities.
4 April 2006
FM 3-11.5/MCWP 3-37.3/NTTP 3-11.26/AFTTP(I) 3-2.60
XI-9
THIS PAGE IS INTENTIONALLY LEFT BLANK.
Chapter XII
LOGISTICS
1.
Background
Many of the materials that are needed to conduct decontamination operations are
identified in this chapter.
2.
Consumption Rates and Replenishment
Serious consideration must be given to consumption rates and the replenishment of
items in order to sustain decontamination operations and remain prepared.
a.
Skin Decontamination and Personal Wipe Down. Each warfighter carries his
own SDK. The SDK will be stored in the individual’s mask carrier. The basis of issue per
individual is two SDKs (12 packets). The unit maintains at least one SDK per assigned
person for resupply. Personal wipe down is also done with these kits.
b.
Individual Gear Decontamination. The standard decontamination kit for
individual gear is the IEDK. Each warfighter carries an IEDK according to procedures
outlined in their unit SOP. The basis of issue per warfighter is one IEDK. Each kit
contains four individual decontamination packets, enough to decontaminate two complete
sets of individual gear.
c.
Operator Wipe Down. The unit or activity will use the M100 SDS for operator
wipe down. The M100 contains two packs of reactive sorbent powder, two wash mitt type
sorbent applicators, a case, and two straps. It allows two operators to perform simultaneous
decontamination operations.
d.
MOPP Gear Exchange. Each warfighter wears or carries one complete set of
MOPP gear. The unit or activity will maintain additional sets of MOPP gear as specified in
the service logistics authorization documents. When a unit or activity undergoes a MOPP
gear exchange, the unit sends a supply vehicle with the replacement MOPP gear and any
decontaminants to rendezvous with the contaminated element at the operational
decontamination site. The units or activities will generally maintain a 5 percent overage of
MOPP gear, based on their personnel strength or authorization (whichever is greater) to
ensure that a complete range of sizes and replacement gear is available. All MOPP gear,
serviceable and unserviceable, is handled as organizational clothing and equipment (Class
II supplies). The higher HQ is responsible for resupplying these items.
e.
Vehicle Wash Down.
(1)
Vehicle wash down is done in the unit or activity AO by the unit
decontamination crew. The crew moves to the operational decontamination site, conducts a
rendezvous with the contaminated element, and conducts the wash down. The vehicle
wash-down crew may use a PDDE to spray 100 to 150 gallons of hot, soapy water on each
vehicle to wash off the gross contamination. For vehicles such as the M1 series armored
fighting vehicles, 200 gallons of water may be required per vehicle. Each 100 gallons of
water provides a two- to three-minute wash. See Chapter IV for planning, coordinating,
and determining the requirements for a vehicle wash down.
4 April 2006
FM 3-11.5/MCWP 3-37.3/NTTP 3-11.26/AFTTP(I) 3-2.60
XII-1
(2)
A PDDA, such as the M12A1, injects detergent into the water as it
operates. It uses 2.5 quarts of detergent for every 1,200 gallons of water (about 1 quart of
soap per 450 gallons of water).
f.
DTD. Generally, the units or activities conduct the DTD with the support of the
CSS assets. Materials for this technique must be requested from the supporting CSS
assets. The reconstitution operations should be closely associated with the
decontamination operations. An assessment and recovery team ensures that the material
and equipment are available for the decontamination operation as a part of the
reconstitution effort.
g.
DED.
(1)
A CBRN unit must have access to a large water source (e.g., rivers, ponds,
or a public water system) to conduct a DED. The CBRN unit leader estimates the amount
of decontaminants that are needed. A CBRN decontamination unit sets up the DED site,
supplies the decontaminants, and conducts the DED. The CBRN decontamination unit
should carry enough decontaminants to service one company or squadron size unit. A
CBRN decontamination unit that is assigned to conduct a DED for approximately 16
vehicles should carry a minimum of 4 gallons of liquid detergent and thirty 50-pound drums
of STB. The CBRN decontamination platoon is usually resupplied through its parent unit.
Command assignment relationships can change the resupply channels. (See Table XII-1 for
the estimated water consumption guidelines for operational decontamination, DED, and
DTD.)
Table XII-1. Estimated Water Consumption
Required Equipment
Time
Water Consumption
Operational Decontamination1
M12A1 PDDA
1-3 minutes
100-150 gallons per regular vehicle
M17 LDS
150-200 gallons per armored or larger vehicle
MPDS
Example:
15 (contaminated vehicles) x 150 (gallons of water) =
2,250 gallons 2
Detailed Equipment Decontamination3
M12A1 PDDA
Varies, see Chapter IV
Regular vehicles:
M17 LDS
Station 1 - primary wash, 250 gallons
Karcher™ MPDS
Station 2 - decontaminant application, 10 gallons per
vehicle
Station 4 - rinse, 200 gallons
Armored or larger vehicles:
Station 1 - primary wash, 300 gallons
Station 2 - decontaminant application, 12.5 gallons per
vehicle
Station 4 - rinse, 200 gallons
Example:
6 vehicles x 460 gallons of water = 2,760 gallons
4 tanks x 512.5 gallons of water = 2,050 gallons
Total: 4,810 gallons
XII-2
FM 3-11.5/MCWP 3-37.3/NTTP 3-11.26/AFTTP(I) 3-2.60
4 April 2006
Table XII-1. Estimated Water Consumption (Continued)
Required Equipment
Time
Water Consumption
Detailed Troop Decontamination
30-gallon container
Varies, see Chapter IV
The initial setup requires approximately 250 gallons of
water. The water must be changed after 10 personnel
have been decontaminated through the DTD to avoid the
transfer of contamination.
Station 1 (120 gallons, four 30-gallon containers)
3-gallon container
Station 2 (6 gallons, two 3-gallon containers)
30-gallon container
Station 4 (180 gallons, six 30-gallon containers)
3-gallon container
Station 7 (12 gallons, four 3-gallon containers)
Example:
About 150 personnel are to be decontaminated through
the DTD. Two hundred-fifty gallons of water will be
needed for every 10 personnel.
150 (number of personnel) ÷ 10 (required water change)
= 15 (the amount of times the water will need to be
changed)
15 x 250 (gallons of water for every 10 personnel) =
3,750 gallons of water for 150 personnel
1 To reduce contamination, conduct operator spray down before the operational decontamination. This process
requires less water consumption during a thorough decontamination.
2 Always include a 10% planning factor to the total estimate of the water consumption for the DED and the DTD.
Example: 2,250 (gallons of water for the DTD) x 10% = 225 (additional gallons of water). A total of 2,250 + 225 =
2,475 (gallons of water required for the DTD).
3 The planner should consider the vehicle predecontamination action to estimate the water consumption. He should
consider the vehicles that were processed through the operational decontamination because they will normally
increase the weatherization process and may reduce the water usage.
(2)
See Table XII-2 for the decontamination resources that should be available
at each organizational level for the USA unit decontamination requirements. See Table
XII-3 (page XII-4) for the USA units estimated requirements for the equipment and
supplies that are needed for the decontamination operations. See service logistics and
authorization documents for their allocation of decontamination resources. See Table XII-4
(page XII-7) for a listing of the decontamination equipment used at a medical patient
decontamination site.
Table XII-2. Decontamination Resources Available at Each Organizational Level (Army)
Organizational Level
Decontamination Resources
Individual
2 SDKs, 1 IEDK
Operators and crews
2 SDKs, 2 IEDKs, 1 onboard decontamination apparatus (M100),
soap and water, two 50-pound drums of STB
Companies
2 immersion heaters, two or three 30-gallon containers, six 3-gallon
containers, 6 long-handled brushes, 6 sponges, 300 plastic trash
bags
Battalion PDDE crews
PDDE (M17 LDS or MPDS), basic load, liquid detergent
Chemical company
PDDE (M12A1 PDDA/M17 LDS/MPDS), basic load, liquid detergent
decontamination squad
Chemical company
PDDE (M12A1 PDDA/M17 LDS/MPDS), sufficient materials to set up
decontamination platoon
a DTD
4 April 2006
FM 3-11.5/MCWP 3-37.3/NTTP 3-11.26/AFTTP(I) 3-2.60
XII-3
Table XII-3. Equipment and Supplies Needed for Decontamination Operations (Army)
Minimum Amounts of Equipment and Supplies
Nomenclature
Class
Unit
Basis of Issue
Needed for Decontamination Techniques
of
of
(See TO&E for
Supply
Issue
Actual
SD1
PW1
OS1
OW1
MGX2
VW2
DTD3
DED3
Authorization)3
N/A
N/A
N/A
1
N/A
N/A
N/A
N/A
M100 SDS
II
Each
1 per every piece of
major equipment
2
1
N/A
N/A
1
N/A
35
N/A
M291 SDK
II
Each
1 per mask
M295 IEDK
II
Each
1 per person
N/A
N/A
N/A
N/A
N/A
N/A
1
N/A
Filter canister,
II
Each
1 per M40 series
C2 or C2A14
mask
N/A
N/A
N/A
N/A
N/A
N/A
1
N/A
Hood, M40
II
Each
1 per mask
mask
N/A
N/A
N/A
N/A
1
N/A
2
N/A
Shears
II
Each
As needed
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Knife
II
Each
As needed
3
3
N/A
N/A
N/A
N/A
N/A
N/A
Axe, single bit
II
Each
1 per most vehicles
3
3
3
N/A
N/A
N/A
N/A
N/A
Shovel, hand,
VII
Each
1 per most vehicles
RD, PT, D
handle
3
N/A
N/A
N/A
N/A
N/A
N/A
N/A
NAAK, Mark 1
VII
Each
3 per individual
3
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Chemical
VII
Each
1 per individual
agent nerve
5 per combat
antidote
lifesaver
10 per trauma
specialist or 10
per
company/platoon
medic
3
N/A
N/A
N/A
N/A
N/A
N/A
3
Paper,
II
Roll
1 per squad
chemical
3 per platoon
agent,
detector, M9
3
3
N/A
N/A
N/A
N/A
N/A
N/A
Paper,
II
Book
6 per company
chemical
agent,
detector, M8
3
3
N/A
N/A
N/A
N/A
N/A
N/A
Radiac meter,
VII
Each
Per TO&E
AN/PDR-2
3
N/A
N/A
N/A
N/A
N/A
N/A
2
Radiac meter,
VII
Each
Per TO&E
IM-93/UD
XII-4
FM 3-11.5/MCWP 3-37.3/NTTP 3-11.26/AFTTP(I) 3-2.60
4 April 2006
Table XII-3. Equipment and Supplies Needed for Decontamination Operations (Army)
(Continued)
Minimum Amounts of Equipment and Supplies
Nomenclature
Class
Unit
Basis of Issue
Needed for Decontamination Techniques
of
of
(See TO&E for
3
Issue
Actual
SD1
PW1
OS1
OW1
MGX2
VW2
DTD3
DED
Supply
Authorization)
3
N/A
N/A
N/A
N/A
N/A
N/A
1
2
Alarm, chemical
VII
Each
Per TO&E
agent, M8A1 or
VII
Each
M22
N/A
N/A
N/A
N/A
N/A
N/A
4
2
CAM
VII
Each
Per TO&E
N/A
N/A
N/A
N/A
N/A
N/A
4
N/A
Detector kit,
II
Kit
1 per squad
chemical agent,
M256A1
N/A
N/A
N/A
N/A
N/A
N/A
1
N/A
Mask sanitizing
III
Tube
4 per 10 masks
solution
2
N/A
N/A
N/A
N/A
N/A
N/A
1
Decontaminating
III
Drum
3 per company
agent, STB
N/A
N/A
1
N/A
N/A
N/A
2
24
Brush, scrub,
N/A
N/A
As required
long-handled
N/A
N/A
N/A
N/A
N/A
N/A
7
N/A
Pail, metal, 14
II
Each
As required
quart
N/A
N/A
N/A
N/A
1
N/A
9
4
Garbage can,
II
Each
2 per company
galvanized, 30
gallon
N/A
N/A
N/A
N/A
N/A
N/A
N/A
6
Mop
II
Each
As required
N/A
N/A
N/A
N/A
N/A
N/A
5
N/A
Sponge,
II
Each
As required
cellulose
N/A
N/A
N/A
N/A
2
N/A
4
6
Brush, scrub
II
Each
As required
N/A
N/A
N/A
N/A
2
N/A
2
N/A
Towels, paper
II
Box
As required
N/A
N/A
N/A
N/A
1
1
1
1
Detergent, GP,
II
Gallon
As required
liquid
N/A
N/A
N/A
N/A
1
N/A
1
1
Bag, plastic
II
Box
125 bags
2
N/A
N/A
N/A
N/A
N/A
N/A
10
TAP apron
II
Each
10 per platoon
N/A
N/A
N/A
N/A
1
N/A
1
N/A
Suit, clothing,
II
Each
2 per soldier
protective
N/A
N/A
N/A
N/A
1
N/A
1
N/A
Glove set, CP
II
Pair
1 per soldier
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Cover, helmet,
II
Each
1 per soldier
chemical
protective
N/A
N/A
N/A
N/A
1
N/A
1
N/A
Overboots
II
Pair
1 per soldier
4 April 2006
FM 3-11.5/MCWP 3-37.3/NTTP 3-11.26/AFTTP(I) 3-2.60
XII-5
Table XII-3. Equipment and Supplies Needed for Decontamination Operations (Army)
(Continued)
Minimum Amounts of Equipment and Supplies
Nomenclature
Class
Unit
Basis of Issue
Needed for Decontamination Techniques
of
of
(See TO&E for
Supply
Issue
Actual
SD1
PW1
OS1
OW1
MGX2
VW2
DTD3
DED3
Authorization)3
N/A
N/A
N/A
N/A
2
2
2
2
NBC marking
II
Kit
1 per squad
kit
N/A
N/A
N/A
N/A
N/A
N/A
2
N/A
Immersion
II
Each
2 per company
heater
1Techniques executed by individual soldiers.
2Techniques executed by units.
3Amounts vary depending on the situation.
4If DF 200 is used, filters must be changed every 12 hours when conducting continuous decontamination operations.
Table XII-4. Medical Equipment Set Chemical-Agent Patient Decontamination
Equipment
Unit of
Issue
Scissors bandage, 7.25”
Each
Bag, special, plastic (poly), 12x15 inches, 500 sheets
Package
Syringe, irrigating, 60-ml, 40
Package
Support, litter, folding
Pair
Litter, folding, 91.6”
Each
Chest, No. 4, 30x18x12 inches
Each
Chest, med ins sup, No. 6
Each
Paper, chemical-agent 25 sheets, M8
Book
Disinfectant, 6-ounce
Bottle
Decontaminating kit
Box
Pail, utility, plastic 3-gallon
Each
Pen, ballpoint, black
Dozen
Form, printed
Hundred
Sponge, cellulose
Each
Bag, plastic
Roll
Plastic sheet (poly)
Roll
Scalp suit ,small
Each
Scalp suit, medium/large
Each
Scalp suit, extra large/extra extra large
Each
Glove set, chemical-protective, small
Set
Glove set, chemical-protective, medium
Set
Glove set, chemical-protective, large
Set
Glove inserts, chemical-protective, cotton, small
Pair
Glove inserts, chemical-protective, cotton, large
Pair
Cutter, seat belt
Each
Soap, castile
Bottle
h.
Patient Decontamination. See Chapter X.
XII-6
FM 3-11.5/MCWP 3-37.3/NTTP 3-11.26/AFTTP(I) 3-2.60
4 April 2006

 

 

 

 

 

 

 

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