One more thing on Level C - mixed products...Level C is out unless the products are very similar and one cannister is rated to protect from both products at the same time, and the products are both known, and the concentration is known, and my head hurts!
Oh fine, go ahead and hide behind the "I'm only a medic..." while the real hero's risk life and limb to save lives! What I want to know is if I gave you my patients, would you know what to do? Have you received training in BHLS? AHLS?
Actually, Ralph, there's a much greater chance that EMS will be the canaries. BZ and I have the safe job for hazmat, we're on the hazmat team, we don't get there first, and we have the most infomration and the best PPE.
... and then there was the time where an ambulance company responded to a Sears store for a reported man down. They found the guy laying on the floor in the auto repair center where they store batteries. The guy had some white powder on him, but no one thought much about it. In fact the guy had spilled a large quantity of battery acid on himself and had respiratory compromise issue not to mention exposure to corrosives. There was a ambulance verses fire department war going on at the time, so the ambulance crew made the call to transport the victim directly to the hospital. There logic was that people that are hurt or injured belong in the hospital as soon as possible. When they arrived at the hospital, and the driver went around the back of the ambulance to open the doors, he witnessed not only the expired patient but his partner. Both dead from inhalation compromise from the off-gassing clothing left on the victim.
And we are hopefully learning from these experiences understanding that FD Hazmat Teams have to be involved with any kind of field hazmat exposure issue. On scene 20-minute flush policies for corrosive exposure for example should be the standard.
All first responders need to have an awareness to the affects of hazardous materials / WMD exposure, how to recognize signs and symptoms and what can be done before definitive advanced hazmat life support can be accomplished. For fire departments with hazmat teams, it's criminal not to preplan what happens if one of the first responders is exposed and has issues as a result.
If you wait until the problem surfaces, e.g. an incident that results in an exposure to the firefighter or rescuer, there is a good chance that the hospital won't know exactly what to do. An all to familiar story surfaces after many incidents where the hospital told the FD and the families that they did the best they could... There's always a side note afterwards that points blame on the fire department for not sharing and preparing the hospitals with information about the potential hazards in the community. If only they had been told ahead of time, maybe they could have saved the firefighter. If only they knew more...
So now you know. Challenge the system, ask them what if? Don't let them have the excuse that you did not warn them ahead of time. Once again, failure to prepare is preparing for failure...
BZ, we had a similar incident in an area where I used to work. A guy who worked in an orchard was preparing to spray Malathion on the trees. He ended up spilling a significant quantity on himself and contaminating his clothing pretty severely. He went to the office for help, where his girlfriend was the receptionist. He was pretty sick and SLUDGEing by this point She helped him into the office, thereby soaking her clothing in the Malathion from his clothes that were wet with it.
EMS responded (no fire, no LEOs) and placed the two patients into one ambulance. They did no decon, no undressing the patients, or nothing special to protect the EMS crew. When they arrived at the hospital, both patients were receiving oxygen and IV atropine. Both were bradycardic, bradypneic, and SLUDGEing. So was the paramedic.
The story ended with both patients having permenent muscle tremors due to the lack of decon and unnecessarily severe exposure. The paramedic was also pretty sick. The hazmat team responded to the ED and decontaminated the patients, now including the paramedic. The EMT/driver had some respiratory exposure, so now there were four patients. The ambulance was out of service for an extended period for decon.
Virtually all of this could have been prevented by EMS asking for fire and hazmat, getting the patients undressed, and washing the patients with soap and water at the scene. They had an industrial-type locker room with tiled showers - a perfect place to do the patient decon, but they were too focused on ALS and transport.
Even after decon, EMS needs to know what to do for contaminated patients.
You don't need AHLS for most EMS toxicology issues, but you do need common sense and fire and hazmat support at the scene to prevent expanding the Hot Zone into the hospital.