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Hazardous Materials Awaran-

For
Emergency Medical Sarvlcaa Personnel

Student Workbook

State -
of -
New
--York
-
George Pataki
Governor

.HD Emergency Medical Services Program


Michael GIibertson
Director

State Emergency Management Office


Donald A. De Vito
Director

June-1992
BYS EIIS-DZIIAT AWARBllBSS COURSB
student workbook

Course schedule: "l'Wo Day Format


session t 1
7:00pm to 7:20pm Introduction & PreQuiz
7:20pm to 7:40pm Hazmat Readiness
7:40pm to 8:00pm OSHA/NFPA Competencies
8:00pm to 8:10pm Break
8:10pm to 9:00pm HAZMAT Classification & Identification
9:00pm to 9:15pm Guidebook Exercise
9:15pm to 9:25pm Break
9:25pm to 10:00pm Review of Incident Command System &
The EMS Role in ICS
Session t 2

7:00pm to 7:30pm The Right to Know Law


7:30pm to 7:55pm Herbicide Case Study
7:55pm to 8:05pm Break
8:05pm to 8:45pm Field Stabilization & Treatment of
Decontaminated Patients
8:45pm to 8:55pm Break
8:55pm to 9:10pm The stages of Decontamination
9:10pm to 9:20pm Medical Monitoring & Documentation
9:20pm to 9:30pm Post Incident Considerations
9:30pm to 9:45pm Annual Refresher Requirements & Summary
9:45pm to 10:00pm PostQuiz & Course Evaluation

course Schedule: one Day Format


9:00am to 9:20am Introduction & PreQuiz
9:20am to 9:40am Hazmat Readiness
9:40am to 10:00am OSHA/NFPA Competencies
10:00am to 10:10am Break
10:10am to 11:00am HAZMAT Classification & Identification
11:00am to 11:15am Guidebook Exercise
11:15am to 11:25am Break
11:25am to 12:00pm Review of Incident Command System &
The EMS Role in ICS
12:00pm to 1:00pm Lunch Break
1:00pm to 1:30pm The Right to Know Law
1:30pm to 1:55pm Herbicide Case Study
1:55pm to 2:05pm Break
2:05pm to 2:45pm Field Stabilization & Treatment of
Decontaminated Patients
2:45pm to 2:55pm Break
2:55pm to 3:10pm The Stages of Decontamination
3:10pm to 3:20pm Medical Monitoring & Documentation
3:20pm to 3:30pm Post Incident Considerations
3:30pm to 3:45pm Annual Refresher Requirements & Summary
3:45pm to 4:00pm PostQuiz & Course Evaluation

Page 2
New York State SECTION A
Department of Health
Emergency Course Schedule
Special Thanks
Table of Contents

Medical
Services
Program

HAZMAT AWARENESS
'i\ Continuing Education Course for EMS Providers"

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NYS BMS-HAZMAT AWARENESS COURSE
student workbook

The NYS EMS-Hazmat Awareness Course Guide & Instructor


outline. as well as the accompanying Student Workbook. was
developed by Robert Elling, Senior EMS Representative with
the State EMS Program and William Campbell, Training Officer,
with the State Emergency Management Organization.
Special Thanks
No single educational offering is developed by one
author. Rather, quality educational programs are a blend or
composite of the best parts of numerous programs focused at
the group for which the course was designed. This course was
desi9ned to meet the needs of the over 46,000 certified EMS
providers who serve the citizens of the State of New York.
We would like to thank the following people who have
taken the time to share their resources and/or time in
contributing to this course:
1. David I. Ruppert, Assistant Program Manager, Public
Employee Safety and Health Bureau, State of NY Department
of Labor for review of the instructor's manual.
2. Harvey Shapiro, Assistant Regional Administrator,
OSHA Federal Region Two, for review of the instructor's
manual.
3. John Bintz, Bureau of Occupational Health, NYS
Department of Health, for review of the instructor's
manual.
4. Linnea Sidi, Educational Consultant for assistance in
developing the quiz.
5. Ellen Lockart, Executive Producer, Emergency Medical
Update for production of the main videotape.
6. NYS Association of Fire Chiefs for material taken
from a previous course outline developed for NYS EMS
Program.
7. Jonathan Politis, EMT-P, Director Colonie EMS
Department, for reviewing the course manuals and
materials.
8. James Soto, EMT-D, Associate EMS Representative, NYS EMS
Program, for review of the instructor's manual .
9. NJ/NY Hazardous Materials Worker Training Center for
permission to use previously developed materials.
10. Kevin Kraus, EMT-P, SEMO: Associate Planner, for
review of the instructor's manual.
11. John Gibb, EMT/FF, SEMO: Planning Supervisor, for
review of the instructor's manual.
12. Joseph Paz, EMT-P, ALS Coordinator NYC EMS Academy,
for review of the instructor's manual.
13. NYS Department of Corrections for assistance on the
Hazardous Materials Classification videotape.
14. Nancy Sweetland, MBA, for proofreading the instructor
& student manuals.
15. The Federal Emergency Management Agency for funds to
support the development of this course.

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Table of contents
Topic

Course Schedule. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Section A
Special Thanks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Table of Contents.................................. 4
Section B
session one:
Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-8
Introduction & Goals of The Course .••...•••..•.•.. 9-11
Why All The concern About Hazmat? •.....••..••••.••. 11-16
Hazardous Materials Definitions ..•.•..•••...•.•.•.. 16
Hazardous Materials Incidents by State .....•..••... 16-17
Hazmat Readiness . . . . • . . . . . . . . . . • . . . . . . . . . . • . . . . . . . . 17-21
Hazardous Materials Pre-Planning survey Form •...•.. 20-21
OSHA/NFPA Competencies ...•••........•.•.......••... 22-31
HAZMAT Classification & Identification .•...•••..••. 32-45
Guidebook Exercise ...•••....•.•.••••....•.•••....•. 46-49
Review of Incident Command System ..•...••••••••.... 49-54
The EMS Role in ICS ..•....••.......•...••..•••..... 54-57
Section c
Session TWo:
Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
The Right to Know Law ......••......•....•.•.•...... 60-61
Material Safety Data Sheet Primer .....••....••..... 62-72
Herbicide Case study ....••.•...•.•.•........•.••..• 72
Field Stabilization & Treatment of Decontaminated
Patients .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72-74
The Stages of Decontamination .••....••••..........• 74-75
Protective Clothing ..•..•••......••..••••...•••..•. 76-78
Medical Monitoring & Documentation •.•..•••...•....• 78-80
Post Incident Considerations ••...•••..•.••..•••..•• 80
Annual Refresher Requirements & Course Summary .•••• 80-81
section D
Appendix:
Hazmat Glossary of Terms ....•....•....•.......... 83-95
References.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96-97
BLS Protocol. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98-99
Agencies For Special Assistance .••.•••...••..•••. 100-101
OFPC Hazmat Assistance Notification Form ••.•••..• 102

Page 5
New York State SECTION B
Department of Health
Emergency Sesslon#1

Objectives

Medical Introduction
Readiness
OSHAINFPA
ClassHication
Services & ldentHication
DOT Guidebook
Incident Command

Program The EMS Role in ICS

HAZMAT AWARENESS
·"A Continuing Education Course for EMS Providers"

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-----------------------------------------------------------
SESSION f 1

Introduction & PreQuiz 20 min.


Hazmat Readiness 20 min.
OSHA/NFPA Competencies 20 min.
Break 10 min.
HAZMAT Classification & Identification 50 min.
Guidebook Exercise 15 min.
Break 10 min.
Review of Incident Command System &
The EMS Role in ICS 35 min.

Objectives
Upon completion of this session, the student will be able to:
1.* Define "hazardous materials".
2.* Describe the risks associated when hazardous materials
are involved in an incident.
3.* Describe the potential outcomes associated with an
emergency created when hazardous materials are present.
4.* Describe the content of the 1989 OSHA Final Rule 29 CFR
Part 1910.120.
5. Discuss NFPA 472 Standard Professional Competence of
Responders to Hazardous Materials Incident and its
similarities to the OSHA regulations.
6. Discuss NFPA 473 (proposed) Standard for Competencies
for EMS Personnel Responding to Hazardous Materials
Incidents.
7. List methods of acquiring information about local hazmat
risks.
8.* Identify six sensory clues that might help the EMS
provider to reco9nize the presence of hazardous
materials in an incident.
9.* Describe methods of identifying hazardous mate~·ials.
10. Identify the function of a Material Safety Data Sheet.
11. State the function of CHEMTREC and CANUTEC.
12. List the components of pre-planning for hazmat
incidents.
13.* Describe the role of the first responder awareness
individual in the employer's (ambulance service)
emergency response plan including site security and
control and the U.S. D.O.T. Emergency Response
Guidebook.
14.* Describe when additional resources are needed at a
hazmat incident and how to make the appropriate
notifications to the communications center.

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15. Describe the priorities of care during hazmat incidents.


16. Describe the function of the U.S. D.O.T. Emergency
Response Guidebook.
17. Name the primary components of the Incident Command
System.
18. Identify the importance of a unified command structure.
19. Explain the importance of comprehensive resource
management.
20. Explain the functions of the triage sector/division
officer.
21. List the communications needs of the hospital(s).
22. Describe the role of the triage, treatment and
transportation officers.

*=OSHA competency

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Introduction & Goals of The course


This course has been designed to meet and/or exceed the
OSHA requirements for hazardous materials training at the
first responder awareness level. In New York State the EMS
Program certifies EMS providers at the following levels:
Certified First Responder (CFR), Emergency Medical Technician
(EMT), EMT-Defibrillation (EMT-D), EMT-Intermediate level
(EMT-I), EMT-Critical care Technician (EMT-CC), and
EMT-Paramedic (EMT-P). The introduction of the levels of
hazardous material training, by OSHA, have absolutely no
correlation to the State levels of EMS training. That is to
say that any level of State certified CFR/BMT or advanced EMT
could be trained at the 11 First Responder Hazmat Awareness
Level." Each ambulance service employer is responsible for
participating in the community emergency response plan. The
plan and the roles described for each of the players will
dictate exactly which level of OSHA hazardous materials
training is needed for the personnel involved.
This course has been designed for ambulance personnel
whose community emergency response plan clearl¥ does not put
them in the warm or hot zone of the hazmat incident. To be
very specific, if you will be called to treat and transport
"decontaminated" patients, the first responder awareness
level will suffice. However if your role is to assist in
decontamination, it will be absolutely necessary for you to
take additional training above and beyond the scope of this
course!
The following is a brief overview of the goal for each
segment of this course:
1. Introduction & PreQuiz - (time 20 min.) during this time
the course is very briefly introduced and the
registration of students occurs. Each student will take
a prequiz to help assess their baseline knowledge of
hazardous material awareness.
2. Hazmat Readiness - (time 20 min.) during this time the
students watch a video which shows very graphical
incidents of hazardous material accidents across the
nation. Then the instructor will lead a brief discussion
about the preparedness of the local community to deal
with a hazmat incident.
3. OSHA/NFPA Competencies - (time 20 min.) during this time
the instructor reviews the pertinent regulations and
standards which apply to emergency responders. An
emphasis is placed on the community emergency response
plan as the document which will determine the actual

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training that will be needed for each t~e of responder


(i.e., CFR, EMT, EMT-P, firefighter, police officer).
4. BAZKAT Classification & Zdentification - (time 50 min.)
during this time the students will watch a video which
describes the United Nations (UN) Classifications of
hazardous materials and then the instructor will discuss
methods of identification using overhead tranparencies.
An emphasis will be placed on use of the DOT Guidebook,
binoculars, and requesting the appropriate resources in
rour community that are designated to mitigate the
incident.
5. Guidebook Exercise - (time 15 min.) during this time the
students will work in small groups sharing copies of the
DOT Guidebook preparing their approach to a series of UN
numbers or chemical names given to them by the
instructor.
6. Review of Zncident command system & The EMS Role - (time
35 min.) during this time the instructor will review the
incident command system with an emphasis on the
functions, components, terminology and the specific roles
that EMS responders will need to play at an incident
which has a medical component. Treatment will be
centered around decontaminated patients.
7. The Right to Know Law - (time 30 min.) during this time
the instructor will review the provisions of the OSHA
hazard communication standard in which employers, such as
ambulance services, must develop a comprehensive program
to inform workers of hazards they may encounter in the
workplace and provide them with the training in the safe
use and handling of products containing hazardous
chemicals. The Material Safety Data Sheet (MSDS) for
commonly used chemicals around an ambulance service will
be discussed. Overhead transparencies will be used for
this section.
8. Herbicide case study - (time 25 min.) during this time
the students will view a video case study reenactment of
a small scale hazardous materials incident that could
commonly occur in any community that has a nursery supply
store. The response is probably not a common response as
this community is clearly prepared to deal with the
incident in a textbook manner. A brief discussion will
take place after viewing the video on how this incident
would be handled in the student's community and what
might happen if the material was more toxic than it
turned out to be.
9. Field Stabilization, Treatment of Decontaminated
Patients - (time 40 min.) during this time the students
will view a video tape which has an interview with a

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national expert and author Jonathan Borak, MD. Doctor


Borak discusses his view of the field stabilization and
treatment that needs to commonly occur in a hazmat
incident. The treatment is specifically focused at the
patient who has already been decontaminated. The video
does show examples of how a hazmat team would have
decontaminated the patient.
10. The Stages of Decontamination - (time 15 min.) during
this time the instructor will briefly review what to
expect a hazmat team to do to decontaminate the
patients. Overhead transparencies will be used to stress
the perimeters that need to be established, the
decontamination corridor and the hot, warm and cold
zones.
11. Medical Monitoring & Documentation - (time 10 min.)
during this time the students will view a video which
shows the role of the ambulance standing by at an
incident. Emphasis will be placed upon taking a full set
of vitals before hazmat team members suit up and after
they have been fully decontaminated. Documentation is
important due to the ~otential longterm effects of
exposure to many chemicals that may occur with the hazmat
team members.
12. Post Incident Considerations - (time 10 min.) during this
time the instructor will discuss the need for critique of
incidents so that future incidents will run better.
13. Annual Refresher Requirements & Summary - (time 15 min.)
during this time the instructor will remind the students
of the OSHA mandate for annual demonstrated competency in
the hazmat awareness objectives and discuss methods to
achieve this at the agency level. The course will be
summarized in a discussion format.
14. PostQuiz & course Evaluation - (time 15 min.) during this
time the students will each take a quiz that tests the
competencies of the course and be asked to complete a
course evaluation that can be used to improve future
courses.

Why All The Concern About Hazmat?

Your first question may very well be, "What is all this
concern about hazmat, we don't have a nuclear reactor or
chemical plant in the center of our town." Consider the
following cases:
1. Marine traffic on San Francisco Bay and aircraft above
were rerouted as a spill of 9,000 pounds of silicone

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tetrechloride rolled across the bay. More than 10,000


people were evacuated from the area and 28 people, mostly
emergency workers, were hospitalized.
2. A vat of plastic resin apparently exploded in the
fifth floor of the Reichhold Chemical plant; one worker
was critically burned, and 13 other ~ersons including
workers, firefighters and police officers were injured
less seriously. The explosion blasted 50 windows and
burned a quantity of resin and other chemicals. Three
air monitors recorded no contamination from the burned
chemicals. (Newark, NJ on January 10, 1992)
3. In the middle of rush hour, one of three cells on a
tanker truck split open on the New Jersey Turnpike and
4,000 gallons of hydrochloric acid spilled and forced the
closing of 15 miles of packed highway near Elizabeth.
Five police officers, seven firefighters and more than a
dozen motorists were hospitalized for treatment of severe
internal burns from the acid.
4. A fireball was visible for 20 miles after a frei~ht train
carrying propane, alcohol and sulfuric acid derailed and
expoloded near Murdock, IL. A large portion of a tank
car was thrown almost a half mile and people within four
miles of the accident were evacuated. Eight emergency
workers were treated for chemical exposure.
5. A Michigan State Trooper died and several other officers
were hospitalized after being exposed to fumes from 3,200
gallons of fluorosulfonic acid released when 14 cars of a
freight train derailed in the downtown section of
Bridgeman. Many of the town's 2,400 inhabitants received
lesser exposure before their evacuation was ordered.
6. Sulfur dioxide spilled on Route 24 after a safety valve
on a 150 pound cylinder broke on a trailer truck. A
motorist called police and said the truck, which had the
slogan on it, "Safety is no Accident", was releasing
something with a foul odor. When stopped, the driver
grabbed a small respirator and went to the trailer to
learn what the problem was. The driver was overcome and
had to be put into the police car and given oxygen. He
was taken to a hospital followed by five drivers in
trucks behind the one with the leaking cylinder. The
truck also contained 72 drums of powdered chlorine and
300 gallons of sodium hypochlorite. The HMRT from the
Morris County Sheriff's Office responded. Two de~uties
and two state employees entered the truck in chemical
suits to fix the cylinder, one of 10 to fall over but the
only one to have its top assembly shear off. (Madison,
NJ on December 18, 1991)
7. More than a dozen people were treated at local hospitals
when anhydrous ammonia leaked from a local brewery. This

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was the second leak within a month at the facility. An


earlier leak resulted in 20 people receiving treatment
for inhalation injuries. (Golden, co in July 1991)
8. A fire erupted in a state-of-the-art 500,000 square foot
refri9erated food storage facility on the east side of
the city of Madison. Thousands of people were evacuated
as arriving fire units detected the pun9ent odor of
ammonia, which was used as the coolant in the
refrigeration system. (Madison, WI in May 1991)
9. Dozens of people were treated for skin and eye irritation
following the derailment of a train carrying weed killer.
Between 12,500 and 19,500 gallons were lost in the event
which fouled the Sacramento River Canyon. (Lake Shasta,
CA in July 1991)
10. A highway accident that involved a propane tanker truck
and two other trailer trucks killed two persons and
injured two others. The propane tank was ruptured
causing a serious fire that burned for a few hours.
{Artesia, MI on January 20, 1992)
11. A 55-gallon drum of thionyl chloride exploded at the
Myers-S9Uibb facility on Route 1 and forced the
evacuation of 500 persons. No fire was started, but
noxious 9as was released. Three workers were taken to
the hospital and four others were treated at the company
infirmary. The Middlesex County Health Department's HMRT
was investigating the incident. The chemical, which is
reactive to water, was stored in a storage shed behind
two buildings where research & development efforts are
centered. (North Brunswick, NJ on February 5, 1992)
12. Firefighters were injured in an explosion while searching
for a gas leak at Tommy's Diner; at least one was blown
through a cellar door. The resultant fire burned for
seven hours and took 80 firefighters from six towns to
bring under control. Public Service Electric & Gas Co.
said the explosion was the result of gas escaping from a
crack in the main located about 15 feet from the service
connection into the diner. {Wallington, NJ on February
3, 1992)
13. JFK Hospital closed its emergency department after a
patient arrived in a taxicab smelling of chemicals.
Hospital officials closed off a portion of the emergency
department to allow a HMRT from the Middlesex County
Health Department to "decon" the room. The man had been
sprayed at the Hatco Corp. facility in Woodbridge, and a
supervisor, apparently reading an incorrect MSDS, later
reported to authorities the worker had been sprayed with
a mixture containing two acids and a cumbustible solvent.
Hatco workers put the man in a shower, then sent him off

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to the hospital in a cab. The HMRT washed the patient,


room, chairs, a stretcher and other hospital ap~aratus.
They also called the taxi company to get the driver in
for a checkup at the same time the cab company cleaned
the vehicle and removed the back seat. A day or two
later, it was determined that the man was actually
sprayed with a non-hazardous substance. (Edison, NJ on
January 8, 1992)
Across the United states in 1990 there were 8,687 hazmat
incidents in transportation, which resulted in 390 injuries,
4 deaths and $33,473,980 in damages.
Could it happen here in New York State? The answer is
that it does every day! Take these incidents for examples:
1. A leaking propane gas tank at a batte':'¥ recycling plant
in Wallkill, NY, exploded and killed five workers and
left a crater six feet deep.
2. A tractor-trailer pulling two 28 foot trailers overturned
on Interstate 390. The two trailers contained small
quantities of hazardous materials. (Rochester, NY on
January 19, 1992)
3. More than 1,500 gallons of fuel oil were dumped into the
Mourning Kill stream on Route 67 after a King Fuels
tanker truck struck the rear of a tractor trailer
rupturing a fuel line on the tanker. The driver was
ticketed by both the Saratoga county sheriff and the
state. Firefighters closed about a half-mile of highway
and spread nearly 11-tons of sand and absorbent
materials. Oil was recovered from the stream using
brooms, absorbent pads and a pumper truck. (Ballston, NY
on January 30, 1992)
4. Natural gas exploded at 139th Street and Hamilton Place
in New York City, touching off a raging fire, and
injurin9 23 persons. Workers were attempting to replace
a gas line that had been shut down for three months due
to leaks. The building had undergone a rent strike since
1990 when residents complained of on9oing gas leaks and
shoddy maintenance. Consolidated Edison Co. had shut
down gas to the building since October 31, and has
restored service in about half of the distribution lines.
(NYC, NY on February 10, 1992)
5. Most of the customs area at the U.S. Canadian border was
shut for a four hour cleanup of five gallons of ethyl
acetate that leaked from a truck. The chemical is
flammable with potentially poisonous fumes. The state
police Hazardous Materials Enforcement Unit was on the
scene. (Lewiston, NY on February 5, 1992)

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6. A tractor trailer carrying 43,000 pounds of corrosive


alkali during bad weather hit a patch of ice and slid off
Route 414 and landed on its side. No cargo was lost but
the site was lost but the site was closed all day for
removal of cargo. (Fayette, NY on February 4, 1992)
7. A propane truck overturned during a winter storm but no
cargo was lost. A cou~le of homes and businesses were
evacuated as a precautionary measure. The propane was
off-loaded, and the truck was righted and towed away.
(Caledonia, NY on February 4, 1992)
8. A dental researcher at the University of Rochester lost
four fingers on his left hand and two on his right in an
experiment involving nitrous oxide and othe chemicals.
He had been working with anerobic bacteria, organisms
that live and grow where no oxygen is present. At about
one in the morning, something went wrong. Safety
devices, including a vent hood and a protective glass
shield, were in place at the time of the explosion. The
lab was heavily damaged. (Rochester, NY on January 31,
1992)
9. An employee mixed a new form of calcium hypochlorite and
made the mix too strong. In addition, the caton the
material was in got wet which started a chemical reaction
releasing chlorine fumes. The Jamestown Fire Department
responded and removed reactin9 containers to the front
porch. As reaction was building, the Chautauqua County
HMRT was called to assist. The reacting material was
overpacked by the HMRT, and arrangement was made to take
the chemical to the city waste treatment plant. All
containers of pellets that were deteriorating were sent
to the treatment plant. (Jamestown, NY on January 13,
1992)
10. An explosion at a garbage plant operated by Albany New
York Solid Waster Recovery system injured three workers
and blew out large sections of the building. The
explosion may have been caused by a propane tank caught
in machinery which shreds garbage. (Albany, NY on
January 3, 1992)

In NYS in 1990 there were 344 hazmat incidents in


transportation, which resulted in 12 injuries and 1 death and
$860,893 in damages. Hazmat incidents are one of the most
under reported incidents that emergency responders handle in
each community. Gas leaks and chlorine leaks which were
traditionally handled by the fire department were not thought
of as hazardous material incidents. As more communities
develop specialty teams to handle hazmat scenes, the
reporting of these incidents will increase.

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Basically, much of the concern about hazmat stems from


the requirements from OSHA and/or PESH that all emergency
responders be trained by their employers. In this course
your instructor will review the key components of the OSHA
requirements and the NFPA standards as they pertain to the
EMS provider.
Definitions of Hazardous Materials
Hazardous Material - "Any substance or material in a quantity
or form which poses an unreasonable risk to health, safety
and property when transported in commerce." [U.S. Department
of Transportation]
Hazardous Substance - "Any substance desi9nated under the
Clean Water Act and the Comprehensive Environmental Response
compensation and Liability Act (CERCLA) as posing a threat to
waterwa¥s and the environment when released." [Environmental
Protection Agency (EPA)]
Hazardous Waste - "Any waste or combination of wastes which
pose a substantial present or potential hazard to human
health or living organisms because such wastes are
nondegradable or persistent in nature, or because they can
biologically magnify or because they may otherwise cause or
tend to cause detrimental cumulative effects." [EPA]
Hazardous Material (Substance/Waste) - "Any substance that
causes or may cause adverse affects on the health or safety
of employees, the general public, or the environment: any
biological agent and other disease-causing agent, or a waste
or combination of wastes." [National Fire Protection
Association Standard# 472]
Hazardous Materials summary by state - 1990
State Incidents Injuries Damages
Alabama 154 20 $ 619,789
Alaska 8 0 $ 2,997,029
Arizona 114 13 $ 423,563
Arkansas 117 3 $ 805,202
California 740 36 $ 1,641,523
Colorado 117 l * $ 539,763
Connecticut 72 2 $ 137,320
Delaware 21 0 $ 225,313
D.C. 25 0 $ 6,519
Florida 362 16 $ 569,463
Georgia 212 6 $ 1,062,649
Hawaii 9 2 $ 9,677
Idaho 23 1 $ 235,699
Illinois 707 16 $ 821,484
Indiana 227 25 $ 1,326,341
Iowa 159 28 $ 184,249
Kansas 166 3 $ 288,847

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Kentucky 128 8 $ 287,247


Louisiana 182 23 $ 666,623

State Incidents Injuries Damages


Maine 28 2* $ 456,811
Maryland 135 2 $ 386,710
Massachusetts 118 5 $ 378,654
Michigan 322 5 $ 550,412
Minnesota 172 0 $ 411,495
Mississippi 95 5 $ 260,889
Missouri 201 13 $ 509,499
Montana 18 2 $ 103,571
Nebraska 45 2 $ 159,120
Nevada 37 0 $ 143,452
New Hampshire 14 3 $ 25,230
New Jersey 179 16 $ 301,878
New Mexico 63 0 $ 274,099
New York 344 13* $ 860,893
North Carolina 395 10 $ 580,812
North Dakota 10 0 $ 1,615
Ohio 613 21 $ 966,973
Oklahoma 66 5 $ 136,255
Oregon 91 5 $ 447,316
Pennslyvania 732 22 $ 3,922,989
Rhode Island 6 0 $ 29,638
south Carolina 86 3 $ 1,475,740
South Dakota 6 0 $ 658
Tennessee 324 12 $ 4,071,617
Texas 497 19* $ 3,032,436
Utah 92 2 $ 156,760
Vermont 7 0 $ 30,514
Virginia 118 3 $ 325,743
Washington 68 3 $ 62,088
West Virginia 47 2 $ 218,749
Wisconsin 167 16 $ 132,312
Wyoming 34 0 $ 107,409
(Territories) 15 0 $ 103,343
TOTAL 8,687 394** $ 33,473,980

* includes one fatalitr


** includes four falalities

Ha.zmat Readiness

Now that you have reviewed the statistics and seen the
introductory videotape there are three key questions you must
ask yourself. Could a hazmat incident happen here in my
community? Would our emergency service providers be

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prepared to handle the situation? How can we become


prepared if we are not already?
Preparing for a hazmat incident is simply not just a
matter of finding the moner and buying protective ec:piipment
and off you go! A significant amount of training is not
only needed but rec:piired by the Occupational Safety and
Health Administration (OSHA). This awareness course will
only be9in to open your eyes to the training needs and
complexity of preparing to respond to a hazardous materials
incident.
After becoming aware of the issues it is important to
begin analyzin9 the risks in your community so that any
additional training can be focused in the areas where an
incident is most apt to occur in your community. since there
is so much to learn about hazardous materials taking the time
to review what types of chemicals are manufactured, stored or
transported through your community will be a helpful
exercise.
Another important area in which preparation is needed
for handling hazardous materials incidents is physical and
mental preparation for a call that could easily make you a
victim. Mental preparedness is closely tied to training in
incident command and dealing with hazardous material
incidents and confidence working as a team to solve complex
situations. The physical preparation is not just a matter of
buying a health club membership so responders will be more
flexible, stronger and have more endurance. A total
commitment needs to be made to physical fitness and well
being through a balance of proper nutrition, aerobic
activities and muscular strengthenin9. The National Fire
Academy has an excellent planning guide for emergency service
agencies who are interested in developing a total physical
fitness plan.

Local Emergency Planning

In October of 1986 the superfund Amendments and


Reauthorization Act of 1986 (SARA) was signed into law by the
President of the United States. The section of SARA which
was of most concern to emergency responders is Title III: the
"Emergency Planning and Community Right-To-Know Act of 1986."
Title III established re9Uirements for local, state and
Federal governments and industry on emergency planning and
community right-to-know re~orting of hazardous chemicals.
The law was designed to build upon the EPA's Chemical
Emergency Pre~aredness Program (CEPP) and many local programs
aimed at helping communities prepare for potential chemical
emergencies.

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Title III has four major sections: emergency planning,


emergency notification, community right-to-know reporting
requirements and toxic chemical release reporting-emissions
inventory. The specific requirements of the Emergency
Planning sections, since they are the most applicable to EMS
providers, are described below.
The Emergency Planning (Sections 301-303) section is
designed to develo~ state and local government pre~aredness
and response capabilities through better coordination and
planning. The Governor of each state was required to appoint
a State Emergency Response Commission (SERC) in 1987. This
commission has broadbased representation from public agencies
concerned with issues relating to the environment, natural
resources, emergency management, public health, occupational
safety and transportation. There are also various public and
private sector groups with interest in Title III involved in
the SERC.
The SERC designated local emer~ency planning districts
and appointed local emergency planning committees or LEPCs in
1987. The SERC is also responsible for supervising and
coordinating the activities of the LEPCs and reviewing local
emergency plans and requests for information collected under
Title III.
The LEPC's primary responsibility will be to develop a
hazardous materials emergency response plan bf October 17,
1988. In developing the plan, the local committee will
evaluate available resources for preparin~ for and responding
to a potential chemical accident. According to Title III the
plan must include:
a. Identify facilities, transportation routes and
secondary facilities.
b. Establish facility and community response procedures.
c. Designate facility and community emergency
coordinators.
d. Facility and public notification procedures.
e. Methods for determinin~ release and impact areas.
f. Describe emergency equipment and personnel at
facilities and in community.
g. Evacuation plans.
h. Training programs and schedule.
i. Methods and schedules for exercising plan.
The makeup of the LEPC must include elected state and
local officials, police, fire, civil defense, public health
professionals, environmental, hospital and transportation
officials as well as representatives of facilities, community
groups, and the media. These are open meetings and most
LEPCs encourage the involvement of EMS provider agencies that
express an interest in attending.

Page 19
Hazardous Materlils Pr•Plannlng
Survey Form

Firm Name: - - - - - - - - - - - -Phone #: ------


Address: ______________________
Last Update of Information:
--------------
Br and Name: - - - - - - -Chemical Name: -------
Type of Material:
------------------
CLASSIFICATION
[Check correct information]

~ ~Poison9us
~f~~g:i1~ f ]if~~able Solids
5
Li8uids
Oxidizers & rganic Peroxides
& Etiologic [ ]R~dioactive Material
Corrosives [ ]Miscellaneous

STORAGE
Amount (Liters, Gallons, Barrels): - - - - - - - - - - -
Location and Storage: ________________
Segregated By:
Protected By:
-------------------
-------------------
REACTIVITY
[How· wi 1-1 this material react when ... ]
In Contact With: Explode Burn Give Off Toxic
Rapidly Heat Vapors
Water: '.

Heat: I !
•'
Air: l l I I
Ordinary Material: l . I
I
i I I I
I I
j
Oxidizing Material:
i

Page 1 of 2

-:l-0
Hazardous Materials Pre-Planning
Survey Form

TOXICITY
[Effect of material or vapors on the human body?]

~ ~
Toxic Nausea
Irritation of Skin Asphyxiation
Choking Headache
Irritation of Eyes and Nose ·
Tear Production [ ] Ch em i ca 1 Burn on Ski n
Other:
---------------------
PROTECTIVE CLOTHING REQUIREMENTS
[ ] SCBA [ ]Skin or Eye Protection [ ]Special Clothing
CONTROL INSTRUCTIONS
Fire:
-----------------------
spi l l or Le a k: -------------------
Cle an up:
----------------------
Ev acu at ion:
--------------------
D. O. T. EMERGENCY RESPONSE GUIDEBOOK INFORMATION
Chemical Name:
Chemical Number:
-------------------
------------------
Chemical GUIDE Number:
----------------
Isolation/Ev acu at ion Distance: - - - - - - - - - - - - -
Chemical Placard ID:
-----------------
CHEMTREC C 1-800-424-9300 l
24 Hour Hotline for Leak, Spill, Fire Exposure or
Accident
Be prepared to give the following information:
r . Name of Ca 11 er
[ .. Call Back Number
L. Carrier Name
L • Location of Problem
1 Local Weather Conditions

. Cons, gnee
1 Shipper or Manufacturer
. Rail Car or Truck Number
Container Type

Page 2 of 2
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BYS BIIS-DZDT AWARBltBSS COURSB
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OSD competencies
Wherever OSHA rec,ulations are cited in this Student
Workbook. the regulation is listed verbatim. However to
better explain some of the complex parts of the regulations,
annotations have been added to the text which will appear in
brackets"[ ]". Please do not mix up the bracketed comments
with the actual regulation.
In addition, the term employer and employee are
frequently used throughout the OSHA regulations. For all
purposes the courts have determined that volunteer agencies
are employers and members of volunteer agencies are employees
regardless of whether they receive remuneration for their
services to the agency or community.
Paragraph Q - EMERGENCY RESPONSE TO HAZARDOUS SUBSTANCE
RELEASES
[ This paragraph covers employers whose employees are engaged
in emergency response no matter where it occurs. )
(6) Training. Training shall be based on the duties and
functions to be performed by each responder of an
emergency response organization. [ Where this should be
found is in the local emergency response plan which
clearly spells out the role of various agencies. It is
the role that the emergency response plan spells out for
your a~ency which helps to determine exactly what level
of training is needed for your personnel. For example,
if the ambulance service will be responsible for treating
and transporting patients in the cold zone that have
alread¥ been decontaminated the plan should say this. ]
The skill and knowledge levels required for all new
responders, those hired after the effective date of this
standard, shall be conveyed to them through training
before they are permitted to take part in actual
emer~ency operations on an incident. Employees who
participate, or are expected to participate, in emergency
response, shall be given training in accordance with the
following paragraphs:
(i) First responder awareness level. First responder
awareness level are individuals who are likely to
witness or discover a hazardous substance release and
who have been trained to initiate an emergency
response sequence by notifying the proper authorities
of the release. First responders at the awareness
level shall have sufficient experience to objectively
demonstrate competency in the following areas:

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(A) An understanding of what hazardous materials


are, and the risks associated with them in an
incident.
(B) An understanding of the potential outcomes
associated with an emergency created when
hazardous materials are present.
(C) The ability to recognize the presence of
hazardous materials, in an emergency.
(D) The ability to identify the hazardous
materials, if possible.
(E) An understanding of the role of the first
responder awareness individual in the employer's
emergency response plan including site security
and control and the U.S. Department of
Transportation Emer~ency Response Guidebook.
(F) The ability to realize the need for
additional resources, and to make appropriate
notifications to the communications center.
(ii) First responder operations level. First responder
at the operations level are individuals who respond
to releases or potential releases of hazardous
substances as part of the initial response to the
site for the purpose of protecting nearby persons,
property, or the environment from the effects of the
release. Their function is to contain the release
from a safe distance, keep it from spreading, and
prevent exposures. First responders at the
operational level shall have received at least eight
(8) hours of training or have had sufficient
experience to objectively demonstrate competency in
the following areas in addition to those listed for
the awareness level and the employer shall so
certify:
(A) Knowledge of the basic hazard and risk
assessment techniques.
(B) Know how to select and use proper personal
protective equipment provided to the first
responder operational level.
(C) An understanding of basic hazardous
materials terms.
(D) Know how to perform basic control,
containment, and/or confinement operations
within the capabilities of the resources and
personal protective equipment available to
their unit.
(E) Know how to implement basic
decontamination procedures.
(F) An understanding of the relevant standard
operating procedures and termination
procedures.

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(iii) Bazar4ous aateriala technician. Hazardous materials


technicians are individuals who respond to releases
or potential releases for the purpose of stopping
the release. They assume a more aggressive role
than a first responder at the operational level in
that they will approach the point of release in
order to plug, patch, or otherwise stop the release
of hazardous substance. Hazardous materials
technicians shall have received at least twenty-four
(24) hours of trainin9 equal to the first responders
operations level and in addition have competency in
the following areas and the employer shall so
certify:
(A) Know how to implement the employer's emergency
response plan.
(B) Know the classification, identification,
and verification of known and unknown materials
by using field survey, instruments and
equipment.
(C) Be able to function within an assigned
role in the Incident Command System.
(D) Know how to select and use proper
specialized chemical personal protective
equipment provided to the hazardous materials
technician.
(E) Understand hazard and risk assessment
techniques.
(F) Be able to perform advance control,
containment, and/or confinement operations
within the capabilities of the resources and
personal protective equipment available with
the unit.
(G) Understand and implement decontamination
procedures.
(H) Understand termination procedures.
(I) Understand basic chemical and
toxicological terminology and behavior.
(iv) Hazardous materials s~ecialist. Hazardous materials
specialists are individuals who respond with and
provide support to hazardous material technicians.
Their duties parallel those of the hazardous
materials technician, however, those duties require
a more directed or specific knowledge of the various
substances they may be called upon to contain. The
hazardous materials specialist would also act as the
site liaison with Federal, state and local
government authorities in re9ards to site
activities. Hazardous materials specialists shall
have received at least twenty four (24) hours of
training equal to the technician level and in
addition have competency in the following areas and
the employer shall so certify:

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(A) Know how to implement the local emergency


response plan.
(B) Understand classification, identification,
and verification of known materials by using
advanced survey instruments and equipment.
(C) Know of the state emergency response plan.
(D) Be able to select and use proper
specialized chemical personal protective
equipment provided to the hazardous materials
specialist.
(E) Understand in-depth hazard and risk techniques.
(F) Be able to perform specialized control,
containment, and/or confinement operations
within the capabilities of the resources and
personal protective equipment available.
(G) Be able to determine and implement
decontamination procedures.
(H) Have the ability to develop a site safety
and control plan.
(I) Understand chemical, radiological and
toxicology terminology and behavior.
(v) on scene incident commander. (Discussed later in
course).
(7) Trainers. Trainers who teach any of the above training
subjects shall have satisfactorily completed a training
course for teaching the subjects they are expected to
teach, such as the courses offered by the U.S. Fire
Academy [ or the NYS EMS Program's Certified Instructor
Coordinator course], or they shall have the training
and/or academic credentials and instructional experience
necessary to demonstrate competent instructional skills
and a good command of the subject matter of the courses
they are to teach.
( 8) Refresher training. (Will be discussed in a later
section of this workbook).
(9) Medical surveillance and consultation. (Will be
discussed in a later section of this workbook).
(10) Chemical protective clothing. (Will be discussed in a
later section of this workbook).
(11) Post-emergency response operations. (Will be discussed
in a later section of this workbook).

The NFPA standards & Hazmat Response

The National Fire Protection Association is the leading

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nonprofit orianization in the world dedicated, since 1896, to


protecting lives and property from the hazards of fire. NFPA
publishes over 260 nationally recognized codes and standards.
Even though NFPA standards are voluntary standards, they are
considered in many areas the "state-of-the-art" and as such
are often brought into the courts as the national standard.
It is important to note here that the NFPA documents do not
limit themselves to the fire service. The intent of the
standards, specifically NFPA 471, 472 and 473, as was clearly
indicated in the Committee Scope approved by NFPA's Standards
Council and the Committee that developed these standards,
that the provisions of the standards be applied to all
persons who might be called on to respond to or take action
at a hazardous materials incident.
Another fact of life is that the OSHA regulation writers
tend to follow the NFPA standards very closely. For this
reason in this course we review the NFPA standards and
introduce NFPA 473 which is entitled Competencies for EMS
Personnel Responding to Hazardous Materials Incidents (1992
Edition). Although there is no OSHA regulation in effect
that corresponds to NFPA 473 at the time this course was
developed, the authors of this course can predict that there
will, at sometime in the future, be an OSHA regulation that
runs parallel to 473 designating two additional levels of EMS
Hazmat Responders.

From NFPA standard 472


Professional Competence of Responders to Hazardous Materials
Incidents
Chapter 2 - First Responder
2-1 General. First responders are divided into two levels of
competency: first responder awareness and first responder
operational. First responders at the awareness level shall
be trained to meet all of the requirements of Section 2-2 of
this chapter and first responders at the operational levei
shall be trained to meet all of the requirements of Section
2-2 and Section 2-3 of this chapter. All first responders
shall receive training to meet federal OSHA or EPA
requirements, whichever is appropriate for their
jurisdiction.
2-2 First Responder Awareness Level.

2-2.1 Goal. The 9oal at the first responder awareness level


shall be to provide those ~ersons, who in the course of their
normal duties may be the first on the scene of a hazardous
materials incident, with the following com~etencies to
respond in a safe manner when confronted with a hazardous
materials incident. These personnel are not expected to take
any actions other than to recognize that a hazard exists,

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call for trained personnel, and secure the area.


a. An understanding of what hazardous materials are, and the
risks associated with them in an incident;
b. An understanding of the potential outcomes associated
with an emergency created when hazardous materials are
present;
c. The abilitr to recognize the presence of hazardous
materials in an emer~ency;
d. The ability to identify the hazardous materials and
determine basic hazard and response information;
e. An understanding of the role of the first responder
on the scene of a hazardous materials incident or
identified in the local contingency plan for hazardous
materials incidents;
f. The ability to recognize the need for additional
resources and make appropriate notifications; and
g. The ability to initiate scene management (i.e.,
implement the Incident Command System, isolate the
immediate site, deny entry to unauthorized persons and
evacuate).
2-3 First Responder Operational Level.
2-3.1 Goal. The ~oal at the first responder operational level
shall be to provide those persons, whose duties include
responding to the scene of emergencies that may involve
hazardous materials, with the followin~ competencies to
respond safely to hazardous materials incidents. The first
responder at the operational level is not expected to use
specialized chemical protective clothing or special control
equipment.
a. The ability to make initial basic hazard and risk
assessments;
b. The ability to determine when the personal protective
equipment provided to the first responders b¥ the
authority having jurisdiction for use in their normal
response activities is adequate for a particular
hazardous materials incident, and the ability to use that
equipment properly;
c. An understanding of basic hazardous materials terms:
d. The ability to perform basic hazardous materials
control operations within the capabilities of the
resources and personal protective equipment available;
e. An understanding of decontamination procedures;
f. The ability to perform basic record keeping tasks; and
g. The ability to expand the Incident Command System.
Chapter 3-Hazardous Materials Technician
3-1 General
3-1.1 The hazardous materials technician shall meet all of

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the objectives indicated for the first responder in Chapter


2. In addition, that person shall meet the training and
medical surveillance program requirements in accordance with
federal OSHA or EPA regulations.
3-1.2 Goal. The goal at the hazardous materials technician
level shall be to provide the responders with the following
com~etencies to respond safely to hazardous materials
incidents:
a. The ability to implement a safety plan:
b. The ability to classify, identify and verify known
and unknown materials by using basic monitoring
equipment.
c. The ability to function within an assigned role in
the Incident Command System;
d. The ability to select and use at least Level B
protection in addition to any other specialized personal
protective equipment provided to the hazardous materials
technician by the authority having jurisdiction;
e. The ability to make hazard and risk assessment;
f. The ability to perform advanced hazardous materials
control operations within the capabilities of the
resources and personal protective equipment available;
g. The ability to select and implement appropriate
decontamination procedures;
h. The ability to complete record keeping procedures; and
i. The ability to understand basic chemical, biological,
and radiological terms and their behavior.
Chapter 4-Hazardous Materials Specialist
4-1 General
4-1.1 The hazardous materials Specialist shall meet all of
the objectives indicated for the first responder and
hazardous materials technician. In addition, that person
shall meet the training and medical surveillance program
requirements in accordance with federal OSHA or EPA
regulations.
4-1.2 Goal. The goal at the hazardous materials s~ecialist
level shall be to provide those persons, whose duties involve
response to specialized hazardous materials problems, with
the following competencies to respond safely to hazardous
materials incidents:
a. The ability to develop a site safety plan;
b. The ability to classify, identify, and verify known
and unknown materials by using advanced monitoring
equipment provided bf the authority having jurisdiction;
c. The ability to function within an assigned role in
the Incident Command System;
d. The ability to select and use Level A protection in

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addition to an¥ other specialized personal protective


equipment provided to the hazardous materials specialist
by the authority having jurisdiction:
e. The ability to perform hazard and risk assessments
involvin~ multiple hazards;
f. The ability to perform s~ecialized hazardous
materials control operations within the capabilities of
the resources and personal protective equipment
available;
g. The ability to develop and implement specialized
decontamination procedures;
h. The ability to implement record keeping and perform
termination procedures; and
i. An understanding of the chemical, toxicological,
biological and radiological terms and their behavior.

NFPA 473 competencies for EMS Personnel Responding to


Hazardous Materials Incidents
There is one very, very important point here. NFPA 473
came out in February of 1992 and is merely a voluntary
standard. However, OSHA has in the past developed their
regulations to follow very closely behind the NFPA standards.
So do not be surprised to see a set of regulations that are
parallel to NFPA 473. Due to the length of the standard only
the key areas appear below:
Chapter One
Scope & Purpose - to set a minimum requirement for competency
to enhance the safety and protection of ALS and BLS personnel
in the prehospital setting.
Chapter Two
"Introduction - all personnel at EMS/Hazmat Level I, in
addition to their BLS and ALS certification, shall be trained
to meet at least the First Responder Awareness level as
defined by NFPA 472, and all competencies of this chapter"
"Definition - EMS personnel at EMS/HM Level I are those
persons who, in the course of their normal duties, may be
called on to perform patient care activities in the cold zone
at a hazardous materials incident. EMS/HM Level I Responders
shall provide care only to those individual who no longer
pose a significant risk of secondary contamination."
"Goal - the goal of the competencies at EMS/HM Level I, shall
be to provide the individual with the knowledge and skills
necessary to safely deliver emergency medical care in the
cold zone. Therefore the EMS/HK Level I Responder shall be
able to:

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(a) Analyze a hazardous materials emeriency to determine


what risks are present to the provider and the patient
by· completing the following task:
1. Determine the hazards present to the Level I
Res~onder and the patient in a hazardous materials
incident, and
2. Assess the patient to determine the risk of
secondary contamination.
(b) Plan a response to provide the appropriate level of
emergency medical care to persons involved in hazardous
materials incidents by completing the following tasks:
1. Describe the role of the Level I Responder in a
hazardous materials incident:
2. Plan a response to provide the appropriate level
of emergency medical care in a hazardous materials
incident:
3. Determine if the personal protective equipment
provided is appropriate: and
4. Determine if the equipment and supplies provided
are adequate.
(c) Implement the planned response by completing the
following:
1. Perform the necessary preparations for receiving the
hazardous materials patient and preventing secondary
contamination:
2. Treat the hazardous materials patient: and
3. Transport the patient as appropriate.
(d) Terminate the incident."
Chapter Three
Describes the specific competencies of a EMS HAZMAT Level II.
"Introduction - all personnel at EMS/HM Level II shall be
certified to the EMT level or higher and shall meet all
competencies for EMS/HM Level I in addition to all the
competencies of this chapter."
"Definition - personnel at EMS/HM Level II are those persons
who, in the course of their normal activities, may be called
upon to perform patient care activities in the warm zone at
hazardous materials incidents. EMS/HM Level II Responder
personnel may provide care to those individuals who still
pose a significant risk of secondary contamination. In
addition, personnel at this level shall be able to coordinate
EMS activities at a hazardous materials incident and provide
medical support for hazardous materials response personnel."

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"Goal - the goal of the competencies at EMS/HM Level II shall


be to provide the Level II Responder with the knowledge and
skills necessary to perform and/or coordinate patient care
activities and medical support of hazardous materials
response personnel in the warm zone. Therefore the Level II
Responder shall be able to:
(a) Anal¥ze a hazardous materials incident to determine the
magnitude of problem in terms of outcomes by completing
the following tasks:
1. Determine the hazard present to the Level II
Res~onder and the patient in a hazardous materials
incident; and
2. Assess the patient to determine the patient care
needs and the risk of secondary contamination.
(b) Plan a response to provide the appropriate level of
emergency medical care to persons involved in hazardous
materials incidents and to provide medical support to
hazardous materials response personnel by completing the
following tasks:
1. Describe the role of the Level II Responder in a
hazardous materials incident;
2. Plan a response to provide the appropriate level
of emergency medical care in a hazardous materials
incident; and
3. Determine if the personal protective equipment
provided EMS personnel is appropriate.
(c) Implement the planned response by completing the
following:
1. Perform the necessary preparations for receiving the
patient:
2. Perform necessary treatment to the hazardous
materials patient;
3. Coordinate and manage the EMS component of the
hazardous materials incident: and
4. Perform medical support of hazardous materials
incident response personnel.
(d) Terminate the incident."

Page 31
llAIIIAT Classification, I4entification

The five clues to detecting and identifying hazardous


materials are: occupancy and/or type of location, container
shapes, markings and colors (such as the DOT identification
numbers and/or NFPA 704 numbers), placards and labels and
shipping papers. Each of these clues are discussed in detail
below.
occupancy an4/or Type of Location

Be familiar with the various locations in your community


where hazardous materials are used, stored, transported, or
produced. To accomplish this consider working together with
the local fire department when they do walk through drills of
facilities that store hazardous materials. By law,
facilities that store chemicals are required to inform the
local fire department of the trpes of chemicals they use, the
volume involved and the specific location in their facility.
Some communities have prearranged a response to
facilities with hazardous materials stored or used which
includes an initial response by both the fire department and
ambulance service. If there are industrial facilities that
your service res~onds to frequently which have hazardous
materials, the time for planning for an incident is now.
Let's say that you have a business that sells pool
supplies in your district. A can of chlorine is spilled and
the store employees wet mop up the powder in an attempt to
clean it up. Now your ambulance is called because the
chlorine fumes are throughout the building and both the
employees and the customers are gettin~ sick from inhaling
the fumes. How might this be handled in your community? The
point in preplanning is to be prepared for the small
incidents and then the mid size incidents rather than staging
the big drill for the overturned tanker truck in the midd1e
of town.
It is also helpful to review the Material Safety Data
Sheets and the DOT Emergency Response Guidebook ahead of time
to extract the a~propriate information and keep it handy in
the response vehicles. The Hazardous Materials Pre-Planning
Survey Form, included in the readiness section of this manual
(page 20-21), may be a helpful planning tool.

container Shapes

The containers for hazardous materials in transport are


specific shapes. Knowledge of the typical shapes of tankers

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container.
An eliptical container with flat ends contains
nonpressurized liquid at atmospheric pressure such as
gasoline or fuel oil (DOT-406). Cylindrical containers with
somewhat rounded ends contain low pressure chemicals such as
flammables or poisons (DOT-407). A round container
surrounded with insulation to keep the contents warm will
have a flat bottom (DOT-407).
Tanks that are the smaller diameter usually carry
corrosive liquid which is heavier than water (DOT-412). A
material which is carried under high pressure such as
liquefied propane gas is carried in a cylindrical or
eliptical container with rounded ends (MC-331). This same
material if carried in a railcar would have a dome fitting
that is totally enclosed with a large cap. A specialized
tanker used to carry a cryogenic looks like the figure MC-338
below.

DOT-406

DOT-412

DOT-407

MC-331 MC338

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Markings and Colors

There are many unique methods of marking vehicles


containing hazardous materials. Examples of non-system
markings which are not uniform or displayed in an approved
manner would be numerous commodities stenciled by name on the
side of the truck in 4-inch-high letters, telephone numbers
on the side of the railcar, or the name of the chemical
company owner.
In November of 1981 the United Nations (UN) system for
identifying hazardous materials have been required on
~ortable tanks, cargo tanks and tank cars. These DOT
identification numbers, as they are more commonly know, can
be seen in color on the DOT Chart 9 which is a handout for
this course. You may also find the use of U.N. numbers
displayed on other conveyances such as tank trucks.
There are three methods of displaying the U.N. numbers.
They are as follows:
1. orange panel adjacent to the placards. (Panel is 5-7/8
by 15-3/4 inches with 4-inch high letters.)
2. Center of appropriate placard. Combustible placards
which display the number will have a white area under the
number display to differentiate them from flammable
liquids.
3. Center of placard sized white ~anel for hazardous
substances and wastes not requiring a placard.
Specific details concerning the symbols on placards and
labels appears later in this section of the Student Workbook.

The NFPA 704 system

The National Fire Protection Association has developed


the 704 Hazard Classification System which is used in fixed
industrial facilities. Although this is a voluntary
standard, it has been required by many municipalities at the
local level. The system incorporates a diamond shaped
diagram divided into four quadrants to identify the "health
or toxicity", "flammability" and "reactivity" of a chemical.
Severity is indicated by numbers o to 4 with 4 being the most
severe. The chart below is an example of the NFPA 704
diagrams that appear on placards which are posted at the
entrance to the building so that responders would easily see
the placard prior to entering the facility.

Page 34
NFPAHAZARD
IDENTIFICATION SYSTEM

FLAMMABILITY
SIGNAL-RED

t
HEALTH

., REACTIVITY
SIGNAL SIGNAL
BLUE
/ YELLOW

t
RADIOACTIVE

or
•••
•w
WATER REACTIVE

RANGE
0= Low Risk
4= Very High Risk
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The specific information listed below describe the significance of the numbers
placed on the NFPA 704 placards.
Health (Blue Section)
In general, health hazard in firefighting is that of a single exposure which may vary
from a few seconds up to an hour. Tfle physical exertion demanded in firefighting
or other emergency conditions may be expected to intensify the effects of any
exposure. Only hazards arising out of an inherent property of the material are
considered. Tfle following expranations are based upon protective equipment
normally used by firefighters and not the typical EMS outerwear.
Health: Four
Materials too dangerous to health to expose firefighters. A few wiffs of this vapor
could cause deatn or the vapor or liquid could belatal on penetrating the
firefighters normal full protective clothing. The normal full protective clothing and
breathing apparatus available to the average fire department will not provide
adequate protection against inhalation or SK.in contact with these materials.
Health: Three
Materials extremely hazardous to health but areas may be entered with extreme
care. Full protective clothing, including self-contained breathing apparatus, coat,
pants, gloves, boots and bands arouna the legs, arms and waist should be
provided. No skin surface should be exposecf.
Health: Two
Materials hazardous to health, but areas may be entered freely with full-faced mask
self-contained breathing apparatus which provides eye protection.
Health: One
Materials only slightly hazardous to health. It may be desirable to wear self-
contained breathing apparatus.
Health: Zero
Materials which on exposure under fire conditions would offer no hazard beyond
that of ordinary combustible material.
Flammability (Red Section)
Susceptibility to burning is the basis for assigning degrees within this category.
The method of attacking the fire is influencea by this susceptibility factor.
Flammability: Four
Very flammable gases or very volatile flammable liquids. Shut off flow and keep
cooling water streams on exposed tanks or containers.
Flammability: Three

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Materials which can be ignited under almost all normal temperature conditions.
Water may be ineffective because of the low flash point.
Flammability: Two
Materials which must be moderately heated before ignition will occur. Water spray
may be used to extinguish the fire oecause the material can be cooled below its
flash point.
Flammability: One
Materials that must be preheated before ignition can occur. Water may cause
frothing if it gets below the surface of the liquid and turns to steam. However1
water fog gently applied to the surface will cause a frothing which will extinguish
the fire.
Flammability: Zero
Materials that will not burn.
Reactivity/Stability (Yellow Section)
The assignment of degrees in the reactivity category is based upon the
susceptiE>ility of materials to release energy either by themselves or in
combination with water. Fire exposure was one of the factors considered along
with conditions of shock and pressure.
Reactivity /Stability: Four
Materials which in themselves are readily capable of detonation or of explosive
decomposition or explosive reaction at normal temperatures and pressures.
Includes materials which are sensitive to mechanical or localized thermal shock. If
a chemical with this hazard rating is in an advanced or massive fire, the area should
be evacuated.
Reactivity/Stability: Three
Materials which in themselves are capable of detonation or of explosive ·
decomposition of explosive reaction which require a strong initiating source or
which must be heated under confinement before initiation. Includes materials
which are sensitive to thermal or mechanical shock at elevated temperature and
pressures or which react explosively with water without requiring heat or
confinement. Firefighting would be done from an explosive resistant location.
Reactivity /Stability: Two
Materials which in themselves are normally unstable and easily undergo violent
chemical change but do not detonate. Includes materials which can undergo
chemical change with rapid release of energy at normal temperatures and
pressure or which can undergo violent chemical change at elevated temperatures
and pressures. Also includes those materials which may react violently with water
or which may form potentially explosive mixtures with water. In advance or
massive fires, firefighting should be done from a safe distance or from a protected

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location.
Reactivity/Stability: One
Materials which in themselves are normally stable but which may become unstable
at elevated temperatures and pressures or which may react witti water with some
release of energy, but not violently. Caution must be used in approaching the fire
and applying water.
Reactivity/Stability: Zero
Materials which in themselves are normally stable even under fire exposure
conditions and which are not reactive with water. Normal firefighting procedures
may be used.

Now using what you have learned about the NFPA 704 ·
System how would you compare the two placards below if you
found them on the outside of two different industrial
facilities?

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SODIUM DIBENZOYL
PEROXIDE

Placards and Labels


Placards are diamond shaped and 10-3/4 inch in size. A
placard provides recognition by the colored background, the
symbol on the top, and the U.N. class number on the bottom as
well as in the center. The 4 digit U.N. number in the center
will not always be found on all placards (i.e.: Explosives).
The nine classes in the United Nations classification
system of hazardous materials are as follows:

U.N. CLASS 1: Explosives & Blasting Agents

Explosive - is any chemical compound, mixture, or device

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which is designed to function by explosion, that


is substantially instantaneous with the release
of gas and heat.
Class A Explosive - detonating or otherwise of maximum
hazard. Items capable of exploding with a
small spark, shock or flame and spreading
the explosion hazard to other packages.
(i.e: Dynamite, Ory TNT, Black Powder)
Class B Explosive - a flammable hazard. Items function by
rapid burning rather than detonation.
(i.e.: Propellant Explosives, Rocket
Motors, Special Fireworks, Flares, Flash
Powders)
Class C Explosive - a minimum hazard containing restricted
quantities of explosives as its
component. Items are a low hazard but
may explode under high heat when many are
tightly packed. (i.e.: Common Fireworks,
Small Arms Ammunition, Ammonium Nitrate,
Fuel Oil Mixtures)
Blasting Agents - a material designed for blastin9 which has
been tested and found to be so insensitive
that there is verr little ~robability of
accidental explosion or going from burning
to detonation.

U.N. CLASS 2: Gases (Compressed, Liquified or Dissolved


under Pressure)

Flammable Gas - (i.e.: Liquefied Petroleum Gas, Acetylene,


Hydrogen)
Nonflammable Gas - any compressed gas other than a flammable
compressed 9as. (i.e.: carbon Dioxide,
Sulfur Dioxide, Anhydrous Ammonia)
Corrosive Gas - (i.e.: Chlorine)

U.N. CLASS 3: Flammable Liquids

Flammable Liquid - a liquid that is easily ignited and


capable of burning with great rapidity.
(i.e.: Acetone, Gasoline, Methyl Alcohol)
Combustible Liquid - any liquid that has a flash point at or
above 100 degrees F. (37.7 degrees c.)

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and below 200 degrees F. (93.3 degrees


c.) (i.e.: Fuel Oils, Ethylene Glycols)

U.N. CLASS 4: Plam.m.able Solids

Flammable Solid - any solid material (other than an


explosive) which is liable to cause fires
through friction or retained heat from
manufacturin9 or processing. It can be
ignited readily and burns so vigorously and
persistentlf, as to create a serious
transportation hazard. Included in this
class are s~ontaneously combustible and
water reactive materials. (i.e.: Pyroxylin
Plastics, Magnesium Aluminum Powder)
Dangerous When Wet - any solid substance (including sludges
and pastes) which react with water by
ignitin9 or giving off dangerous
quantities of flammable or toxic gases.
(Sodium and Potassium Metals, Calcium
Carbide, Magnesium metal, Aluminum
Phosphide, Lithium Hydride, Phosphorus)

o.N. CLASS 5: oxidizers

oxidizers - a highly reactive substance that may react with


other materials to generate heat or ignition.
Oxidizers may also accelerate fires to the point
of explosion. (i.e.: Ammoniun Nitrate Fertilizer,
Hydrogen Peroxide Solution, Calcium Hypochlorite
[bleach])
Organic Peroxides - an organic compound containing the
bivalent -o-o structure. It may be
considered a derivative of hydrogen
peroxide where one or more of the
hydro9en atoms have been replaced by
organic radicals. (i.e.: Benzoyl
Peroxide, Peracetic Acid Solution)

U.N. CLASS 6: Poisons

Poison A - extremely dangerous poisons in which a very small


amount of the gas, or vapor of the liquid, mixed
with air is dangerous to life. Gas often listed
under Class 2. (i.e.: cyanide Gas, Arsine,
Hydrocyanic Acid, Phosgene)

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Poison B - less dangerous poisonous substances, liquids or


solids (includin~ pastes and semi-solids), other
than Class A or irritating materials, so toxic to
man that they are a hazard to health during
transportation. (i.e.: Aniline, Arsenic, Methyl
Bromide)
Irritant - a liquid or solid substance which, upon contact
with fire or air, gives off dangerous or intensely
irritating fumes. They do not include any
poisonous material Class A. (i.e.: Tear Gas,
Xylyl Bromide)
Etiologic Agent - a living microorganism or its toxin which
causes or may cause human disease. (i.e.:
Anthrax, Botulism, Rabies, Tetanus,
biomedical waste)

U.N. CLASS 7: Radioactive Materials

Radioactive Material - any material or combination of


materials that spontaneously gives off
ionizing radiation. It has a specific
activity greater than 0.002
microcuries per gram. The three
classes (I, II, III) have to do with
the level of radiation emitted from
the product. (i.e.: Plutonium,
Cobalt, Uranium, Uranium Hexafluoride,
carbon 14, Thorium 232, Radon 222)

U.N. CLASS s: corrosives

Corrosive Material - substances which destroy the texture or


substance of tissue. (i.e.: Hydrochloric
Acid, Oleum, Sulfuric Acid, Caustic
Soda, Caustic Potash, Alkaline Liquid,
Sodium Hydroxide)

U.N. CLASS 9: Other Regulated Materials

Other Regulated Materials (ORM) - applies to materials


that may pose an unreasonable risk to health and safety or
property and is not covered under the hazardous materials
warning label requirements.

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ORM A - materials with anesthetic, irritatin9, noxious, toxic


or other properties that can cause discomfort to
persons in the event of leakage. (i.e.: Dry Ice,
carbon Tetrachloride, 1,1,1-trichloroethane (dry
cleaning), Trichloroethylene, Chloroform)
ORM B - materials specifically named or capable of causing
significant corrosion damage from leakage. (i.e.:
Lead Chloride, Quicklime, Metallic Mercury, Barium
oxide)
ORM C - materials s~ecifically named and with characteristics
which make it unsuitable for shipment unless properly
packaged. (i.e.: Oakum, Bleaching Powder, Lithium
Batteries, Magnetized Materials, Sawdust, Asbestos)
ORM D - materials such as consumer commodities which present
a limited hazard due to form, quantity, and
packaging. They must be materials for which
exceptions are provided. (i.e.: Hair Sprays, Shaving
Lotions, small Arms Ammunitions)
ORME - materials that are not included in any other hazard
class, but are regulated as an ORM. (i.e.:
Pentachlorophenol, Adipic Acid, hazardous wastes, and
hazardous substances)

Labels

Labels are small versions of placards. Since federal


laws require only one label on the outside of shipping
containers, labels may not be visible due to the way they are
loaded. Labels may be found not only on metal containers,
but also those made of wood, plastic, cardboard, and even
paper bags. Containers are sometimes intentionally
mislabeled to prevent identification of illegally shipped
material. The colors and symbols used all have significance.
The following is a listing of the specific meanings of the
colors and symbols that appear on placards and labels:
1. Orange - indicates explosive material.
2. Red - indicates flammable material.
3. Green - indicates nonflammable material.
4. White - indicates poisonous material.
5. White with vertical red stripes - indicates flammable
solid.
6. Yellow over white - indicates radioactive material.
7. White over black - indicates corrosive material.
8. The bursting ball - indicates explosive material.
9. The flame symbol - indicates flammable material.
10. The slashed "W" - indicates dangerous when wet.

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11. The skull and crossbones - indicates poisonous material.


12. The circle with the flame - indicates oxidizing material.
13. The cylinder - indicates nonflammable gas.
14. The propeller - indicates radioactive material.
15. The test tube hand symbol - indicates corrosive material.
16. The word "RESIDUE" - indicates that the hazardous
material remaining in a packaging, including a tank car,
after its contents have been unloaded to the maximum
extent practicable and before the packaging is either
refilled or cleaned of hazardous material and purged to
remove any hazardous vapors.

Shipping Papers and Other Documents

If the shipping papers can be accessed, without putting


the responders in any danger, they can be very helpful. The
shipping papers should be located in the cab of a truck, in
the possession of a train crew member on a train, in the
bridge of a vessel or in the pilot's possession on an
aircraft. A "Waybill" on a train or a "Bill of Lading" in
trucking or other forms of transportation should have the
following information:
1. Proper shipping number.
2. Hazard classification.
3. Identification number.
4. Number of packages.
5. Type of packages.
6. Correct weight.
7. Emergency response telephone number.
In addition emergency response information must be
attached to a part of the shipping papers and must contain
the following information:
1. Description of the hazardous material.
2. Risks of fire or explosion.
3. Immediate hazards to health.
4. Immediate methods for handling small or large fires.
5. Immediate precautions to be taken in the event of an
accident.
6. Initial methods for handling spills or leaks in the
absence of fire.
7. Preliminary first aid measures.

Properties of Hazardous Materials

From the standpoint of how hazardous materials can hurt


you, they are characterized in three ways, flammability,
health or toxicity, and reactivity.

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PllLDUllability

Exposure to flammability is measured by burns.


Protection against flammability is achieved by distance from
the source and shielding oneself with protective clothing.

Health (Toxicity)

Exposure to toxic materials can occur by:


1. Inhalation - breathing in the chemical.
2. Ingestion - digesting the chemical.
3. Absorption - through the skin, eyes, or hair.

Reactivity

1. Explosives.
2. Oxidizers - release oxygen when combined with other
material.
3. Corrosives - may release explosive hydrogen gas when
combined with certain metals e.g. hydrochloric and
sulfuric acids.

Using the u.s. D.O.T. Emergency Response Guidebook

Every emergencr response vehicle in our State should


have a current version of_the Emergency Response Guidebook in
the glove compartment readily accessible to the responding
personnel. The guidebook will assist EMS personnel in
protecting themselves and advising others on the scene until
more qualified personnel arrive. There are three steps in
using the Emergency Response Guidebook.
First it is necessary to identify the material. This is
done in one of three ways. You can note the four digit
identification number on a placard or orange panel on the
vehicle or the shipping papers and look it up. If available,
the material name from the shipping papers, placard, label or
package can help give you something to look up. If either
way is not possible try to identify the placard and compare
it with those printed in the back of the Emergency Response

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Guidebook and turn to the appropriate guide number.


Next look u~ the material's two digit guide number in
either the identification number index, which is the yellow
pages in the first section of the book, or the material name
index, which is the blue pages in the second section of the
manual. Explosives are handled in a special manner by using
Guide 46 for the category of Explosive A, Band blasting
agents, and using Guide 50 for the cate~ory of Ex~losive c.
Materials listed which are highlighted in either index are
generally more hazardous and have recommended evacuation
distances listed in the green bordered pages at the end of
the Emergency Response Guidebook.
Next turn to the appropriate guide number, these are the
white pages with orange tops, and read the page carefullr
before taking action or giving advice. Since the book is
primarily for emergency responders, most of the response
activities listed are more appropriate for firefighters than
for EMS personnel because they will often be involved in the
warm and hot zones.

Guidebook Exercise

During class your instructor will review using the


Emergency Response Guidebook. After the students have gotten
a chance to flip through the book a few problems will be
solved by small groups of students using the Emergency
Response Guidebook. The sample used in class will be a box
with a label on it that says# 1851. When you look this
number up, you find it is listed as 11 Drugs n.o.s. 11 and the
referenced Guide number is 11. Take a look at guide number
11 to review the specific information, precautions and
actions for emergency response personnel to take.
The following is a summary of what appears in Guide#
11. The specific methods or techniques for mitigation of· the
hazards are directed at the agency that will be taking
responsibility for managing the incident, which in most cases
will be the fire department.
Potential Hazards
Fire or Explosion
* Flammable/combustible material: may be ignited by heat,
sparks or flames.
* May ignite other combustible materials (wood, paper, oil,
etc.).
* Container may explode in heat of fire.

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* Reactions with fuels may be violent.


* Runoff to sewer may create fire or explosion hazard.
Health Hazards
*Maybe fatal if inhaled, swallowed or absorbed through
skin.
* Contact may cause burns to skin and eyes.
* Fire may produce irritating or poisonous gases.
* Runoff from fire control or dilution water may cuase
pollution.
* Keep unnecessary people away: isolate hazard area and deny
entry.
* stay upwind: keep out of low areas.
* Positive pressure self-contained breathing apparatus (SCBA)
and structural firefighter's protective clothing will
provide limited protection.
Call CHEMTREC at 1-800-424-9300 for emergency assistance.
If water pollution occurs, notify the appropriate
authorities.
Fire
* Small Fires: Dry chemical, CO2, water spray or regular
foam.
* Large Fires: Water spray, fog or regular foam. Move
container from fire area if you can do it without risk.
Apply cooling water to sides of containers that are exposed
to flames until well after fire is out. Stay away from
ends of tanks. For massive fire in cargo area, use
unmanned hose holder or monitor nozzles; if this is
impossible, withdraw from area and let fire burn.
Spill or Leak
*Shutoff ignition sources: no flares, smoking or flames in
hazard area. Keep combustibles (wood, paper, oil, etc.)
away from spilled material. DO NOT TOUCH OR WALK THROUGH
SPILLED MATERIAL.
* Small Spills: Take up with sand or other non-combustible
absorbent material and place into containers for later
disposal.
* Large Spills: Dike far ahead of liquid spill for later

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disposal.
First Aid
* Move victim to fresh air and call emer9ency medical care:
if not breathing, give artificial respiration; if
breathing is difficult, give oxygen.
* In case of contact with material, immediatel¥ flush skin
or eyes with running water for at least 15 minutes.
* Remove and isolate contaminated clothing and shoes at the
site.
* Keep victim quiet and maintain normal body temperature.

Exercise fl

EMS personnel, traveling on the highway, spot a disabled


vehicle with a placard containing the number 1090.
What is the material? What Guide number in the Emergency
Response Guidebook should be used in response?
Use the space below for your notes on this substance:

Exercise t2

A man runs into your EMS station saying that his truck is in
the parking lot leaking a large quantity of chlorine. What
color index would you look the material name up in? What
Guide number would be used as a basis of response?
Use the space below for your notes on this substance:

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Exercise t3

You respond to a motor vehicle collision. Upon arrival you


find a truck and a car were involved in the accident. The
truck has the I.D. number 1972 on orange panels on four sides
of the vehicle. What is the material? What would be the
appropriate Guide number?
Use the space below for your notes on this substance:

History of The Incident command System

Over the past few years the term incident command system
or ICS has become second nature to most emergency service
agencies throughout the United States. This section will
briefly describe the history of ICS, discuss the major
components and functional areas of ICS and the EMS role. To
sum it up in one phrase - great leaps forward have
traditionally followed multiple tragedies.
As a result of a series of devastating wildfires which
roared across Southern California, burning over 600,000 acres
and 772 structures, in the Fall of 1970, a task force was
formed to develo~ a mana9ement system which allowed multiple
agencies in multiple jurisdictions to work together with a
common goal of life safety and property conservation. The
task force which developed the original incident command
system consisted of representatives from the California
Department of Forestry and Fire Prevention through the U.S.
Forest Service and the Federal Emergency Management Agency
along with the California State Fire Marshal's Office, the
Office of Emergency Services and FIRESCOPE (Firefighting
Resources of California organized for Potential Emergencies).
Though originally developed for fire services, ICS can
be adapted to serve all emergency response disciplines. The
system consists of procedure for controlling personnel,
facilities, equipment and communications. It is desi9ned to
begin developing from the time an incident occurs until the
requirement for management and operations no longer exists.
The National curriculum Advisory Committee on res emergency

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operations management systems recommended adoption of ICS as


an all risk all agency system.
In the early 1980's Chief Alan Brunacini of the Phoenix
Fire Department was very active throughout the country
presenting a series of workshops on the function of the fire
service incident commander. In 1982 Chief Brunacini's then
Captain, today Battalion Chief Gary Morris published an
article in the Journal of Emergency Medical Services (JEMS)
magazine which broached the issue of medical incident
command. Ironically, this milestone in EMS occurred after a
series of MCis across the United States including the MGM
Grand and Hilton fires, the Kansas City Hyatt Regency hotel
skywalk collapse and the Washington, DC combined aircrash and
subway accident.
According to Morris the most effective commander must be
a mana9er who is experienced in managing under emergency
conditions on a daily or frequent basis. He or she must be
familiar with the disaster plan, the EMS system and the
standard operating procedures of each agency responding.
Command, as well as all sector officers, should be clearly
designated by a colorful vest and should simply use the radio
designation of "Command". Early establishment of command and
transferrin9 command were addressed in the JEMS article as
well as medical operations and fire operations branches for
the ICS of a combined fire and EMS incident.
Large scale incidents often entail multiple treatment
sectors. Accordin9 to Morris, "in the model used in Phoenix
there is no traditional triage officer. This is because they
feel tria9e is a continuous process that is initiated by
first arriving units and is closely monitored during the
extrication, treatment and transportation process. In
addition, each sector manager is responsible for providing
triage monitoring within their sectors".
Brunacini went on to document his views in the excellent
book Fire Command, published by the National Fire Protection
Association in 1985, which has become the bible for educating
fire service officers in the command of an incident. Many of
the principles of this book are a detailed elaboration of the
essential components of ICS.
There has been a recent rebirth of interest in ICS as a
direct result of a series of events that have occurred since
1986. The Occupational Safety and Health Administration
(OSHA) was directed by the Superfund Amendments and
Reauthorization Act {SARA) of 1986 to establish rules for
operations at a hazardous materials incident. OSHA requires
in CFR 29 Part 1910.120 {Paragraph Q - Emergency Response to
Hazardous Substance Releases {6) (v)) that all organizations
that handle hazardous materials incidents must use an
incident command system. This section of the regulation

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appears below:
Paragraph Q - EMERGENCY RESPONSE TO HAZARDOUS SUBSTANCE
RELEASES
(6) (v) On Scene Incident Commander
Incident commanders, who will assume control of the incident
scene beyond the first responder awareness level, shall
receive at least 24 hours of training equal to the first
responder operations level and in addition have competency in
the following areas and the employer shall so certify:
(A) Know and be able to implement the employer's incident
command system.
( B) Know how to implement the employer's emergency response
plan.
(C) Know and understand the hazards and risks associated
with employees working in chemical protective clothing.
( D) Know how to implement the local emergency response plan.
( E) Know of the state emergency response plan and of the
Federal Regional Response Team.
( F) Know and understand the importance of decontamination
procedures.
Non-OSHA states are required under the Environmental
Protection Agency (EPA) rules to use an res at hazardous
materials incidents also.
In 1987 the NFPA developed Standard 1500, under the
committee chair of Chief Brunacini, which establishes a fire
department occupational safety and health program. This
standard clearly states that all departments should establish
written procedures for an incident command system. The
standard goes on to require that all members be trained in
res, that the responsibility for safety be specified for all
supervisory personnel, that a system for accountability of
all personnel at an incident be developed, that the safety
requirements be outlined by the Department, and that
sufficient supervisory personnel be provided to control the
position and function of all employees operating at the scene
of an incident.
In 1990 NFPA issued Standard 1561 which defines fire
department emer~ency management systems. This standard
provides guidelines for what should be included in an
emergency management s¥stem. It emphasizes the importance of
agencies and jurisdictions that may work together in
emergency operations having a common emergency management
system.
Many states have dealt with this renewed interest in the
incident command system by developing training programs for
police, fire and EMS personnel to work together at large

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RYS BKS-BAZD'l' AWARJDIBSS CO'OllSB
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incidents. The New Jersey course is an excellent example of


an interagency incident command course. In New York State,
the State EMS Office had previously developed a model medical
incident plan and issued MCI kits to each ambulance service
which contained standardized triage tags and assorted site
management materials.
During 1990 there were four major incidents in New York
state which again sparked a renewed interest in ICS. They
were the Coldenham school collapse from a tornado, the
Avianca plane crash on Long Island due to insufficient fuel,
the Blenheim pipeline explosion and the Happyland Social Club
fire in the Bronx which was set by an arsonist. In April of
1990 the then Chairman of the NYS Disaster Preparedness
Commission (DPC), Dr. David Axelrod, directed the State
Emergency Management Office to review the command and control
element of response to disasters in New York State. A task
force under the auspices of the DPC was formed to make
recommendations on how emergency and disaster scenes can be
more effectively managed. Represented on this task force
were the State Emergency Management Office, the Office of
Fire Prevention and Control, the Department of Health's
Emergency Medical Services Program, the Division of State
Police and the Division of Criminal Justice Services' Bureau
of Municipal Police.
The 16 hour trainin~ program that was developed by the
task force, and piloted in early 1991, is called Public
Safety Critical Incident Management or (PSCIM). The PSCIM
course is designed to train all three emergencr service
disciplines together in one room at the same time on the same
incident command concepts. The course involves a series of
simulations utilizing a HO model city for the students to
work out on the board. It is the belief of the DPC Task
Force agencies that this type of unique and integrated
training will lay a solid foundation towards addressing the
concerns of command and control that surfaced during the 1990
incidents. The intent is to expand the availability of the
course to community colleges throughout the State. For
additional information about where the PSCIM course can be
taken, contact Bill Campbell at SEMO (518) 457-9987.

Key Components of an Incident Command system

The incident command system has nine key components.


The key components are: strong visible command, common
terminologr, modular organization based upon incident needs,
comprehensive resource management, manageable span of
control, providin~ personnel safety and accountability,
integrated communications, unified command and NOT singular
command, and consolidated action plans using goals and
objectives.

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NYS EMS-HAZMAT AWARENESS COURSE
Student Worltbook

These components working together provide the basis for


an effective operation. There is an essential need for
common terminolog¥ in any emergency management system which
will potentially involve multiple agencies from multiple
disci~lines. During the MCI is not the time to begin
figuring out another agencies' "code system". Indeed plain
English works best of all. It is much easier for all
responding units to refer to the incident commander rather
than trying to remember that Chief 62 or Medic 600 is the
incident commander at this event.
res organizational structure develops in a modular
fashion at each incident. The development of the
organization is top down, meaning that at the least an
incident commander is always identified for all incidents.
As the incident needs dictate, additional responsibilities
may be assigned by the IC. If they are not assigned, the IC
plays all roles which is all the more reason for delegating
responsibilities since one person cannot do all the job in a
large or complex incident such as a hazmat incident.
Management of communications at an incident requires
integrated communications. An integrated communications plan
includes standardized procedures, use of clear instruction
with common terminology, two way confirmation that the
messages are received and status reports on the assignments
given to keep the IC updated. Radio frequencies should be
set up ahead of time so that all arriving units have common
frequencies and there are tactical and command frequencies
that can be used at the incident.
A unified command structure is a key component of res as
opposed to the more traditional singular command. This means
that all involved agencies contribute to the command process
by determining the overall goals and objectives, joint
planning for tactical activities and maximizin~ use of all
assigned resources at the incident. When setting up a
command post, a unified command structure is best achieved by
setting up one command post instead of a separate one for
police, fire and EMS.
Every incident needs a consolidated action plan.
Complex incidents may require written action plans which
cover all strategic goals, all tactical objectives and
support activities for the entire operational period of the
incident.
Another key component of ICS is span of control. A
manageable span of control is the number of subordinates that
one supervisor can manage effectively. The desired range is
from three to seven with five being optimum. It becomes very
easy to lose track of your people at an incident if they are
not assigned to smaller units.

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ICS uses designated incident facilities such as the


command post which is usually the location of each agency
representative, the communications center, and the center of
all planning and incident operations direction. A base is a
location that is often used for hostage situations, search
and rescue operations and civil disorders. Staging areas are
designated facilities designed to keep from clogging up the
scene with equipment, vehicles and personnel, yet to keep
them all within a few minutes of the incident to respond as
directed.
Finally, ICS requires comprehensive resource management.
Effective management should maximize resource use,
consolidate control of large numbers of single resources such
as ambulances, and reduce the communications load. Knowledge
of the status of resources is critical to effective resource
management. Three status conditions are recommended:
assigned which means actively performing functions, available
which means ready for assignment and out of service which
means the unit is unavailable or assigned to another
incident.
Three terms used in res to describe organizational
levels are: branch, division and group. Think of these
levels like the anatomy of the respiratory system. A branch
is the organizational level having responsibility for major
segments of the incident operations. The branch level in the
res chart is located between the section and the group or
division similar to the bronchioles. A division and a group
are both at the same level of organization yet the division
has the responsibility for operations within a defined
geographic area. The group has the responsibility for a
specific functional assignment. This level is between the
single resources and the branch, similar to the terminal
bronchioles. This level is also referred to as a sector in
some management systems. The single resource would be the
equivalent of the alveoli and the section would be the
equivalent of the right or left bronchi with the trachea as
the IC.

The ICS Major FUnctional Areas

res also has five major functional areas. Depending on


the size of the incident each of the five may be a different
person's responsibility or in smaller incidents the
functional areas may be combined. The functional areas that
is always staffed is command. The four other functional area
are Operations, Planning, Logistics and Finance which can
each be staffed as the need develops. The incident commander
is the individual with the overall responsibility for
managing the incident.

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These responsibilities include assessing incident


priorities, determining the strategic goals and tactical
objectives, developin9 incident action plan and the
appropriate organizational structure, managing incident
resources, ensuring personnel safety, coordinating activities
of outside agencies and authorizing release of information.
With this long list of responsibilities it is easy to see the
need for delegation and establishment of various section
chiefs as the incident dictates.
The Operations section is responsible for all tactical
operations at an incident. Since most incidents are not
commanded by EMS such as a motor vehicle collision or a
hazmat incident, the EMS or Medical Command could turn out to
be an operations chief. At a lar9e scale incident this may
include up to five branches, 25 divisions or groups and 125
single resources, task forces or strike teams. A task force
is defined as a group of any type and kind of resources, with
common communications and a leader, temporarily assembled for
a specific mission, not to exceed five resources. A strike
team is defined as five of the same kind and type of
resources, with common communications and a leader.
The Planning section is responsible for the collection,
evaluation, dissemination, and use of information about the
development of the incident and the status of resources.
This includes situation status, resource status,
documentation and demobilization units as well as technical
specialists.
The Logistics section is responsible for providing
facilities, services and materials for the incident. This
includes the communications unit, medical unit, food unit,
service branch, su~ply unit, facilities unit and ground
support units within the support branch.
The Finance section is responsible for all costs and
financial consideration at an extensive incident. This
includes the time unit, the procurement unit, compensations
and claim units and the cost unit.

EMS Roles at an MCI

The EMS Branch has a number of ke¥ divisions. In an


incident which is primarily an EMS incident the EMS Command,
or Medical Command as some agencies refer to, would often be
the first crew chief on the first arriving EMS unit. At a
major motor vehicle accident with multiple patients the EMS
Command would actually be serving in the role of the
operations chief. His or her responsibilities would include
confirming the incident to dispatch, sizing up resources and

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the need for additional EMS response, managing the EMS


response, coordinating activities of all EMS personnel at the
incident, designating EMS division and/or sector officers,
ensuring the safety of all EMS personnel, establishing
communication contacts and notifying hospitals. The EMS
Commander may need to establish a Command Post and remaining
at that location. If a command Post is alreadf established,
the EMS crew chief becomes the EMS representative at the
Command Post. He or she will work cooperatively with police
and fire service commanders in the Command Post.
As it becomes necessary, EMS Command may choose to
designate a Safety Officer and a Staging Division/Sector
Officer. The EMS Safety Officer should be responsible for
ensuring scene safety for all EMS personnel. They will be
paying close attention to details that the Medical Commander
may not have the time to focus upon such as whether the
personnel can be adequately seen at the scene or are they
wearing the appropriate protective gear for the incident. We
have all seen ma1or motor vehicle collisions where the fire
department is doing disentanglement activities with hydraulic
tools wearing the appropriate protective gear and the
ambulance personnel are in the action circle with short
sleeve shirts! This is simply unacceptable and leads to
injuries of EMS personnel. The Safety Officer should
determine if personnel are getting themselves into a
situation that they cannot get out of safely and take
responsibility for assuring compliance with the appropriate
level of infection control followup for the incident per OSHA
and NFPA guidelines.
The EMS staiing Division/Sector Officer is appointed by
EMS Command and is responsible for establishing an assembly
point and mobilization area for personnel and vehicles,
releasing resources to the incident as requested by EMS
Command or other sector officers and ensuring the
physiological needs of the personnel are being met.
The Triage Division/Sector Officer is appointed by EMS
Command and is res~onsible for establishing triage procedures
as dictated by incident type. In some cases this involves
extrication of trapped patients and in other cases it
involves corralling all the patients to funnel them to the
treatment sector to assure they are medically evaluated.
When extrication is needed or patients are entra~ped, the
Triage Officer must work very closely with the fire officer
responsible for extrication to assure that the appropriate
patients are removed from the wreckage in the correct order.
In some instances, where patients are simply piled upon each
other it may be necessary to remove a low priority patient to
be able to access a higher priority patient. This officer
can appoint triage support personnel as needed to aid in the
movement of patients to treatment and/or transportation
sectors. He or she is also responsible for coordinating

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NYS EMS-HAZMAT AWARBJIBSS COURSE
student Workbook

personnel and equipment usage.


The Treatment Division/Sector Officer is appointed by
EMS Command with the responsibility of setting up treatment
areas as requested, as warranted by site and transportation
considerations. He or she supervises the treatment area and
any area set up to hold patients prior to transport from the
scene as well as coordinating activities of all EMS personnel
assigned to the division. The Treatment Officer may appoint
treatment personnel, directly oversee the patient care
provided, determine the need for additional personnel and
equipment and coordinate with the transportation division
officer movement of patients to ambulances.
The Transportation Division/Sector Officer is appointed
by EMS Command to establish and maintains ambulance loading
areas. He or she is responsible for supervising patient
movement in conjunction with the treatment division officer,
accessing and monitoring local/area hospital capabilities and
determining the patient destinations. The Transportation
Officer coordinates helicopter evacuations if they are used
at the incident and maintains documentation of these patient
destinations. This can be accomplished using a patient log
or copies of the triage tags. He or she is also responsible
for supervising the hospital communications network which may
involve appointing a hospital communicator to operate the
hospital communications network, maintaining hospital status
and capability and providing patient information to hospitals
via radio. During a major incident individual ambulances
should not be calling into the hospital with lengthy radio
reports. This is done directly by the hospital communicator
in an abbreviated manner. The Transportation Officer may
also appoint vehicle loaders to facilitate patient loading
and ambulance movement from the scene.
Learning how to use the ICS takes interagency planning,
time and practice. We suggest that you first conduct
training to assure all personnel understand ICS and the EMS
roles. Then conduct a series of small exercises involving 10
patients with a few ambulances. Once this runs smoothly then
consider taking on a larger drill involving multiple agencies
and multi~le jurisdictions. Some services have gotten very
creative in practicing for MCis recognizing that a well
managed MCI should be an extension of what we do everyday.
We suggest that you may want to consider tag days where all
patients are tagged specific days of the month to give all
crews practice using the tags. Another helpful policy is to
declare an MCI and establish command at all ambulance
responses involving more than two ambulances. This would
give crews practice using the plan and being in the command
position as well as triaging, tagging and donning the sector
vests. Whatever works in your community, the key is clearly
practice, training, practice, training and more training.
After all, failing to plan is truly planning to fail!

Page 57
New York State SECTION C
Department of Health
Emergency Sesslon#2

Objectives

Medical Right to Know


MSDS
Herbicide Case
Field Stabilization

Services & Treatment


Decontamination
Medical Monitoring

Program Post Incident


Refresher Requirements

HAZMAT AWARENESS
·~ Continuing Education Course for EMS Providers"

ss
NYS EMS-HAZMAT AWARENESS COURSE
student Workbook

------------------------------------------------------------
SESSION f 2
--------------------------------------------~---------------
The Right to Know Law 30 min.
Herbicide Case Study 25 min.
Break 10 min.
Field Stabilization & Treatment of
Decontaminated Patients 40 min.
Break 10 min.
The Stages of Decontamination 15 min.
Medical Monitoring & Documentation 10 min.
Post Incident Considerations 10 min.
Annual Refresher Requirements & Summary 15 min.
PostQuiz & Course Evaluation 15 min.

Objectives
Upon completion of this session, the student will be able to:
23. Discuss the OSHA Hazardous Communication Standard
requirements and the steps your employer has taken to
compl~ with the right to know provisions.
24. Explain how to read and interpret the information
provided on container labels and MSDSs.
25. List operations in the ambulance service work area where
hazardous chemicals are used, stored or produced.
26. Discuss the MSDS for each product identified in
objective 25.
27. Ex~lain the proper use of protective equipment for the
daily contact with materials identified in objective 25
and explain when it is appropriate to call other
resources to manage a hazardous substance.
28. List steps in the general approach for the care of
hazmat victims.
29. Cite chemicals that require special handling.
30. Identif~ personnel that need to be medically assessed at
hazmat incidents.
31. Describe on-scene treatment of hazmat patients.
32. Explain the reason for designating receiving facilities
in hazmat situations.
33 • Describe the components of a medical surveillance
program.
34. Describe the medical monitoring of hazmat personnel.
35. Name complications from being in an encapsulated suit.
36. Describe the importance of communication and observation
of team members.
37. Define the rescuer's role as related to documentation.
38. Describe the refresher requirements of the OSHA
training.

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The Right to ltDOV Lav


The law, OSHA Hazard Communication Standard 29 CFR Part
1910.1200, requires that employers develop a comprehensive
program to inform employees of the hazards encountered in the
workplace and provide training in the safe use and handling
of products containing hazardous chemicals.
It has been determined by the courts that volunteers are
employees who are not compensated and volunteer fire
departments and ambulance services are employers.
You must ask yourself the following four questions: Does
your EMS agency meet the intent of this law? Does your
service document having provided the training to all
employees? Does your employer post Material Safety Data
Sheets in the station or in an accessible place for the
emplo¥ees? And finally what are the potential hazardous
materials you work, in and around the ambulance business?
If you answered no to any of the first three questions
someone simply is not doing their job. This could be because
they are not aware of this law or the prior administration
did not hand down the information on the law. Let's give
them benefit of the doubt and sa¥ they are uninformed. Well,
that is not an excuse, so it's time to get up to speed with
this regulation. After reading this section of the Student
Workbook we would suggest that your service leadership should
contact the New York State Department of Health, Bureau of
Occupational Health (2 University Place, Room 155, Albany, NY
12203-3313) for a Right To Know Implementation Kit. This kit
is actually a very informative manual that will help answer
questions about the law which space limits us to addressing
here in this Student Workbook.
This section of the Student Workbook will present an
overview to this important training and help you, as an
employee, understand how to read the Material Safety Data
Sheets (MSDS). A Material Safety Data Sheet, or MSDS, is a
manufacturer's summary of a product's potential hazards. The
MSDS provides recommendations for the safe use, handling and
storage of the product as well as emergency procedures to
follow in the event of a spill or leak. An MSDS must be
prepared for every product that can be considered hazardous
under the OSHA Hazard Communication standard.
An MSDS must include several categories of information,
but there is no "standard" MSDS format that must be used.
OSHA has developed an optional form, OSHA 174, that includes
all the categories required by law. Manufacturers can use
this form or one of their own design as long as it provides
the required information. This discussion of MSDSs follows
the OSHA 174 form.

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MSDSs can be difficult to understand. Publications that


explain terms and language used in MSDSs are available from a
variety of sources. "How Toxic Is Toxic?" is one such
booklet prepared by the New York state Department of Health.
Copies are available through the Bureau of Occupational
Health at (518)458-6392. MSDSs should not have anr blanks,
but occasionally important information may be missing. If
specific information is unknown or not applicable, that fact
should be indicated in writing on the MSDS. If an MSDS is
deficient in any way, contact the manufacturer for
clarification.
Copies of the MSDSs must be present in the workplace and
consulted whenever there is a question about a product.
Manufacturers and importers of hazardous chemicals are
required to evaluate their products and prepare MSDSs and
container labels with hazard warnings. These are required to
be made available to employers who use the products.
An MSDS contains a variety of information about a
product including:
1. Product and chemical names of hazardous ingredients.
2. Name, address and telephone number of the manufacturer.
3. Physical and chemical properties and hazards.
4. Routes of exposure.
5. Established exposure limits.
6. Any product ingredients linked to cancer.
7. Precautions for safe handling and use.
8. Recommended engineering controls and protective
equipment.
9. Emergency and first aid procedures.
The following ten pages give explanations of the terms
that appear on a sample MSDS.

Page 61
IDUfflTY(AII IJNdMUIIIIIUIII Lill)
J•anni•' • M&CJiC: Cl•an•~
Section I
illlonnlliallil ......... -~----·inlliallltlfllll.
llilole: 8llnlr . . - - - ,.,,,,,.,_, • .,, . . . . . . . . . . . . flt flO

ManufllCIUIW'S N.- EIIW9fl'CY r..,._. Nune.


llandv Chea1cals 1-100-321-1234
Add_(N,.,,,._., SliNf. Cly, S1111• UIII ZIP C41dtl T..,,_N~lor~
l Che•ic:•1 llay l-!23-32!-4567
0... PrtllllUIMI
::he10ic&l Citv, ll<tw ro« !2J4S 1111/H

Section I must indicate the product name as it appears on the container label; the name,
address and telephone number of the manufacturer; emergency telephone number; and the
date the MSDS was prepared or last revised. An MSDS may include the signature of the
preparer and additional product identifiers such as chemical class, commonly used trade
names, and chemical synonyms.

Section II - Hazardous Ingredients/Identity Information


01118< Lml$
OSHA PEL ACGIHTLV Recol11119ildecl
"'~
NlOSII 10 ht
Acetone :::: npr.: 1~~ PPffl zso ppnt 4C\

A.-<>nium Hydroxide !2111 !:


fA.T~an~al
e>~ C;\:HJi ,:; op!ll ,o ...
,, 19'

Fe rrna l dei'I yde J Dp!";


~""' O. I Pl"" C:L 0. >I

.fraqra~c:e ;:A NA C. >I

Water 7132-!8-5, ~" ~A 40\

The MSDS must list commonly accepted chemical names and established exposure
limits for:

• any hazardous chemica I present in the product at concentrations of 1 percent


or more;
Chemicals that have exposure standards established by OSHA or recommended exposure limits
developed by the American Conference of Governmental Industrial Hygienists (ACGIH), or that meet
hazard determination criteria in the OSHA Hazard Communication Standard (Appendices A & B), must
be considered hazardous. Many manufacturers also list the percenuiges of product components.
• any carcinogen present at concentrations of 0.1 percent or more; and
Chemicals determined to be carcinogens by OSHA, the National Toxicology Program (NTP) or the
ImemationaJ Agency for Research on Cancer (IARC) must be identified.
• any substances known to be present and that constitute a hazard at concentrations
below 1 percent.
Contaminants should be identified if they can be considered hazardous even at very low concentrations.
Examples include sensitizing agents, such as formaldehyde and toluene diisocyanate (TDI), and trace
amounts of highly toxic chemicals, such as dioxins in the herbicide 2.4.5-T.
Manufacturers are permitted to withhold the identity of product components considered
trade secrets. All other infonnation must be provided and the MSDS must state that
chemical identities are being withheld as trade secrets.

Exposure limits are estimates of the maximum amount of a substance in air that most
workers can breathe regularly without experiencing adverse health effects. Limits arc
usually expressed as parts per million (ppm) or milligrams per cubic meter (mg/m3). The
lower the limit. the more hazardous the substance. There are three types of exposure limits:

• time-weighted average (TWA) - The highest concentration of a substance most


workers can encounter, day after day, without adverse effects. Actual exposure levels
are permitted to fluctuate but the average calculated over any workshift, usually 8
hours, must not exceed the TWA
• short-term exposure limit (STEL) - A concentration above an 8 hour TWA to which
workers can be exposed continuously for up to 15 minutes. Exposures at the STEL
should not be repeated more than four times per day and at least 60 minutes are required
between successive exposures.
• ceiling limit (C) - The maximum allowable level. A ceiling is the upper limit for any
TWA or STEL and should not be exceeded at any time.
Some substances, including many pesticides and solvents, can be absorbed through the
skin, eyes or nasal passages from airborne concentrations or by direct contact. Absorption
can contribute significantly to exposure by inhalation. Exposure limits for these substances
may also list "-Skin" or "(Skin)" to indicate the potential hazard.

Exposure limits have been established for hundreds of substances by government


agencies and professional organizations. The most common are:

• permissible exposure limits, or PELs, set by OSHA;


OSHA PELs are federal standards, legal requirements lhat arc enforced by OSHA and the New York
State Department of Labor. The employer can be cited and fined for failure to comply. OSHA PELs are
established for 600 substances.
• threshold llmlt values, or TI..Vs, set by the American Conference of Governmental
Industrial Hygienists (ACOll:l); and
ACGIH is an independent professional organwuion that annually reviews and updalcs existing exposure
limits based on the most recent infonnation available. The lL Vs, often lower than OSHA PELs, are
recommendations not legal requirements. However, many lLVs have rcc:enlly been adopled as P:ELs by
OSHA.
• recommended exposure limits, or RELs, set by the National Institute for Occupational
Safety & Health (NIOSH).
NIOSH, under the authority of the OSH Act of 1970, prepares comprehensive reviews and summaries
of workplace hazards that include the development of REL's for potentially hazardous substances or
conditions in the workplace. NIOSH recommendations are considered by OSHA in the development of
standards. RELs are usually much lower than OSHA PELs. NIOSH also ba,;es its time-weighled
averages on IO hour workshifts.
For many people, current exposure limits may not be sufficient. Most exposure limits
are developed with the assumption that worker populations are made up of healthy adult
men exposed to a single substance. Several factors should be considered in evaluating
exposure Jimits:

• existing physical conditions;


Individuals with medical conditions that intc..fcre with the body's ability to endure chemical exposures
are at b'TCater risk. Anyone with a health condition involving the heart, lungs, kidneys, liver or nervous
system may be more susceptible to chemical exposures that affect those organ systems.
• reproductive hazards;
The potemial reproductive hazards of chemical exposure arc not adequately addressed by current
exposure limits. Pregnant women and their babies arc at greater risk of adverse health effects. In
addition. both men and women may suffer decreased fcnility and an increased risk of birth defects in
future pregnancies as a result of workplace exposure Lo chemicals.
• chemical interaction;
Exposure to several substances at once may produce more severe health effects than exposures to
individual substances. Smoking or the use of prescription medications, alcohol or drugs can also
contribute to the effects of chemical exposure.
• additional sources of exposure;
Depending upon frequency. duration and levels of exposure, home projects or hobbies that use or
release chemicals can contribute to the effects of workplace exposure. The hazards associated with
activities such as automoLive repair. furniture refinishing, ans, cmfL<;, paint removal, soldering and
many others. arc often overlooked.
• individual variation.
Some people are naturally more susceptible to certain substances and may experience health effects at
levels below recommended exposure limits. Occasionally, individuals will develop an allergic sensiLivity
to certain substances, such as fonnaldehyde, and experience adverse health effects at extremely low
levels of exposure.

64
Section 111- Physical/Chemlcal Charecteristlcs
Boi1ngP0tnt 133°F Spaciic: Gravnr (~ 0 • 1J
C56"C! al 60"F t20"CI 0.19
Vapor Pt.....,1'11 (mm Hg) ld&ftl'IQ P01m -70.6",
at ill"F (20" C! 110 !Ml liq C-95"Cl
Vapor 0ensrty (AIR• 1) Evapot111,an Ra!•
2.0 (8uly!Alcelal8•1) 7.7
Solubil!ly 1n Waler
Completely mi1cibl•
Appearance and Odor
Clear liquid llifit.h aff'4'1\0nia-lilt• odor

Section III provides many indications of the possible hazards of a product.

Boiling Point is the temperature at which a substance changes from a liquid to a gas.
The most obvious example is water heated until it becomes steam. Flammable materials
with low boiling points may present a special fire hazard. The boiling point of gasoline is
100°F.

Specific Gravity is an expression of the weight of a substance compared to water. A


specific gravity greater than LO means a substance is heavier than water. A specific gravity
less than 1.0 means a substance is lighter than water. Materials that do not dissolve in water
will either sink or float. Water applied to fires involving materials that float may spread the
fire rather than extinguish it.

Vapor Pressure is an indication of how quickly a substance will evaporate. Most vapor
pressures are reponed in millimeters of mercury (mm Hg) at room temperature (usually
68°F or 20°C) to allow comparisons between materials. Substances with vapor pressures
above 20 mm Hg may present a hazard, particularly in enclosed areas with poor ventilation.

Melting Point is the temperature at which a substance changes from a solid to a liquid.
The most common example is ice melting to form water at 32°F.

Vapor Density is the comparison of the weight of the vapor given off by a substance to
air. Vapors heavier than air (greater than 1.0) will fall to the ground and spread, concentrating
in low or enclosed areas. Vapors that are lighter than air (less than 1.0) will rise in air and
tend to dissipate, unless they are confined. The vapor densities of the products being used
should be considered in the design and operation of workplace ventilation systems.
Flammable vapors that are heavier than air can spread to sources of ignition and flash back
to the source. ·

Evaporation Rate is the rate at which a substance evaporates compared to butyl acetate
(designated as 1.0). Evaporation rates greater than 3 (acetone, 5.6) are considered fast; rates
between 0.8 and 3 (ethyl alcohol, 1.4) are moderate; and rates below 0.8 (water, 0.3) are
slow. Evaporation rates are a better indicator of potential inhalation hazards than vapor
pressures.

65
Solublllty In Water is a term indicating the percent by weight of a substance that can be
dissolved in water. Solubility is expressed as:

less than 0.1 percent,


0.1 to 1 percent,
1 to 10 percent,
more than 10 percent, and
freely soluble.

This information is helpful in selecting cleanup procedures following a spill or in fighting


fires involving a specific substance.

Appearance and Odor should accurately describe the product including color, physical
state (powder, liquid, gas) and odor. ff the description does not match, the product may
have decomposed, become contaminated or been mislabeled.

Section IV - l"lr11 arid l!xplNlon Hazard Data


F........... LimH LEL UEL
2.6, u.n
Foa,a,. dry cftea1cal, carHn C1iox1ae: Wilt.er spray 11i1y N used t.a cool f.tre ••pasecl cant.atners.
Special Fie Figlllint ~
For fir•f1qht.inq. use • self-cont..ained breat.h1oq •ppar11t.u1 ,dth .a tul.l !.1c• p1ec:e operat.ed 1n ,1

poatt.t.ve prHaiar• Mde.


Unulual Fl,. and EIPIOSiDn HcMla
V,1.pors are heavier t.h.an air .and c.n spread t.o a distant. 1gn1t.1on sourc• and fl.ash back.

This section provides information and recommendations for fighting fires concerning
substances that will bum or contribute to the burning of other materials. The fact 'mat a
product does not pose a fire or explosive hazard should also be noted in this section.

Flash Point is the lowest temperature at which a flammable liquid gives off enough
vapor to ignite in air. The lower the flash point, the greater the danger of combustion. A
material should not be stored or handled at temperatures above its flash point without
special precautions.

Flammable Limits indicate the range of percentages of a substance in air that will burn.
Below the lower limit there is not enough substance (or fuel). Above the upper limit there is
not enough air.
Extinguishing Media lists any method that should be used in the event of a fire.
Options are usually water, foam or dry chemical extinguishers designed for specific types
of fire: Class A - combustibles {e.g., wood); Class B - flammables {e.g., gasoline);
Class C - electrical; and Class D - metal and metal alloys.

Special Fire Fighting Procedures provide protective equipment recommendations.

Unusual Fire and Explosion Hazards are any properties of a product that affect fire
fighting effons. Water, for example, should not be used on fires involving concentrated
corrosives, calcium carbide or reactive metals such as sodium.

S.Ctlon V - Reactlvhy Data


Slabitrty Unstable Condibons to Avad
X H@at. sunllqht. prolonqed cont,c:t with air
Stable
Tmaperatures above 90 • F
l11C0""'8libol1ty /M-U IOAl!Oid/
Water and oxiditJ.nq .aqe-nts such as chlcr1ne, p-@rM.al'lqu1at.e- and dicriromaite-
Hazardous Oeco"l'0$il101\ or Bypr0due1S
Toxic q..tse-s anct vapors .such .t.s carbon monoxide
Hazardous May Occur !
CcndillDI\S to Avoid
Potymeuzatcn X Heat~ 11qnt and ao not. remove inhibit.or
Wih Not Oca,r

Many substances will change, sometimes violently, when mixed with other materials or
when exposed to physical conditions such as moisture, heat or sunlight. This section
indicates whether a product has special storage requirements.

Stability is the tendency of a substance to remain unchanged. A substance is considered


stable if it does not require any special storage or handling requirements. Unstable products
can vary in severity from shock-sensitive explosives to substances that will spoil if not kept
dry or refrigerated. Specific conditions to avoid will be listed. ·

Incompatibility identifies materials known to react chemically with the product. Toxic
fumes or other hazardous chemicals may be released or fire hazards created by chemical
reaction. Materials listed here should be stored separately.

Hazardous Decomposition or Byproducts describes the substances released if the


product is involved in a fire or reacts with the materials or conditions listed in the Stability
and Incompatibility sections.

Hazardous Polymerization is a chemical chain reaction that releases large amounts of


energy very rapidly, resulting in fires, explosions or ruptured containers. This section states
whether hazardous polymerization will occur and under what circumstances.

67
dllliD••!, n•uut, iDS99£diMtion, 1111 Pf 1 M!Sb, fl:ftliDIII t 11d NY r11Mlt in set IDbtltSiPD If ln
cancntradon• over a lon9 period My caun irdudon of ti,. rHP1rat.ory 'tract, coul)bift9 and uadadl•.
Skln-prolon9ecl or repoat•d contact MY cauH dry1nq of okin, r - a a . irritation and J.ncr••- doll of
Iniectlon. Vapors NJ eau1• aye irritation. ln.. ,t~on .,.Yea.Ya• lrrlt~tlon of th• Gi ~ract.

NTP?
No

Sign& and S:,mplam ol E,ipaaul9


£.ye irrit.at.iori,. headache~ dit.rin•••• naua•a and drov1in•••

MedcalCondiliOM
O-alyAggra¥111adbyE1pOSUn1 Penons with liver or kidney diauH ahould chack with their physician before

Erneigonc:y and Firsr A,,11 Pl'OCtldUNIS ty•• - fluth with water for IS llinutea. Skin - r••ovo contall111&tod clothint,
fli&Sh ti1ith pl•nt.y pf water. lnh&lf\iOn - r.-OVe t.O fresh air, giv• OAY91!'.! 01' lrt.ffiCifl refpiQ\iOftc if
nece,,ary. lnte•tion - ••ell IU<lical attention or contact nearest poison control enter. ln all.,. ..,, •••k
Mdlcal atunUon. if necesury.

The health hazards presented by a specific product depend on the chemical and physical
propenies of the product components and the manner in which if is used. When used
properly, even highly toxic substances present little risk. When used improperly, even
substances with very low toxicities can be dangerous. This section describes the ways in
which the product can enter the body, adverse health effects, symptoms of exposure and
what to do in an emergency.

Route(s) of Entry
Chemicals can enter the body through the lungs by inhalation, through the skin or eyes
by direct contact or elevated airborne concentrations and through the mouth by ingestion.
An MSDS should indicate what routes of entty may contribute to exposure.

lnhalation is the primary route of exposure to chemicals in the workplace. Most


exposure limits are based upon inhalation exposure. Ventilation systems should be
designed to keep concentrations of product components in workplace air below any
applicable exposure limits. If ventilation is not sufficient, respirators should be used to
limit exposure. Ventilation and protective equipment recommendations should be listed
under Section VIII - Control Measures.
Skin contact is also a common route of workplace exposure. Many solvents will
penetrate the. skin and enter the blood stream. Some chemical vapors can be absorbed
from the air through the eyes or the linings of the nose, mouth and throat. Exposure .
limits for these chemicals may indicate skin absorption. Other chemicals, such as strong
acids and caustics, can cause severe and sometimes irreversible damage to the skin or
eyes on contact. Section VITI should also provide recommendations for protective
clothing and equipment to limit exposure.
Ingestion is not usually an expected route of exposure in an occupational setting.
However, eating or storing foods, and drinking or smoking in contaminated work areas
can pass chemicals into the mouth. Even licking a finger to turn a page can contribute to
exposure. The amounts ingested are usually very small, but a substance that is highly
toxic or that concentrates in the body over rime can cause serious harm. Ingestion
exposures can be controlled by keeping the work area clean, washing hands before
breaks and eating, drinking and smoking in areas separate from the work area.

Health Hazards
This section lists all adverse health effects known or expected to occur as a result of
overexposure to the product or its components. The description of health hazards must
include the specific parts of the body that can be affected (lungs, nervous system, skin, etc.).
Exposure hazards are classified in two ways:

Acute health hazards are the effects of brief exposures to a substance, usually as a result
of an accident, leak or spill. The resulting effects usually appear quickly. Many acute
effects are reversible and will disappear soon after exposure stops. However, depending
on the substance and the level of exposure, the effects of acute exposures can vary
greatly in severity from minor irritation to death.
Chronic health hazards are the effects of repeated exposures to a substance. The effects
of chronic exposures develop over a long period of time and are usually not reversible.
Lung disease resulting from prolonged exposure to dusts and adverse reproductive
effects are examples of chronic health hazards.

Carcinogenicity
Product components determined to be carcinogens (cancer-causing) by OSHA, the
National Toxicology Program (NTP) or the International Agency for Research on Cancer
(IARC) must be identified. On some MSDS's, this information may be included under
Section II - Hazardous Ingredients.

Signs and Symptoms of Exposure


This section should list effects to watch out for when working with the product. Many
substances produce mild symptoms, such as eye irritation, headache or dizziness, that may
serve as a warning before more serious health effects develop.

69
Medical Conditions Aggravated by Exposure
Chemical exposures can make an existing health problem worse. For example. the
effect of carbon monoxide or carbon dioxide on the heart can be dangerous for individuals
with heart conditions. Some health problems can interfere with the body's ability to deal
with chemical exposures. Individuals with diseases of the liver or kidneys may be more
sensitive to organic solvents.

Emergency and First Aid Procedures


This section lists general instructions for each route of exposure such as "move victim
to fresh air" for inhalation and "flush affected area with plenty of water" for skin. In most
cases, if someone needs first aid they should get prompt medical attention to determine
whether additional treatment is necessary.

Section VII - Precautions for Sale Handling and Use


Steos to Be Ta•en ,n Case Material Is Re<- 01 Sp1lle0
~o::!y a:: oe:~c~~el ot :ar:e s~i:ls or lea~s. ~e~ove a:. io~rccs o! !~ni:_=~- ~eaci~q ?rooer protec~~ve

Waste Disposal Metnoo


Do ~o: f!ush oow~ s•nit•ry sewers. For sm•l! soills, i~ei~•r•tion is ~he ~re!er~P.a method. Very •mall •Nounts
m•y oe •bsor~ed •nd !et: to ev•por•te. For l•rqe spills, considet recl•~minq or cont•ct • licensed dispos•l
cor.,,p,ar:y.

Precaunonst0BeTaMn1n~andlingandStonng Stor•qe ~u·•• shoul'CS be cool ano vel.: ventil•ted aw.ay from he.at,
oxidizinq aqe~~s and direct sunliqnt, Containers snould DP kcrt tiqhtly Closed •nd kept free froffl d•m•qe.
£iectrlcai o~tlets snould be cxp~osior. proof.

01ne, Precauuons

Steps to Be Taken in Case Material is Released or Spilled provides detailed


instructions on what to do in the event of an accident or emergency, including: limiting
access to the area, selection of protective clothing and equipment, selection of materials to
use to contain or absorb the spill, proper cleanup techniques, recommended waste containers
and decontamination methods. Large spills may require different procedures than small
ones.

Waste Disposal Method often states simply that the material should be disposed of
according to city, state and federal regulations. Available methods can vary from location
to location and may depend on what cleanup procedures are used. Many materials can be
disposed of with normal trash if they are properly treated. Other materials must be specially
packaged and treated as hazardous waste.

Precautions to Be Taken in Handling and Storing describes how the product should
be used or stored considering the information found under Section V - Reactivity.

10
Other Precautions include any special training or equipment necessary to use the
product in a safe manner.

Secllon VIII - Control Measures


Re&ptratory Protecoo-n (Spsciy TypsJ for emerqeancy or non-routinr eaposurrs., ua• an epprov•d ch...,lcal cartridge or
canist.er qas mask {up to 5,,000 ppftll or sel!-contained respirator wlfull face piece (up to 20,,000 pp-.).

Yu Exclosion-proof ventilation
Mechancal /Gent,ra/J
Yu
Pn:IIIICIIYll Gloves
.Butyl rubber or natural rubber
I Eye Pr01ea,on
Safety qlaues
Olher Pr018C1NB Clothing or Equ~meotSoots, apro:ir face shield and respirator ,u:y ~ necessary to prevent e•po2ure ~
Slnlts, shower, and eye"'esh ttation.t should Q:e readily available,
Won<!Hyg-lC P,acr,ces
Launder contaminated clothing be!Ot.'11! reuse.

This section provides manufacturer's recommendations to limit exposure including


respirator selection, engineering controls, protective equipment and work practices.

Respiratory Protection should identify respirators approved for use with the product
or its components. Depending on exposure levels, several options may be given. Generally,
exposures should be controlled through ventilation and engineering controls. If respirators
are used, employees must be trained in proper respirator use and maintenance.

Ventilation will indicate whether normal room ventilation is sufficient in a work area or
that additional engineering controls may be required including local exhaust fans, fume
hoods or enclosed systems. Work area ventilation should be evaluated by an industrial
hygienist to determine what modifications or changes in work practices are necessary.

Protective Gloves should identify specific materials (butyl rubber, nitrite, PVC, etc.)
recommended for use with the product and its components. Simply specifying "impervious
gloves" is not enough. Chemicals can pass through or dissolve the wrong type of glove and
may make skin exposures worse by keeping the chemical in contact with the skin.

Eye Protection should be worn whenever a splash hazard exists. Safety glasses,
chemical goggles or face shields may be indicated.

Other Protective Clothing or Equipment may include· such items as eye wash
stations, splash-proof aprons or boots and temperature resistant gloves.

7/
RYS BMS-DZDT AWAREIIBSS COURSE
Student Workbook

What are some examples of products found in or around an


emergency medical service that may need a MSDS? Well a few
that come to mind are: oxygen, hydrogen peroxide, ammonia
solution for infection control, mannequin cleaner, and
electrode gel. Can you think of any others? Try a walk
through the station and make a list of additional chemicals
you find.
Training programs for employees can vary greatly in
content depending on your job. Each program should include
at least the following:
1. A discussion of the requirements of the HCS and the steps
your employer has taken to comply.
2. Instruction in how to read and interpret the
information provided on container labels and MSDSs.
3. Identification of operations in the work area where
hazardous chemicals are used, stored or produced.
4. Information on how to detect the presence or release
of hazardous chemicals.
5. Detailed discussion of the MSDS for each product you use.
6. Instruction on the selection and pro~er use of
respirators and other protective equipment, if required
due to the chemicals used in the work environment.

Herbicide case study

During the course you will watch a case story


reenactment of a herbicide poisoning which occured at a large
nursery. Could this happen in your district or neighboring
mutual aid districts? Was the response overkill? What
would happen in your district? Has your employer develo~ed
an Emergency Response Plan? What is your agency's role in
the plan?

Field Stabilization & Treatment of Decontaminated Patients

This EMS Hazmat Awareness course is clearly designed for


EMS providers who may be treating patients who are already
decontaminated. However, it is helpful to understand about
field stabilization and what the decontamination corridor
consists of to be prepared to properly treat patients in the
cold zone.
one might naturally ask how is hazardous material
harmful to people? There are four basic ways in which a
hazardous substance gets into a person's bod¥. They are
absorption, inhalation, ingestion and injection. Absorption
is the entry of chemicals through the skin or open cuts or

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NYS EMS-HAZMAT AWARENESS COURSE
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abrasions. Inhalation is the most rapid route of entry by


breathing in the chemical powder or vapor which introduces
toxic chemicals to respiratory tissues and the bloodstream.
In the blood chemicals are transported throughout the body
and accumulate in target organs. Ingestion is the entry
into the digestive system. Although most of us could not
picture a person being spoon fed toxic chemicals, the
materials can get into ¥our mouth through hand to mouth
contact or coughing up inhaled particulate material and then
swallowing the material. Injection is the entry of
chemicals into the bloodstream. This usually occurs by a
puncture wound from stepping or brushing up against a sharp
object.
How might the assessment of hazmat victims be different
than non-exposed patients? Exposure to solvents may cause a
patient to act intoxicated. Burns may be present as well as
respiratory distress from severe inhalation burns. An
example would be a patient who has inhaled chlorine gas which
can combine with the water or humidity in the respiratory
track to produce hydrochloric acid.
How might the management of hazmat victims be different
than non-exposed patients? Water soluble chemicals can
cause rapid swelling of upper airways. Endotracheal
intubation may be needed to properly secure the airway so if
ALS is available, call for them to assist you.
Hydrocarbons may alter the ventricular fibrillation
threshold of the heart. This threshold is the amount of
electrical energy required to generate an impulse that can
throw the ECG into ventricular fibrillation. As you know
from your EMS training, v-fib is synonymous with cardiac
arrest. This makes the heart very sensitive to medications
used to treat hypertension, bradycardia, and bronchospasm.
Why should there be early physician contact with either
medical control or poison center when treating patients at a
hazardous materials incident? First of all hazmat incidents
produce patients with injuires that are often unfamiliar to
even the most experienced EMT in your service. For ALS
providers the medications given to the patient may need to
have altered doses depending on the chemicals to which the
patient has been exposed. The triage criteria may vary
somewhat based upon the salvagibility of patients exposed to
specific chemicals. The poison control center will have more
information on the appropriate treatment of an exposed
patient to assist the EMTs and Medics on the scene. For the
phone number of the poison control center review the latest
copy of the NY Statewide Adult & Pediatric BLS Treatment
Protocols.
Since we are never really sure if 100% decon has
occurred what does Jonathan Borak, MD, the expert on the

Page 73
NYS BMS-BAZIIA'l' AWARBDSS COURSE
student Workbook

videota~e, suggest EMTs wear at all hazmat incidents? The


appropriate personal protective gear for EMTs at a hazmat
incident for the cold zone if you will be treatin9 patients
that are already decontaminated is a Tyvek jumpsuit and
double vinyl or latex gloves. Respiratory protection is not
needed for treating decontaminated patients provided the cold
zone has been appropriately situated far enough away from the
incident.
What antidotes do we carry? The universal antidote for
low oxygen environments is oxygen which we carry on all
ambulances. Water is helpful for rinsing burns off. ALS
personnel carry the medication Atropine for symptomatic
bradycardia and asystole. Atropine is also helpful as an
antidote for insecticides, although the dosage is different
than typically given for other medical problems. Some
antidotes are too dangerous for ambulances to carry. For
example the cyanide antidote can cause hemoglobin that does
not carry oxygen if not administered properly.
When planning for a hazmat in your community, evaluate
the substances used in fixed facilities and the need to carry
special equipment and antidotes with the advisement of your
service Medical Director.

The Stages of Decontamination

The decontamination corridor presented in the diagram on


the next page is only a sample as there are different
techniques to accomplish this principle. The basic ~rinciple
is to complete the decontamination process entirely in the
warm zone so that the person being decontaminated would step
from the hot zone into the corridor and proceed in one
direction through the corridor. The final step out of the
corridor is into the cold zone. Note the clear separations
between the hot, warm and cold zones in the diagram. The
nine stations of the decontamination corridor are described.
1. Single entry/exit point to the hot zone. Tools are
dropped here. As much contaminants as can possibly be
removed mechanically is done.
2. Gross decontamination is done by showering and
scrubbing team members. The scrubbers are always in the
appropriate personal protective clothing for the
chemicals involved.
3. Protective clothing is removed and bagged.
4. SCBA removal.
5. Personal clothing is removed and bagged.
6. Body washing with a mild soap.
7. Dry off team members and issue hospital gowns or scrubs.
8. Medical monitoring and assessment of all team members
and patients. consult with Medical Control and Poison

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NYS EMS-HAZKA'l' AWARBDSS COURSE
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Control as needed.
9. Transport of patients and team members for definitive
care as is necessary.
The role of the EMT with only EMS Hazmat Awareness
training is in the cold zone. EMTs in the warm zone will
require additional training above the awareness level.
SAMPLE
DECONTAMINATION CORRIDOR
.J-
0 Equipment Drop

...
... ~ Gross Decontamination
Hot Zone • \..:..J
I============+;::::=:====~====~
Warm Zone /.::-...
/ 5 '- ,,,(J) Protective Clot1ing Removal
*Medical Redress .,,, .,,, .J-
Monitoring .,,,
of Vital Signs ~ © SCBA Removal
by EMT in Tank Change .J-
Protective
Clothing @ Personal Clothing Removal
...
© Body Washing
...
(]) Dry Off & Dress in Scrubs
Warm Zone

Cold Zone
Medical Monitoring:
Assessment of Patients
· & Post-Suit Exam
Transport For Definitive Care
(As Needed}

* NOTE: Additional training beyond the


HAZMAT Awareness Level
is required for EMTs in the Warm Zone

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BYS BIIS-BAZJIA'l' AlrARBNBSS COURSE
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Protective Clothing

There are at least four levels of protective clothing.


since this course is focused at the awareness level, we do
not discuss the specific types of suits used by Hazmat Teams.
It is useful to note that all levels of protection are
evaluated in terms of three forms of chemical intrusion:
degradation, penetration and permeation.
Degradation is the loss in beneficial properties caused
by exposing gloves, protective clothing, and other
elastomeric samples to various liquid chemicals. Penetration
is the flow of hazardous materials through zippers, stitched
seams, and iores or other imperfections in clothing material.
Permeation is the process of chemicals moving through
protective clothing at the molecular level. The process
consists of absorption of molecules of liquid into the
outside surface of the material, diffusion of absorbed
molecules through the material and then desorption of the
molecules of liquid out of the inside surface of the
material.
When response activities are conducted where atmospheric
contamination is known or suspected to exist, personal
protective equipment (PPE) is designed to prevent or reduce
skin and eye contact as well as inhalation or in~estion of
the chemical substance. Proper training is required to
assess the need for and appropriate level of protection to be
used. The EMS Hazmat Awareness course does not specifically
prepare students to make these decisions. The levels of
protections are discussed here so students can be informed
about them. Selection of appropriate materials and the use
of Level A, B, C PPE requires specific training.
Level A
Level A protection should be worn when the highest level
of respiratory, skin, eye and mucous membrane protection is
used. Level A personal protective equipment includes the
following:
1. Positive-pressure (pressure demand), self-contained
breathing apparatus (SCBA).
2. Fully-encapsulated chemical resistant suit.
3. Gloves, inner chemical resistant.
4. Gloves, outer, chemical resistant.
5. Boots, chemical resistant, steel toe and shank;
(depending on suit construction, worn over or under suit
boot).
6. Two-way.radio communications (intrinsically safe).
7. Hardhat (under suit).

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NYS EMS-HAZMAT AWARENESS COURSE
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Level B
Level B protection should be worn when the highest level
of respiratory protection is needed but a lesser level of
skin and eye protection. Level B protection is the minimum
level recommended on initial site entries until the hazards
have been further identified and defined by monitoring,
sampling and other reliable methods of analysis. Level B PPE
includes the following:
1. Positive-pressure (pressure demand), self-contained
breathing apparatus (SCBA).
2. Chemical resistant clothing (overalls and long-
sleeved jacket, coveralls, hooded two piece chemical
splash suit, disposable chemical resistant coveralls).
3. Gloves, inner, chemical resistant.
4. Gloves, outer, chemical resistant.
5. Boots, chemical resistant, steel toe and shank.
6. Two-way radio communications (intrinsically safe).
7. Hardhat (under suit).
Level C
Level C protection should be selected when the type of
airborne substance is known, the concentration has been
measured, criteria for respiratory protection are met and
skin and eye exposure are unlikely. Periodic monitoring of
the air must be performed. Level C is commonly found at work
sites as routine protection being worn. It is rarely
appropriate during a hazardous materials incident. Level C
PPE includes the following:
1. Positive-pressure (pressure demand), self-contained
breathing apparatus (SCBA).
2. Chemical resistant clothing (one piece coverall,
hooded two piece chemical splash suit, chemical resistant
hood and apron, disposable chemical resistant coveralls).
3. Gloves, outer, chemical resistant.
4. Boots, inner, chemical resistant, steel toe and shank.
5. Two-way radio communications (intrinsically safe).
6. Hardhat (under suit).
The chart on the next page is a good illustration of why
different chemicals require different protective suits to be
worn.

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IIYS BNS-DZD'l' ADJtBlfBSS COUUJI
Student Worlmook

Butyl Polyvinyl Natural


Generic Class Rubber Chloride Neoprene Rubber
Alcohols,
Organic acids,
Inorganic bases E E E E
and salts
Ethers, natural
fats and oils G-F G E-G G-F
Aldehydes E-G G-F E-G E-F
------~-----------------------------------------------------
Amines E-F G-F E-G G-F
Esters G-F p G F-P
Fuels F-P G-P E-G F-P
Halogenated
hydrocarbons G-P G-P G-F F-P
Hydrocarbons F-P F G-F F-P
Inorganic acids G-F E E-G F-P
Ketones E p G-F E-F
E=Excellent G=Good P=Fair P=Poor

Medical Monitoring, Documentation

The specific requirements of the OSHA regulation


concerning medical monitoring appear below:
Paragraph Q - EMERGENCY RESPONSE TO HAZARDOUS SUBSTANCE
RELEASES
(9) Medical surveillance and consultation.
(i) Members of an organized and designated HAZMAT team and
hazardous materials specialists shall receive a baseline
physical examination and be provided with medical
surveillance as required in paragraph (f) of this
section.
ii) Any emergency response employees who exhibit signs or
symptoms which may have resulted from exposure to
hazardous substances during the course of an emergency
incident, either immediately or subsequently, shall be
provided with medical consultation as required in
paragraph (f) (3) (ii) of this section.

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In rour role as the EMS personnel providing care to


decontaminated patients in the cold zone you may be asked to
assist in medical monitoring. Any EMS personnel involved in
medical monitoring or medical treatment situated in the warm
zone needs additional training beyond this course and will
need to wear the appropriate level of PPE.
so you may ask "what activities can be done by EMTs and
Paramedics in the cold zone?" The following is a list of
responsibilities that may be done by EMS personnel within the
action plan prepared by incident command.
Advise the Hazmat Team members of the specific dangers
of exposure and any early signs and symptoms of exposure to
the chemical they are planning to contain. Make sure the
Hazmat Team is well informed of the signs and symptoms of
dehydration and heat exhaustion from wearing the encapsulated
suit. It is helpful to encourage team members to drink
plenty of water prior to suiting up. It is easy to become
dehydrated from fluid loss in an encapsulated suit.
Prior to team members suiting up, EMS personnel should
conduct a pre-suit medical exam including: respiration,
pulse, BP, mental status, ECG, motor skills, hydration
status, and weight of the team member. This means a portable
scale would be needed. We suggest the response team carry
this in their vehicle since it is not routinely used in the
field by EMS personnel.
The EMS personnel can assist the Safety Officer with
monitoring the team members via binoculars and/or radio for
central nervous srstem symptoms from exposure such as
clumsiness, disorientation or slurred speech and dizziness or
fatigue from overheating. Should any team member appear
disorientated, both the team member and his partner must exit
the incident and report to the decontamination corridor
immediately.
EMS personnel can conduct a medical assessment in
Station# 8 of the decontamination corridor which is clearly
located in the cold zone. Consult with Medical Control or
Poison Control as needed on treatment of the decontaminated
patients. A post-suit medical exam including: respiration,
pulse, BP, mental status, ECG, motor skills, hydration
status, and weight of the team member should be conducted and
well documented. Advise the team members to seek followup
examination with the Medical Director.
Be sure to document all examinations you conduct on a
PCR for potential future compensation cases and/or lawsuits.
Another medical consideration that should be given some
thought is encouraging team members to keep a log of all
calls where exposure has occurred and the follow-up that was
taken.

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The best programs provide for pre-employment, post-exposure


and termination of employment physical exams that include
extensive blood analfsis, urinalysis, chest x-rays, and
cardiopulmonary testing.

Post Incident considerations

The OSHA requirements are as follows:


Paragraph Q - EMERGENCY RESPONSE TO HAZARDOUS SUBSTANCE
RELEASES
(11) Post-emergency response operations. Upon completion of
the emergency response, it is determined that it is
necessary to remove hazardous substances, health
hazards, and materials contaminated with them from the
site of the incident, the employer conductin~ the
clean-up shall comply with one of the following:
(i) Where the clean-up is done on plant property using plant
or workplace employees, such employees shall have
completed the training requirements of the following: 29
CFR 1910.38(a); 1910.134; 1910.1200, and other
appropriate safety and health training made necessary by
the tasks that they are expected to perform such as
personal protective equipment and decontamination
procedures. All equipment to be used in the performance
of the clean-up work shall be in serviceable condition
and shall have been inspected prior to use.
In respect to a post incident critique this should be
conducted to discuss and review at least the following
aspects of the response in a non-threatening manner:
1. Areas of strongest ~erformance.
2. Areas needing additional work.
3. Additional personnel and equipment needed next time. ·
4. Items transported which were unnecessary.
5. Restocking requirements.
6. Assess need for a Critical Incident Stress Debriefing.

Annual Refresher Requirements

The OSHA regulation addresses annual refresher


requirements in the following way:
OSHA 29 CFR Part 1910.120 Paragraph Q
(8) Refresher training.
{i) Those employees who are trained in accordance with

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paragraph (q) (6) of this section shall receive annual


refresher training of sufficient content and duration to
maintain their competencies, or shall demonstrate
competency in those areas at least yearly.
( ii) A statement shall be made of the training or
competency, and if a statement of competency is made,
the employer shall keep a record of the methodology
used to demonstrate competency.
To accomplish this requirement we recommend that each
year the competencies in this course be reviewed with EMS
personnel. By offering a quiz that tests knowledge on each
of the competencies upfront the instructor can mold the
course to fit the demonstrated needs of the students. This
may range from one to six hours to complete depending on the
students. It is the responsibility of the employer to
maintain records that the training was conducted for each
employee each year. This can be done by placing a synopsis
of the curriculum covered, dates and times, who covered it
and the student's examination results as well as a copy of
the completion certificate issued in each employee's file.

PostQuiz & course Evaluation

All students must complete and pass with at least a 70%


(minimum competency) on the post course quiz. To be eligible
to take the post-quiz each student must attend all portions
of the course. Students attending the course as a refresher
may have attendance at sections of the course waived based
upon successful demonstration of competency (80%) on the pre-
quiz.
To help the instructor as well as the authors of this
course evaluate the program each student is asked to complete
a student course evaluation form. It is not necessary to put
your name on these forms should you desire your comments to
remain anonymous. We strongly encourage you to write
comments about the course and your instructor's ability to
present the material that are contructive feedback. The
evaluations are collected by the instructor, read over and
returned by the course sponsor to the NYS EMS Program.
In exchange for a completed evaluation, provided the
student has demonstrated minimum competency on the post-quiz,
they will be issued a course completion certificate. Should
a student fail the written exam, they should be encouraged to
study the student workbook and then retake the quiz.

Page 81
New York State SECTION D
Department of Health
Emergency Appendix:

Glossary

Medical References
BLS Protocol
Agencies for
Special Assistance
Services
Program

HAZMAT AWARENESS
·~ Continuing Educati.on Course for EMS Providers"

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Appendix: Glossary of Terms

Absorption - to take up or soak up a liquid and retain it.


Absorption names the taking up of liquids into the body.
Absorption also also names the process b1 which liquid
hazardous materials are soaked up to limit the spread of
contamination.
Accident - an unexpected event generally resulting in injury,
loss of property, or disruption of service.
Acute exposure - a dose that is delivered to the body in a
single event or in a short period of time.
Air purification devices - respirators or filtration devices
which remove particulate matter, gases, or vapors from the
atmosphere. These devices range from full face piece, dual
cartridge masks with eye protection, to half-mask, face piece
mounted cartridges with no eye protection.
Air reactive materials - substances with very low
autoignition temperatures.
Air supply devices - respirators that provide compressed air,
at pressures that are greater than atmospheric pressure, to a
face mask which is worn by a rescuer.
Allocated Resources - resources dispatched to an incident
that have not yet checked in with the Incident Communications
Center.
Alkali - a substance that is basic and has the ability to
neutralize an acid and form a salt.
Assigned Resources - resources checked in and assigned work
tasks on an incident.
Autoignition temperature - the lowest temperature at which a
flammable gas or vapor air mixture will ignite from its own
heat source or a contacted heated surface without necessity
of spark or flame.
Availat,le Resources - resources assigned to an incident and
available for an assignment.
Base - that location at which the primary logistics functions
are coordinated and administered (Incident name or other
designator will be added to the term base). The Incident
Command Post may be co-located with the base. There is only
one base per incident.
Boiling point - the temperature at which liquid changes ats
phase to a vapor or gas; the temperature where the pressure

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of the liquid equals atmospheric pressure.


Branch - that organizational level having functional/
geogra~hical responsibility for major segments of incident
operations. The Branch level is organizational between
section and division/groups.
Breach - an opening in a hazardous materials container
through which hazardous material matter can escape.
caustic - substance that strongly irritates, burns, corrodes,
or destroys living tissues.
CERCLA - the comprehensive environmental response
compensation and liability act of 1980, also known as the
Superfund.
Chemical degradation - the altering of the chemical structure
of a hazardous material during the process of
decontamination.
Chemical protective clothing - clothing specifically designed
to protect the skin and eyes from direct chemical contact.
The two types are nonencapsulating and encapsulating.
Chemical resistance - the ability of chemical protective
clothing to maintain its integrity and protection qualities
when it comes into contact with a hazardous material.
Chief - res title for individuals responsible for command of
the functional sections i.e. operations, planning, logistics,
and finance.
Chronic exposure - low doses repeatedly received by the body
over a long period of time.
Cold Zone - the uncontaminated area surrounding a hazardous
materials incident location, where personnel should not be
exposed to hazardous conditions.
Colorimetric tubes - devices that are used to determine the
presence and approximate concentration of chemicals that
might be found in the atmosphere to be tested.
Combustible gas indicators - devices that measure the air
concentration of a flammable gas or vapor for which the
indicator has been specifically calibrated.
Combustible liquid - any liquid that has a flash point at or
above 100 degrees F (37.7 degrees C) and below 200 degrees F
(93.3 degrees C).
command Officer - an officer who is not a part of the
staffing of a single resource.

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Command Post (CP)- that location at which primary command


functions are executed, usually co-located within the
incident base.
Command Staff - the command staff consists of the safety
officer, liason officer and information officer who report
directly to the Incident Commander.
Command - the act of directin9, ordering, and/or controlling
resources by virtue of explicit legal, agency or delegated
authority.
Communications Officer - the communications officer is
responsible to establish and maintain contact with the E.O.C.
~rovide communications needs of all sectors and relay
information between the E.O.C. and the operations officers.
Company Commander - the individual responsible for command of
a company. This designation is not specific to any
particular fire department rank (may be firefighter,
lieutenant, captain or chief officer, if responsible for
command of a single company).
Company - a ground vehicle providing specified equipment
capability and personnel (engine company, truck company,
rescue company, etc.).
Compatal::>ility chart - a chart that rates the strengths of a
protective clothing material against exposure to specified
chemicals.
confinement - those procedures taken to keep a material in a
defined or loacl area.
Contamination - the presence of hazardous material in an
unwanted location.
Coordination - the process of systematically analyzing a
situation, developing relevant information, and informing·
appropriate command authority (for its decision) of viable
alternatives for selection of the most effective combination
of available resources to meet specific objectives. The
coordination process (which can be intra- or interagency)
does not, in and of itself, involve command dispatch actions.
However, personnel responsible for coordination may perform
command or dispatch functions within limits as established by
specific agency delegations, procedures, legal authority,
etc.
Corrosives - Substances which destroy the texture or
substance of tissues.
Debriefing - a post incident review that primarily focuses on
the adequacy of response plans and needs for systematic

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changes.
Decontamination - the process of removing or neutralizing
contaminants from personnel or equipment.
Degradation - the loss in beneficial properties caused by
exposing gloves, protective clothing, and other elastomeric
samples to various liquid chemicals.
Diking - application of a barrier which ~revents passage of a
hazardous material to an area where it will produce more
harm.
Dilution - the use of water to flush a hazardous material
from protective clothing and equipment.
Direct acting chemicals - chemicals that are able to cause
harm without first being transformed or changed.
Direct readini instruments - a portable device that measures
and displays in a short time period, the concentration of a
contaminant in the environment.
Director - ICS title for individuals responsible for command
of a branch.
Dispatch Center - a facilit¥ from which resources are
directly assigned to an incident.
Dispatch - the implementation of a command decision to move a
resource or resources from one place to another.
Diversion - controlled movement of a hazardous material to an
area where it will produce less harm.
Division - that organizational level having responsibility
for o~erations within a defined geographical area. The
division level is organizational between the single resource,
task force or strike team and the branch.
DOT - the Department of Transportation, the federal agency
which regulates the transportation of hazardous materials
also publishes aids for emergency response.
DOT Hazard Classification - the hazard class designations for
specific hazardous materials as found in DOT regulation.
DOT Emergency Response Guidebook - Department of
Transportation reference book which lists hazardous materials
and indicates health hazards and emergency actions.
Downwind - in the direction in which the wind is blowing,
unsafe in a hazardous materials incident.

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Durability - the ability of chemical protective clothing to


restrict tearing and punctures.
Emergency Medical services Coordinator - a ~erson delegated
by the County Health Department who is to aid and assist the
Medical O~erations Officer in promulgating his duties. May
also provide an additional command vehicle (not an
ambulance), act as a liaison between agencies, keep records,
coordinate multi-agency activities and evaluate operations at
each situation.
Engulfment - occurs when the hazardous material is released
and spreads out and disperses.
Environmental hazard - a condition capable of posing an
unreasonable risk to air, water, or soil quality, and to
plants and wildlife.
Enzyme poisons - chemicals that inhibit specific cellular
reactions by competing with or altering the enzymes necessary
to catalyze those reactions.
Evacuation - a prolonged precautionary stay away from an area
affected by a hazardous material.
Exothermic reactions - chemical reactions that produce heat.
Explosive - an¥ material that may suddenly and violently
release mechanical, chemical or nuclear energy.
Exposure - in the vicinity of, without making contact with, a
specific product. personnel may be exposed to a radioactive
substance by standing near an unshielded pile of radium dust.
They become contaminated when a gust of wind covers them with
the radium dust.
Extrication Unit Leader - a person responsible for the
supervision of the removal of entrapped victims.
Finance Section - responsible for all costs and financial
considerations of the incident. Includes the Time Unit,
Procurement Unit, Compensation/Claims Unit and the Cost Unit.
Flammable - easily ignited and capable of burning with great
rapidity.
Flammable (explosive) range - the range of gas or vapor
concentration (percentage by volume in air) that will burn or
explode if an ignition source is present. limiting
concentrations are commonly called the "lower explosive
limit" and the "upper explosive limit". Below the flammable
limit the mixture is too lean to burn; above the upper
flammable limit the mixture is too rich to burn.

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Flash point - the minimum temperature at which a liquid 9ives


off enough vapors to ignite and flash over, but not continue
to burn without the addition of more heat.
Fumes - fine particles of dust dispersed in air.
Gas - a state of matter distinguished by very low density,
the ability to diffuse rapidly, and a tendency to distribute
evenly throughout the container.
Grou~ - that or9anizational level having responsibility for a
specified functional assignment at an incident (triage,
treatment transportation).
Hazard Area - a geographically identifiable area in which a
specific hazard presents a potential threat to life and
property. (Inner perimeter)
Hazard communication Standard - 29 CFR Part 1910.1200 the
OSHA right to know standard which requires that employers
must develop a comprehensive program to inform em~loyees of
the hazards encountered in the workplace and provide training
in the safe use and handling of products containing hazardous
chemicals.
Hazardous Material Incident - an occurrence which causes the
release or potential release of a hazardous material into the
environment.
Hazardous Materials Response Unit - a team consisting of a
minimum of two members trained and equipped in the
identification, handling and transportation of hazardous
material.
Hazardous Material - any substance or material in a quantity
or form which poses an unreasonable risk to health, safety
and property when transported in commerce. [U.S. DOT]
Hazardous Material (Substance/Waste) - any substance thab
causes or may cause adverse affects on the health or safety
of employees, the general public, or the environment; any
biological agent and other disease-causing agent, or a waste
or combination of wastes. [NFPA 472]
Hazardous substance - any substance designated under the
Clean water Act and the Comprehensive Environmental Response
Compensation and Liability Act (CERCLA) as posing a threat to
waterways and the environment when released. [EPA]
Hazardous Waste - any waste or combination of wastes which
pose a substantial present or potential hazard to human
health or living organisms because such wastes are
nondegradable or persistent in nature, or because they can
biologically magnify or because they may otherwise cause or

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tend to cause detrimental cumulative effects. (EPA]


Hot zone - the area at a hazardous materials incident within
which contamination exists or could occur.
Hypergolic materials - materials that.i9nite spontaneously on
contact with one another without requiring a source of
ignition.
IDLH - immediate danger to life and health.
Ignition (autoignition) temperature - the minimum temperature
re911ired to ignite gas or vapor without a spark or flame
being present.
Impingement - occurs when the released hazardous materials
actually makes contact with people, objects, and things.
Incident Action Plan - the strategic goals, tactical
objectives and support requirements for the incident. All
incidents re911ire an action plan. For simple incidents the
action plan is not usually in written form. Large or complex
incidents will require that the action plan be documented in
writing.
Incident Command system - a system developed in California,
in response to the wildfires of the 1970s, to manage
personnel and equipment resources at a hazardous materials
incident.
Incident command Post - that location at which the primary
command functions of all executed and usually co-located
with the operations post.
Incident commander - the individual responsible for the
overall management of all incident operations.
Indirect acting chemicals - chemicals that must be
transformed before they can provoke injury.
Information Officer - responsible for interface with the
media or other appropriate agencies requiring information
direct from the incident scene. Member of the command staff.
Inner Perimeter - see hazard area.
Irritatin~ Material - a liquid or solid substance which upon
contact with fire or when exposed to air gives off dangerous
or intensely irritating fumes, but not including any
poisonous material, Class A.
Jurisdictional Agency - the agency having jurisdiction and
responsibility for a specific geographic area.

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Leader - ICS title for individuals responsible for command of


a crew, task force, strike team, or functional unit.
LBL - Lower explosive limit. Below the lower explosive limit
there is not enough vapor for a chemical to burn.
Liquid - a state of matter in which a product exhibits a
readiness to flow and little tendency to disperse.
Level A, B, c and D Personal Protection - the four categories
of personal protective clothing established by EPA which
provide different degrees of respiratory and body protection.
Liason Officer - the point of contact for assisting or
coordinating agencies. Member of the command staff.
Local Emergency (State definition) - in the event of
disaster, rioting, catastrophe, or similar public emergency
within the territorial limits of any county, city, town or
villa9e, or in the event of reasonable ap~rehension of
immediate danger thereof, and u~on a finding by the chief
executive thereof that the public safety is imperiled
thereby, such chief executive may proclaim a local state of
emergency within any part or all of the territorial limits of
such local government.
Logistics Section - Responsible for providing facilities,
services, and materials for the incident. Includes the
communications unit, medical unit and food units, within the
service branch and the supply unit, facilities unit and
ground support units, within the support branch.
Major Disaster (Federal definition) - any hurricane, tornado,
storm, flood, high-water, wind-driven water, tidal wave,
tsunami, earthquake, volcanic eruption, landslide, mudslide,
snowstorm, drought, fire, explosions, or other catastrophe in
any part of the United States which, in the determination of
the President, causes damage of sufficient severity and
magnitude to warrant major disaster assistance under the
Federal Disaster Relief Act, above and beyond emergency
services by the Federal Government, to supplement the efforts
and available resources of States, local 9overnments and
disaster relief organizations in alleviating the damage,
loss, hardship or suffering caused thereby.
Mists - liquid droplets dispersed in air.
Mitigation - actions taken to prevent or reduce the severity
of harm.
KSDS - Material Safety Data Sheet - a sheet required to be
furnished by every manufacturer of hazardous materials.
NFPA 472 - National Fire Protection Association standard for

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professional competence of responders to hazardous materials


incidents.
NFPA 473 - National Fire Protection Association standard for
competencies for EMS personnel responding to hazardous
materials incidents.
NFPA 704 - National Fire Protection Association
identification system for categorizing health, flammability
and reactivity hazard levels.
NIOSB - National Institute for Occupational Safety and
Health.
Officer - ICS title for the command staff positions of
safetr, liaison, and information. Also used when a single
individual performs a unit function within planning,
logistics or finance.
Operations section - responsible for all operations at the
incident. Includes up to 5 branches, 25 divisions or groups,
and 125 single resources, task forces, or strike teams.
organic Peroxide - an organic compound containing the
bivalent -o-o structure and which may be considered a
derivative of hydrogen peroxide where one or more of the
hydrogen atoms have been re~laced by organic radicals must be
classed as an organic peroxide.
OSHA - Occupational Safety and Health Administration.
Oxidizer - a highly reactive substance that may react with
other materials to generate heat or ignition. Oxidizers may
also accelerate fires to the point of explosion.
out-of-Service Resources - resources assigned to an incident
but unable to respond for mechanical, rest, or personnel
reasons.
outer Perimeter - traffic control points designated to limit
and control access to the incident area.
PCBs - Polychlorinated biphenyls. A carcinogenic substance
commonly found in underground wiring insulation and in
viscous cooling fluid used in older electrical transformers.
These transformers are frequently found on overhead
electrical poles, in underground vaults and in high rise
buildings.
PEL - permissible exposure limit: the maximum average
concentration averaged over 8 continuous hours to which 95%
of otherwise healthy adults can be repeatedly and safely
exposed for periods of 8 hours per day, 40 hours per week.

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Penetration - is the flow of hazardous materials through


zippers, stitched seams, and pores or other imperfections in
clothing material.
Permeation - process of chemicals moving through protective
clothin9 at the molecular level. The process consists of:
absorption of molecules of liquid into the outside surface of
the material, diffusion of absorbed molecules through the
material, and desorption of the molecules of liquid out of
the inside surface of the material.
pH - a measure of a substances's ability to react as an acid
(low pH) or as an alkali (high pH).
Plannin9 Section - responsible for the collection,
evaluation, dissenmination, and use of information about the
development of the incident and the status of resources.
Includes the situation status, resource status, documentation
and demobilization units as well as technical specialists.
Poison - any substance that causes injury, illness or death,
usually by chemical means.
PPM - parts per million. The unit of measurement for
particles of a contaminate within the ambient air.
Radiation meter - devices that detect the presence and
measure the quantity of radiation emitted by the decay of
radioactive substances.
Radioactive - any substance that emits potentially harmful
atomic energy. Atomic radiation is known to cause cancer,
birth defects and cell destruction.
Release - once a breach has occurred and the hazardous
materials enter the atmosphere and/or environment.
Resources - all personnel and major items of equipment
available, or potentially available, for assignment to
incident tasks on which status is maintained.
Right to Know - 29 CFR Part 1910.1200 the OSHA standard which
requires that employers must develop a comprehensive program
to inform employees of the hazards encountered in the
workplace and provide training in the safe use and handling
of products containing hazardous chemicals.
Route of Entry - one of four pathways for hazardous materials
to enter the body, i.e. inhalation, absorption, ingestion or
injection.
Safety Officer - responsible for monitoring and assessing
safety hazards or unsafe situations and developing measures
for ensuring personnel safety. Member of the command staff.

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SARA Tit1e III - Superfund Amendment and Reauthorization Act


requires health and safety regulations to be established for
hazardous waste site operations.
SCBA - self contained breathing apparatus, consisting of a
compressed air tank, regulator, connector hoses and mask.
Section - that organizational level having functional
responsibility for primary segments of incident operations,
such as: operations, planning, logistics, and finance. The
section level is organizational between branch and incident
commander.
Sing1e Resource - an individual company or crew.
Sloughing - the ~rocess by which necrotic cell separate from
the tissue to which they have been attached.
So1id - a product of greater density than liquids or gases.
Solids readil¥ disperse in powdered form, otherwise solids
display a minimal tendency to disperse.
Solubilitr - the ability of a solid, liquid, gas or vapor to
dissolve in a solvent; the ability of one material to blend
uniformly with another.
Solvent - a liquid substance capable of dissolving another
substance.
Spontaneous Combustible Materia1 - a material that is likely
to heat spontaneously under conditions normally incident to
transport or to heat up in contact with air and then is
likely to catch fire.
Sta~ing Area - that location where incident personnel and
equipment are assigned on an immediately available status.
state Disaster Emergency - means a period beginning with a
declaration b¥ the Governor that a disaster exists and enaing
upon the termination thereof. Once a state Disaster
declaration is made, the State assumes direction of the
incident response.
Strategic Goals - the overall ~lan that will be used to
control the incident. Strategic goals are broad in nature
and are achieved by the completion of tactical objectives.
Strike Team - five of the same kind and type of resources,
with common communications and a leader.
supervisor - res title for individuals responsible for
command of a division or a group.
Support Branch - a branch within the logistics section.

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Responsible for providing the personal, equipment and


supplies to support incident operations. Components include
the supply unit, facilities unit and ground support units.
Tactical unit - specified combination of the same kind and
type of resource, with a common communications and leader.
Task Force - a group of any type and kind of resources, with
common communications and a leader, temporarily assembled for
a specific mission, not to exceed five resources.
TLV/C - threashold limit value ceiling. the maximum
concentration to which a healthy adult can be exposed without
risk of injury.
Toxic - harmful, destructive or deadly.
Transportation Division - the organizational level having
responsibility, within a defined geographic area, for the
transport o·f patients to the hospital. This division level
is organizational between hospital communications, vehicle
loaders and the EMS branch.
Transportation Group - the organizational level having
responsibility for the specific assignment of patient
transportation.
Transportation Officer - the person responsible for the
transportation group activities.
Treatment Division - the organizational level having
responsibility for the treatment of patients within a defined
geographic area. This division level is organizational
between the patient care providers and the EMS branch.
Treatment Group - the organizational level having
responsibility for the specific assignment of patient
treatment.
Treatment Officer - the person responsible for the treatment
group activities.
Triage - the process of sorting sick or injured on the basis
of urgency and type of condition present, so that they can be
properlr treated, stabilized and routed to medical facilities
appropriately situated and equipped for their care.
Triage Area - located near the incident site where injured
persons are removed from the hazardous incident site for
medical priority sorting and life threatening condition are
stabilized prior to removal to the treatment area.
Triage Division - the organizational level having
responsibility for sorting of patients within a defined

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geographic area. This division level is organizational


between the triage team and the EMS branch.
Triage Group - the organizational level having responsibility
for the specific assignment of patient triage.
Triage Officer - the person responsible for the triage group
activities.
Triage Team. - up to five members who have the same kind and
type of resources, with common communications and a leader.
they will evaluate the condition of the patients.
Triage Unit Leader - that person who has been duly trained in
the procedures and techniques of evaluating for treatment the
victims involved in an emergency situation (usually the
attendant of the primary ambulance).
UEL - upper explosive limit. Above the upper explosive limit
the mixture of air and vapor is rich for a chemical to burn.
UN Number - United Nations Number which identifies and is
used to mark hazardous substances during transportation.
Upwind - away from the direction in which the wind is
blowing, the safe area in a hazardous materials incident.
Vapor density - the weight of a given volume of vapor or gas
compared to the weight of an equal volume of dry air, both
measured at the same temperature and pressure.
Vapor pressure - a measure of the tendency of a liquid to
vaporize into a gas.
Vapors - the gaseous form of substances which are normally in
the solid or liquid state at room temperature and pressure.
warm zone - the transition area between contaminated and
clean areas at a hazardous materials incident, where
decontamination takes place.
Water reactive materials - any substance that readily reacts
with or decomposes in the presence of water with substancial
energy release.
Water solubility - the quantity of chemical that will mix or
dissolve in water.
29 CFR 1910.120 - The OSHA regulation which establishes
training requirements and procedures to be followed during
hazardous waste site operations including emergency response
activities.

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Appendix: References
The following sources provide information on the topics in
this course:
American Academr of orthopedic Surgeons, 1991, Emergency~
and Transportation of the Sick and Injured. Fifth Edition,
Park Ridge, Illinois, AAOS.
American Academy of Orthopedic Surgeons, 1990, Basic Rescue
and Emergency care. First Edition, Park Ridge, IL, AAOS.
Borak, J., et al., 1991, Hazardous Materials Exposure
Emergency Response and Patient Care. Englewood Cliffs, NJ,
Prentice Hall, Inc.
Bronstein, A., currance, P., 1988, Emergency Care for
Hazardous Materials Exposure. st. Louis, MI, c.v. Mosby Co.
Caroline, N., 1991, Emergency Care in the Streets. Fourth
Edition, Boston, MA, Little, Brown and Co.
Emergency Handling of Hazardous Materials in Surface
Transportation, Washington, DC, Association of American
Railroads, 1981.
Emergency Response Guidebook, Washington, DC, US Department
of Transportation.
Grant, H., Murray, R., Bergeron, J., 1990, Emergency Care.
Fifth Edition, Englewood Cliffs, NJ, Prentice Hall, Inc.
Hafen, B., Karren, K., 1992, Prehospital Emergency Care and
Crisis Intervention. Fourth Edition, Englewood, co, Morton
Publishing Co.
Lefevre, M.J., First Aid Manual for Chemical Accidents. Van
Nostrand Reinhold, New York, NY 1980.
Lockert, E., et al, 1991, Emergency Medical Update, Volume 4,
Number 9, & Volume 5 Number 2, Lockart-Jackson Associates,
Winslow, WA.
Martin, H.F., ed., 1989, Hazardous Materials Response
Handbook. First Edition, Quincy, MA, National Fire Protection
Association.
Meyer, E., Chemistry of Hazardous Materials, Brady Books,
Englewood Cliffs, NJ, 1989.
Morgan, D.P., Recognition and Management of Pesticide
Poisonings. Washington, DC, US Environmental Protection
Agency, 1989.

Page 96
NYS EMS-HAZMAT AWARENESS COURSE
student Workbook

National Fire Protection Association standards: 472, 473,


1500, 704., Quincy, MA.
New Jersey Hazmat Emergency Response Course Level i
Awareness. New Jersey Hazardous Material Training Committee,
a program of the New Jersey/New York Hazardous Materials
Worker Training Center, 1991, Piscataway, NJ.
NIOSH Pocket Guide to Chemical Hazards. Washington, DC, us
Department of Health and Human Services, 1985.
Proctor, N.H., Hughes, J.P., Fischman, M.L., Chemical
Hazardous of the Workplace, J.B. Lippincott, Philadelphia,
PA, 1988.
Public Safety Critical Incident Management. Instructor's
Guide, NYS Disaster Preparedness Commission, 1991, Albany, NY
Sax, N.I., Lewis, R.J., Dangerous Properties of Industrial
Materials. Van Nostrand Reinhold, New York, NY, 1989.
Stutz, D.R., et al, 1982, Hazardous Materials Injuries: A
Handbook for Prehospital Care, First Edition, Greenbelt, MD,
Bradford Communications Corp.

Page 97
BASIC LIFE SUPPOR.T PROTOCOL:

BURNS/ DECONTAMINATION CHEMICAL

Section #1. The EMT Reqonden lnilial Situation A.nemnent

NEVER ENTER A HAZARDOUS MATERIAU CHEMICAL RELEASE AREA WITHOtrr


PROPER PROTECTIVE CLOTHING. Bmmacnc, Medical Semc:e providers responding to
accidents or known Hazardous Marcrials areas must adhere ID their individual department's Standani
Operating Procedures/Pre-Plans.

I 1ESTABLJSB A SAFE ZONE ~

'.,Jl:~lrfJflilTfiti~,
Notify yolD' dispatcher to comact all Pre-Planned appropriate emergency agencies of the chemical
release. Local Fue Depanmcm. Haz-Mal. Team. Police Depanmcm. and Local Hospira! Triage Teams.

I ~OGMTION OF CHEMICAL SPILi.ED ~

SECTION #2 • PATIENT CARE FOR DECONl'AMINATED VICTIMS

CAUTION!
TAKE PRECAUTIONS NOT TO CONTAMINATE SELF OR OTHERS

USE MINIMUM EMS PERSONNEL TO HANDLE 11IE TASK OF PATIENT CARE AT A


HAZARDOUS MATERIALS INCIDENT.

90
BASIC LIFE SUPPORT PRarocoL:

BURNS / DECONTAMINATION CHEMICAL

I I AIRWAY MANAGEMENT ~
Administer high flow oxygen to all patients who present signs of breathing difficulties (even patients
with known C.O.P.D.), especially those victims involved in a fire related incident (respiratory bums).

IF CHEMICAL IS A LIQUID ~
The patient you receive in your SAFE Z.ONE should be DECONTAMINA1ED. Always check to make
sure. There should be no contaminated clodling or jewelry on lhe victim. Flush the decontaminaled areas
with copious amoums of water.

IF THE CHEMICAL IS A DRY POWDER ~

Any patient you receive should again be DECONTAMINATED. If small amounts of a powdery substance
arc still present. BE CAREFUL not to spread it over unaffecled areas. Flush skin with copious amounts of
water.

IF THE EYE(S) ARE CONTAMINATED ~

Irrigate the eyc(s) with copius amounts of wau:r or saline solution continuously. Make sure the patient
blinks during irrigation.

CAUTION:
DO NOT CONTAMINATE THE UNINJURED EYE WITH THE
RUN OFF IRRIGATION FLUIDS FROM mE CONTAMINATED EYE.

TRANSPORTATION OF HAZARDOUS MATERIALS VICTIMS

1. Treat the patient ror shock (refer to ~ shock Protocol - Page 37)/
l. Cover· all burns with· dry sterile (if poai"ble) sheets or burn .pack; •··•···.•· .•. . .. . ...•
. ) ..•. \DO NOT PUNCl1JRE<UNBROK.EN SECOND DEGREEBURN.'BLISTERS! ..··· /t i <
3~·0btain' and record aJl.vitalsipsncf repeattbe~lood preaur~·proce.cJure OD Opposite arm While····
: enroute. Take all vital sigm as often ..s necmarJ.
Make sure you fill nut the Pre-Hospital Care ·
at
.'Report Form{before :you arrive Hie hospital y':, . . · •· · . . . ·. . { \t) •.·.·. .
4. Transport patient in a wana. mriron:mmt.This is important .sincf borD patients tend to lose body
beat and become bypothmnic. ·
)r~!tUL:;:·:~-·:::
New Ymt State Basic Life Suppon Protocol
99
RYS BMS-RAZDT A1fAltlUIBSS COUltSB
stu4ent Wor]CJ)ook

Agencies Por Specia1 Assistance


CHEMTREC (Chemical Transportation Emergency center)
1-800-424-9300

54th Explosive Ordinance Disposal


Ft. Monmouth, N.J.
(disposal of military explosives)
908-532-7055

143rd Explosive Ordinance Disposal - Seneca Army Depot


Romulus, N.Y.
(disposal of military explosives)
607-869-0363

146th Explosive Ordinance Disposal - Stuart Army Annex


West Point, N.Y.
(disposal of military explosives)
914-563-3232 or 3233

55th Ordinance Detachment - Explosive Ordnance Disposal


Fort Drum, N.Y.
(disposal of military explosives)
315-773-4044

For commercial explosives and improvised explosive devices


you should contact the local police department bomb squad at
the local station of the Division of the State Police.
New York State Department of Environmental Conservation
(emergencies involving hazardous wastes and hazardous
materials spills or releases)
1-800-457-7362 (24 hour hotline)
New York state Department of Health
(emergencies involving radioactive substances and/or
infectious substances)
(DOH Duty Officer answering service 1-518-465-9720)

New York State Department of State


Office of Fire Prevention & Control
(Hazmat technical assistance 24 hour hotline 1-518-474-6746)
(It is suggested that the Emergency Notification Form, on
next page, be used.)

Page 100
NYS EMS-HAZMAT AWARENESS COURSE
student Workbook

New York State Warning Point


state Emergency Management Office
(all emergencies which re91-1ire any State emergency
response or involvement)
1-518-457-2200 (24 hour hotline)

Nuclear Regulatory Commission (NRC) l-301-951-0550

National Pesticide Telecommunications Network (NPTN)


1-800-858-7378

Centers for Disease Control (CDC) 1-404-633-5313

Agency for Toxic Substance and Disease Registry (ATSDR)


1-404-488-4100

National Response Center


1-800-424-8802

Association of American Railroads (AAR)


1-202-639-2222

Note:
Most State agencies have field offices in various areas
throughout the State. The telephone numbers of those offices
should be included in the local Hazardous Materials Emergency
Plan.

Page 101
N.Y.S. DEPT. OF STATE - OFFICE OF FIRE PREVENTION & CONTROL
HAZARDOUS MATERIALS TECHNICAL ASSISTANCE
24 HR. HOTLINE -1-518-474-6746
EMERGENCY NOTIFICATION INFORMATION
• Tell the operator you are .requesting Hazardous Mate~iaJs assistance. Be prepared before you call
to give the following infonnation:

Name of caller------------Phone# -------


Identification
----------------------
Brief description of incident
---------------
Location of incident (town, county, street} --------

Date & date


Time & of incident
time call receiv_e________________
Material(s) involved & amount______________
Status (leaking, burning, etc.
Container type{s)
Placard/Label inf_o·_________________
Shipper identification
------------------
Transportation vehicle or storage information- - - - - - -

Fatalities _ _ _ Injuries___ Population endangered


Water/environmental hazards ---
Weather conditions (rain, snow, wind)
Personnel at scene {Fire, Haz-Mat Tea-m-,~E-M-s~)------------
Actions initiated
--'--------------------
The following have been notified (name, title)
Local Emergency Agencies ______________
Other County/Regional Agencies
CHEMTREC [l-800-424-9300] ---------
Shippers or owner
-------------------
* All requests will be evaluated to determine the most appropriate level of .assistance. Should on
scene technical assistance be deemed appropriate, two OFPC staff members will be dispatched
irrmediately to assist. Assistance can be requested whenever:
- NYS Fire Mobilization and Mutual Aid Plan is activated.
- County Fi re Coordinator detemi nes that assfstance is required,
- the Hazardous Materials Emergency Contingency Plan is activated.
- another agency requests assistance, and
- a request from a municipality is detemined to require specialized assistance and activation
of the State Fire Mobilization ana Mutual Aid Plan is not needed.