Abstract
Accidents involving release of chemical, biological, radiological or nuclear substances may prompt the need to decontaminate exposed casualties prior to further medical treatment. Health service workers who carry out decontamination procedures wear protective suits to avoid direct contact with contaminants.We developed an analytical framework based on queueing theory to inform UK Department of Health’s decisions on the stock of protective suits that ambulance services and hospitals with emergency departments in England should hold. Our aim was to ensure that such allocation gave an accepted degree of resilience to locally identified hazards.Here we give an overview of our work and describe how we incorporated information in the public domain about local hazards with expert opinion about the patterns of demand for decontamination associated with different types of incident. We also give an account of how we worked with decision makers to inform national guidance on this topic.
Highlights
Self-presenting casualties – Community Risk Register (CRR) do not contain a priori information about where exactly each event would possibly take place in an Local Resilience Forum (LRF) or about how casualties would split among emergency departments (ED) depending on the event, so we assumed that all EDs within the same LRF need to plan for equal proportions of casualties solely based on the density of EDs within the LRF: the higher the density, the smaller the proportion of casualties assigned to each ED
We developed an analytical framework allowing estimation of the number of protective suits needed to be held by each ambulance service and emergency department within a given region in order to be able to carry out decontamination procedures in response to HazMat events
Algorithms based on queueing theory were developed to obtain expected protective suit demands for each event considered
Summary
Incidents involving release of Chemical, Biological, Radiological, or Nuclear (CBRN) materials can have a significant social and health impact. When caused by human error, technological failure or, for example, extreme weather events, these are commonly referred to as “HazMat” events. Such accidents, as well as malicious incidents (for instance, criminal or terrorist acts), have the potential for significant human losses and environmental damage. Healthcare workers are required to establish decontamination and triage areas and carry out decontamination procedures in order to end casualties’ exposure to the hazardous substance as soon as possible and prior to further clinical treatment. Decontamination is fundamental to prevent the spread of toxic substances to other people/areas
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