Chemical Disaster Preparedness for Hospitals and Emergency Departments

Preparing to evaluate and treat victims of a chemical exposure incident is one aspect of hospital disaster preparedness. Past chemical disasters, including terrorist attacks and industrial or transit accidents, have highlighted the need for hospital planning, preparation, and training. Emergency department and hospital staff members must be familiar with their facility-specific protocols and be trained for their individual roles during these incidents. This article provides a brief review of the requirements and guidelines related to chemical disaster response from a healthcare perspective. Resources for training and the evaluation of chemically contaminated patients are discussed. Decontamination procedures, including pre-hospital and hospital-based decontamination of ambulatory, non-ambulatory, and at-risk patients are also reviewed. Physicians and clinicians, especially in the emergency department, must be familiar with methods of evaluating chemical exposures, identifying substances, recognizing toxidromes, ensuring appropriate personal protective equipment (PPE) use, performing decontamination, and initiating treatments for life-threatening conditions. By understanding the guidelines and resources available, clinicians will be better equipped to safely evaluate and treat chemically exposed or contaminated patients.