Transcript TEMS Chemical Emergency Response Training For Members of Tulane Emergency Medical Services (TEMS)

TEMS Chemical Emergency
Response Training
For Members of Tulane Emergency
Medical Services (TEMS)
August 2011
Tulane University - Office of Environmental Health & Safety (OEHS)
Tulane University - Office of Environmental Health & Safety (OEHS)
Tulane University - Office of Environmental Health & Safety (OEHS)
Tulane University - Office of Environmental Health & Safety (OEHS)
Objectives
• To learn how to identify chemicals
• To learn how chemicals can enter the body and
the types of effects they may have
• To learn how to protect yourself from
chemicals
• To learn some of the chemical classifications
and where different types of chemicals can be
found on Tulane’s Uptown campus
Tulane University - Office of Environmental Health & Safety (OEHS)
Objectives (cont.)
• To learn the proper response for a TEMS
member when encountering a chemical incident
• To understand the role of Tulane’s Office of
Environmental Health & Safety in emergency
response incidents
• To know your role in hazardous materials spill
response
Tulane University - Office of Environmental Health & Safety (OEHS)
Information About Chemicals
• Information about a chemical can be found on the
label and the Material Safety Data Sheet (MSDS)
• MSDSs can be obtained on the OEHS website:
http://tulane.edu/oehs, or call OEHS at 9885486, then press 1
• Most laboratory doors at Tulane have signs
showing types of chemicals within the lab and
emergency contact information
Tulane University - Office of Environmental Health & Safety (OEHS)
Chemical Routes of Entry
•
•
•
•
Inhalation
Ingestion
Skin Contact/Absorption
Injection
Tulane University - Office of Environmental Health & Safety (OEHS)
Types of Effects of Chemicals
• Acute effect – characterized by sudden and severe
exposure and rapid absorption of the substance.
Adverse health effects are often reversible. (Example:
carbon monoxide poisoning)
• Chronic effect – characterized by prolonged or
repeated exposures of a duration measured in days,
months, or years. Symptoms may not be immediately
apparent. Health effects are often irreversible.
(Example: mercury poisoning)
Tulane University - Office of Environmental Health & Safety (OEHS)
Types of Effects of Chemicals
• Local effect – an adverse health effect that takes place
at the point or area of contact. Absorption does not
necessarily occur. (Example: strong acid)
• Systemic effect – an adverse health effect that takes
place at a location distant from the body’s initial point
of contact and presupposes absorption has taken place.
(Example: benzene affects bone marrow)
Tulane University - Office of Environmental Health & Safety (OEHS)
Types of Effects of Chemicals
• Cumulative poisons – characterized by materials that
tend to build up in the body as a result of numerous
chronic exposures. Effects are not seen until a critical
body burden is reached. (Example: heavy metals)
Tulane University - Office of Environmental Health & Safety (OEHS)
Types of Effects of Chemicals
• Synergistic effect – When two or more hazardous
materials are present at the same time, the resulting
effect can be greater than the effect predicted based on
the additive effect of the individual substances.
(Example: smoking and asbestos)
Tulane University - Office of Environmental Health & Safety (OEHS)
Other Factors Affecting Exposure
• Rate of entry, chemical dose
• Age, lifestyle, state of health, and genetic
disposition of individual exposed
• Previous exposures (can lead to tolerance or
increased sensitivity)
• Environmental factors: temperature and
pressure
Tulane University - Office of Environmental Health & Safety (OEHS)
Chemical Classifications/Possible
Locations (Uptown Campus TU)
Carcinogens – Chemicals which can cause or are
suspected of causing cancer
• Examples: Benzene, Chloroform, Formaldehyde,
Carbon Tetrachloride, Dichloromethane
• Possible Locations: Stern Hall, Israel (ESB)
Building, Boggs Building
• Cancer is a chronic effect – it takes a long time to
develop.
Tulane University - Office of Environmental Health & Safety (OEHS)
Chemical Classifications/Possible
Locations (Uptown Campus TU)
Compressed Gases – Gases which are stored in a
container (cylinder, lecture bottle) under pressure
• Examples: Argon, Nitrogen, Chlorine, Carbon
Dioxide, Oxygen, Acetylene
• Possible Locations: Stern Hall, Israel (ESB)
Building, Boggs Building, Art, Facilities Services
• Exhaust Ventilation is needed when using
compressed gases to prevent asphyxiation.
• Cylinders must be chained and have protective caps
in place. If valve is damaged, cylinder can act as a
missile.
Tulane University - Office of Environmental Health & Safety (OEHS)
Chemical Classifications/Possible
Locations (Uptown Campus TU)
Corrosives – Chemicals which can cause irreversible
alterations/chemical burns to human tissue (Acids/Caustics)
• Examples: Sulfuric Acid, Nitric Acid, Hydrofluoric
Acid, Ammonia Gas, Hydrochloric Acid
• Possible Locations: Stern Hall, Israel (ESB) Building,
Boggs Building, Art, Facilities Services, Blessey
• Hydrofluoric Acid - will attack glass – use benzalkonium
chloride solution or calcium gluconate gel for first aid
treatment.
• For other acids or caustics, get victim to emergency
shower or eyewash and wash for at least 15 minutes.
Tulane University - Office of Environmental Health & Safety (OEHS)
Chemical Classifications/Possible
Locations (Uptown Campus TU)
Cryogenic Liquids/Gases – Liquefied gases used at very
low temperatures (below -200C)
• Examples: Liquid Nitrogen, Liquid Oxygen
• Possible Locations: Stern Hall, Israel (ESB)
Building, Boggs Building
• Heavy gloves, face shield, and eye protection are
needed when handling cryogenic liquids/gases
Tulane University - Office of Environmental Health & Safety (OEHS)
Chemical Classifications/Possible
Locations (Uptown Campus TU)
Explosives – Chemicals which can release pressure, gas,
and heat when subjected to shock, pressure, or high
temperature
• Examples: Nitroglycerin, TNT, Picric Acid,
Sodium Azide
• Possible Locations: Stern Hall, Israel (ESB)
Building, Boggs Building
Tulane University - Office of Environmental Health & Safety (OEHS)
Chemical Classifications/Possible
Locations (Uptown Campus TU)
Flammables – Chemicals which can ignite easily and
burn rapidly, either spontaneously (pyrophoric) or from
exposure to a high-temperature environment
(autoignition), or a spark or open flame
• Examples: Solvents, Ether, Hexane, Mineral Spirits,
Diesel Fuel, Gasoline
• Possible Locations: Stern Hall, Israel (ESB)
Building, Boggs Building, Art, Facilities Services
• Fire triangle: Ignition source + oxygen + fuel
Tulane University - Office of Environmental Health & Safety (OEHS)
Chemical Classifications/Possible
Locations (Uptown Campus TU)
Flammable Gases – Gases which can form flammable
mixtures with air
• Examples: Hydrogen, Acetylene
• Possible Locations: Stern Hall, Boggs Building,
Art, Facilities Services
• Flammable gases are extremely dangerous fire
hazards and require precisely regulated storage
conditions.
Tulane University - Office of Environmental Health & Safety (OEHS)
Chemical Classifications/Possible
Locations (Uptown Campus TU)
Irritants – Chemicals which can cause reversible
inflammatory reactions (watery eyes, itchy skin)
• Examples: Formaldehyde, Ammonia, Hydrogen
Sulfide
• Possible Locations: Stern Hall, Israel (ESB)
Building, Boggs Building
• Some irritants have distinctive odors.
• Get exposed person to fresh air.
Tulane University - Office of Environmental Health & Safety (OEHS)
Chemical Classifications/Possible
Locations (Uptown Campus TU)
Oxidizers – Chemicals which promote combustion
• Examples: Oxygen, Perchloric Acid, Nitric Acid
• Possible Locations: Stern Hall, Israel (ESB)
Building, Boggs Building, Art
• Keep oxidizers away from flammables.
Tulane University - Office of Environmental Health & Safety (OEHS)
Chemical Classifications/Possible
Locations (Uptown Campus TU)
Sensitizers – Chemicals which can cause allergic
reactions in normal tissue after repeated exposure to the
chemical
• Examples: Chromium compounds, Nickel
compounds, Toluene Diisocyanate
• Possible Locations: Stern Hall, Israel (ESB)
Building, Boggs Building, Art
• Not everyone reacts to chemicals in the same way.
• Reaction may be as mild as a rash or as serious as
anaphylactic shock.
Tulane University - Office of Environmental Health & Safety (OEHS)
Chemical Classifications/Possible
Locations (Uptown Campus TU)
Toxic – The ability of a chemical to produce a health
effect or injury once it reaches a susceptible site in or
on the body
• Examples: Lead and its salts, Arsenic, Dimethyl
Mercury, Silica Dust, Cyanides, Hydrogen Bromide
• Possible Locations: Stern Hall, Israel (ESB)
Building, Boggs Building, Art, Blessey
• All chemicals will exhibit a toxic effect if given a
large enough dose.
Tulane University - Office of Environmental Health & Safety (OEHS)
Chemical Classifications/Possible
Locations (Uptown Campus TU)
Water Reactives – Chemicals that react with water
• Examples: Sodium metal, Potassium
• Possible Locations: Stern Hall, Israel (ESB)
Building
• Combustible metals need special type fire
extinguishers (Class D).
Tulane University - Office of Environmental Health & Safety (OEHS)
Chemicals May Have More Than
One Property
• Example: Acetic Acid – flammable and corrosive –
Possible locations: Stern Hall, Israel (ESB)
Building, Boggs
• Example: Pyridine – flammable and toxic (bad
odor) – Possible locations: Stern Hall, Israel (ESB)
Building
• Example: Nitric Acid – oxidizer and corrosive –
Possible locations: Stern Hall, Israel (ESB)
Building, Boggs Building, Art
Tulane University - Office of Environmental Health & Safety (OEHS)
Summary
• There are many types of chemicals at this university.
• The potential effect a chemical can have on a body
depends on many factors. Not everyone reacts the
same to chemical exposures.
• The dose and route of entry of a chemical affects the
body’s response.
• Many chemicals have more than one property.
• Information about chemicals can be found on the
label and the MSDS.
• Chemical effects are not always additive.
Tulane University - Office of Environmental Health & Safety (OEHS)
Emergency Response - Who is a
First Responder?
• First Responders
respond to the site or
point of release
• Includes Supervisors,
Fire Fighters, Public
Safety, HAZMAT
teams, Emergency
Medical Technicians
Tulane University - Office of Environmental Health & Safety (OEHS)
First Responder Job Functions
• Secure the area of hazardous materials spill
incident
• Protect lives and environment
• Give medical treatment
- Care for sick or injured people
- Transport injured persons to appropriate
medical facility
- Protect first receivers (at medical facility)
Tulane University - Office of Environmental Health & Safety (OEHS)
Definition of HOT ZONE:
Hot Zone – An area in and immediately
surrounding a hazardous materials release, which
extends far enough to prevent adverse effects from
hazardous materials releases to personnel outside
the zone.
Tulane University - Office of Environmental Health & Safety (OEHS)
Beware Hazard Transmission to First
Responders
Secondary Exposures from hair, skin and clothing of
victims are possible.
• Influenced by
– Inherent characteristics of the toxin
– Concentration of the release
– Contact time with victim
• Less than at the site of release
Tulane University - Office of Environmental Health & Safety (OEHS)
Response to a Major Chemical
Incident at Tulane
•
•
•
•
Role of Supervisor
Role of Tulane Dept. of Public Safety
Role of OEHS
Role of TEMS
Tulane University - Office of Environmental Health & Safety (OEHS)
Role of Supervisor
• Attend to injured or contaminated persons.
Remove them from further exposure.
• As needed, immediately flush the eyes with water
using the eyewash fountain or use the safety
shower for body exposure. Flush for at least 15
minutes.
• Alert others in area to evacuate.
• Turn off or remove sources of ignition in the
vicinity of the spill.
Tulane University - Office of Environmental Health & Safety (OEHS)
Role of Supervisor (Cont.)
• Confine the spill (e.g., upright container, close
doors, pull down sash of hood)
• Evacuate the area
• Close doors to affected area
• Notify OEHS (988-5486, ext. 1), and Tulane
Police/TUPD
• Standby to assist emergency personnel in
uncontaminated area
Tulane University - Office of Environmental Health & Safety (OEHS)
Role of Tulane Dept. of Public Safety
• Secure the scene of the incident
• Prevent all unauthorized personnel from
entering the chemical spill area
• Provide necessary support for
transportation, traffic control, and security
Tulane University - Office of Environmental Health & Safety (OEHS)
Role of OEHS
• Secure spill area
• Help facilitate clean up activities
• Act as a Liaison between Tulane and
outside response agencies
• Ensure that all Tulane personnel and injured
persons are properly decontaminated if
medical treatment is necessary
Tulane University - Office of Environmental Health & Safety (OEHS)
Role of TEMS
• Know there is a high probability of
exposure to chemicals
• Look for signs of chemicals on
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–
–
–
–
Clothing
Skin
Shoes
Hair
Face
Tulane University - Office of Environmental Health & Safety (OEHS)
Role of TEMS (cont.)
• Do not enter chemical spill area without
Public Safety and/or OEHS knowledge
• Contact OEHS for instructions/advice
• Cautiously provide medical care and
transport for injured persons – DO NOT
rush in to contaminated area
• Protect yourself by wearing appropriate
PPE
Tulane University - Office of Environmental Health & Safety (OEHS)
Role of TEMS (cont.)
• Decontaminate victim when possible before
transport by using eyewash, emergency
showers
• Remove contaminated clothing at the
incident site for removal by OEHS
Tulane University - Office of Environmental Health & Safety (OEHS)
Summary
• Emergency response to a chemical incident
is a team effort. The supervisor, TUPD,
TEMS, and OEHS each have a distinctive
role.
• Never rush in when chemicals are involved.
• Recognize the need to decontaminate
injured personnel before transporting to a
medical facility and to wear personal
protective equipment.
• Seek and follow advice from OEHS – 9885486.
Tulane University - Office of Environmental Health & Safety (OEHS)
Personal Protective Equipment
(PPEs) - Basics
For TEMS Employees of Tulane
University
August 2011
Tulane University - Office of Environmental Health & Safety (OEHS)
Objectives
• To know how to assess the area for PPE needs
• To understand the importance of providing
adequate amounts and various sizes of personal
protective equipment
• To understand why potentially contaminated
PPE should not be worn outside the work area
• To know how to properly select, use, and store
PPE
Tulane University - Office of Environmental Health & Safety (OEHS)
Proper Dress
• Dress appropriately for your job
• Usually best to wear closed-toe shoes and
appropriate clothing (no shorts, sandals, flip
flops)
• Wear PPE as needed
Tulane University - Office of Environmental Health & Safety (OEHS)
Control of Workplace Hazards
• Engineering controls (Ex. Ventilation)
• Administrative and work practice controls
(Ex. Proper written procedures)
• PPE is to be used when work practices
and/or engineering controls do not lessen or
eliminate the hazards, and in emergency
situations. It is important to select and use
PPE properly to reduce and/or eliminate
exposure to the hazard.
Tulane University - Office of Environmental Health & Safety (OEHS)
PPE/Hazard Assessment
• Assessment for personal protective equipment
application must be done per hazard (physical and
chemical):
- Chemical
- Impact
- Biological
- Penetration
- Radiological
- Compression
- Noise
- Heat/Cold
- Vibration
- Harmful Dust
- Light radiation
Tulane University - Office of Environmental Health & Safety (OEHS)
PPE/Hazard Assessment
• Assessment must include the following
areas of the body which may be affected:
–
–
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Head – eyes, ears, face, respiratory
Hand – wrist, fingers and palms
Body – torso and legs
Foot – shins and feet
Tulane University - Office of Environmental Health & Safety (OEHS)
PPE/Hazard Assessment
• Proper PPE must be provided for each worker that the
hazard affects.
• PPE must be made available in adequate amounts and
different sizes.
• PPE must be stored as per manufacturer
recommendations to prevent damage, distortion or
contamination.
– Bag respirators; don’t hang from straps
– Rinse reusable gloves
– Don’t leave in sunlight
Tulane University - Office of Environmental Health & Safety (OEHS)
Use of PPE
• All who wear PPE must be trained on its uses,
limitations and proper decontamination/storage.
• Those who wear PPE must not wear it outside
their work area.
• If PPE is reusable, it must be properly cleaned and
decontaminated after use.
• All PPE must be stored in a clean and safe
manner.
Tulane University - Office of Environmental Health & Safety (OEHS)
Eye Protection
• Safety glasses (with side shields and brow guard) – impact
hazards
• Safety goggles – liquid chemicals
• Face shield – used with eye protection
- For impact protection, face shields alone do not offer eye
protection. They must be used with approved safety glasses
or goggles.
- Notes:
– The American Chemical Society advises that contact lenses
may be worn around hazardous materials as long as the
appropriate type of eye protection is used. Contact lenses do
not provide adequate eye protection.
Tulane University - Office of Environmental Health & Safety (OEHS)
• Aprons
-
Protective Clothing
Clean if contaminated with hazardous materials
Replace if torn, ripped or tattered
• Laboratory Coats
-
Must be worn only inside the work area
Must be removed before leaving work area for breaks, lunch
and end of the work day.
Must be cleaned by a professional cleaning service. DO
NOT TAKE CONTAMINATED CLOTHING HOME FOR
WASHING.
• Fluid Resistant Clothing
-
When working with bloodborne pathogens, disposable
clothing and/or laboratory coats may not be adequate
protection for the employee. Such clothing must be resistant
to blood and body fluid splashes.
Tulane University - Office of Environmental Health & Safety (OEHS)
Hand Protection
• Latex Gloves
- Supervisors must supply adequate supplies and
sizes.
- Worker and supervisor should be aware of latex
allergies and must supply the appropriate substitute
PPE as needed.
• Rubber Gloves
- Must be worn when working with highly corrosive
or toxic materials
- Must be cleaned, decontaminated and properly
stored after each use
• Temperature Resistant Gloves (non-asbestos)
• Leather
Tulane University - Office of Environmental Health & Safety (OEHS)
Hand Protection
• Gloves must be inspected before each use
for tears, holes, cracks, and deterioration.
• If gloves are defective or badly soiled, they
must be discarded.
• Disposable gloves must not be reused.
• Contact OEHS for information on latex
allergies and glove use.
Tulane University - Office of Environmental Health & Safety (OEHS)
Hand Protection - Chemical
• For information as to the type of glove that
should be used to protect yourself from a
particular chemical, consult the glove
manufacturer’s chemical compatibility
chart.
• Contact OEHS for further assistance.
Tulane University - Office of Environmental Health & Safety (OEHS)
Foot Protection
•
•
•
•
Rubber Booties
Chemical Resistant Shoes/Boots
Steel-toe Shoes
Paper booties
Tulane University - Office of Environmental Health & Safety (OEHS)
Types of Respiratory Protection
• Air Purifying
- TB Respirators (N-95)
- Cartridge Respirators
- Dust/Mist/Particulate Respirators
- Positive Air-Purifying Respirators (PAPRs)
• Air Supplied
- Self-Contained Breathing Apparatus
(SCBAs)
Tulane University - Office of Environmental Health & Safety (OEHS)
Respiratory Protection
• Respiratory protective equipment is
needed when work practices and
engineering controls cannot eliminate
the inhalation hazard.
• The selection and type of respirator is
based on the air contaminant and other
factors (such as the concentration of
the contaminant, oxygen deficient
atmosphere, etc.).
Tulane University - Office of Environmental Health & Safety (OEHS)
Respiratory Protection
• In order to wear a respirator, the following must
be done:
– The employee must receive a copy of the
OSHA Respiratory Protection Standard and the
Tulane University Respiratory Protection
Program.
– The employee must be clean shaven.
– The employee must have a medical evaluation
to determine their ability to wear a respirator.
– The employee must be fit-tested by OEHS on
an annual basis or when the employee’s facial
features have changed dramatically.
– Contact OEHS for more details on the
Respiratory Protection Program.
Tulane University - Office of Environmental Health & Safety (OEHS)
PPE Summary
• A PPE hazard assessment must be done when
responding to an incident.
• PPE must be adequate for the job and available to
the employee in different sizes and styles.
• PPE must not be brought home for laundering.
• PPE must be stored properly so that it will not be
damaged.
Tulane University - Office of Environmental Health & Safety (OEHS)
Tulane University
Office of Environmental Health & Safety (OEHS)
http://tulane.edu/oehs
Pam Fatland - Manager, Chemical Safety
(504) 988-2800, [email protected]
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