Photo Credit: Smederevac

The following is a summary of “Mass casualty decontamination following a chemical incident: evaluating improvised and interim decontamination protocols in a controlled cross-over volunteer study,” published in the December 2024 issue of Emergency Medicine by Davidson et al. 

Researchers conducted a retrospective study to examine the effectiveness of UK improvised and interim decontamination protocols in response to chemical incidents occurring in sequence.  

They applied a simulant consisting of methyl salicylate (MeS) in vegetable oil and a fluorophore to participants’ shoulders, arms, and legs. Participants either received no decontamination or followed 1 of 4 protocols as, improvised wet, improvised dry, improvised dry followed by interim, or improvised wet followed by interim. Gas chromatography tandem mass spectrometry was employed to quantify MeS remaining on the skin, and UV imaging detected the fluorophore. Urine samples were collected for 8 hours post-application to analyze MeS levels.  

The results showed significantly less simulant was recovered from the skin following decontamination compared to no decontamination. No significant differences were found in the total simulant recovery across all decontamination protocols. However, more simulant was recovered from the shoulder compared to the arm and leg. Variability in simulant recovery was significantly higher in improvised-only protocols than in combined protocols. Decontamination had no impact on the amount of MeS excreted in urine over 8 hours.  

Investigators concluded the early and sequential decontamination procedures, including improvised and interim decontamination, were crucial for optimal outcomes in chemical exposure cases. 

Source: emj.bmj.com/content/early/2024/12/04/emermed-2024-214221