Amlôt Richard, Carter Holly, Riddle Lorna, Larner Joanne, Chilcott Robert P
Emergency Response Department Science & Technology, Public Health England, Porton Down, Salisbury, Wiltshire, United Kingdom.
Research Centre for Topical Drug Delivery and Toxicology, School of Pharmacy, University of Hertfordshire, Hatfield, United Kingdom.
PLoS One. 2017 Jun 16;12(6):e0179309. doi: 10.1371/journal.pone.0179309. eCollection 2017.
Previous studies have demonstrated that rapid evacuation, disrobing and emergency decontamination can enhance the ability of emergency services and acute hospitals to effectively manage chemically-contaminated casualties. The purpose of this human volunteer study was to further optimise such an "Initial Operational Response" by (1) identifying an appropriate method for performing improvised skin decontamination and (2) providing guidance for use by first responders and casualties. The study was performed using two readily available, absorbent materials (paper towels and incontinence pads). The decontamination effectiveness of the test materials was measured by quantifying the amount of a chemical warfare agent simulant (methyl salicylate) removed from each volunteer's forearm skin. Results from the first study demonstrated that simulant recovery was lower in all of the dry decontamination conditions when compared to matched controls, suggesting that dry decontamination serves to reduce chemical exposure. Blotting in combination with rubbing was the most effective form of decontamination. There was no difference in effectiveness between the two absorbent materials. In the following study, volunteers performed improvised dry decontamination, either with or without draft guidelines. Volunteers who received the guidance were able to carry out improvised dry decontamination more effectively, using more of the absorbent product (blue roll) to ensure that all areas of the body were decontaminated and avoiding cross-contamination of other body areas by working systematically from the head downwards. Collectively, these two studies suggest that absorbent products that are available on ambulances and in acute healthcare settings may have generic applicability for improvised dry decontamination. Wherever possible, emergency responders and healthcare workers should guide casualties through decontamination steps; in the absence of explicit guidance and instructions, improvised dry decontamination may not be performed correctly or safely.
先前的研究表明，快速疏散、脱衣和紧急去污可以提高应急服务部门和急症医院有效管理化学污染伤员的能力。这项人体志愿者研究的目的是通过（1）确定一种进行简易皮肤去污的合适方法，以及（2）为急救人员和伤员提供使用指导，来进一步优化这种“初始行动响应”。该研究使用了两种容易获得的吸收性材料（纸巾和失禁垫）。通过量化从每位志愿者前臂皮肤上去除的化学战剂模拟物（水杨酸甲酯）的量，来测量测试材料的去污效果。第一项研究的结果表明，与匹配的对照组相比，在所有干式去污条件下模拟物的残留量都更低，这表明干式去污有助于减少化学暴露。 blotting与rubbing相结合是最有效的去污形式。两种吸收性材料在效果上没有差异。在接下来的研究中，志愿者在有或没有指导方针草案的情况下进行简易干式去污。接受指导的志愿者能够更有效地进行简易干式去污，使用更多的吸收性产品（蓝色卷纸），以确保身体的所有部位都得到去污，并通过从头部向下系统地工作来避免身体其他部位的交叉污染。总体而言，这两项研究表明，救护车上和急症医疗环境中可用的吸收性产品可能普遍适用于简易干式去污。只要有可能，应急响应人员和医护人员都应指导伤员完成去污步骤；在没有明确指导和说明的情况下，简易干式去污可能无法正确或安全地进行。
