12 May 2005: Hospitals unprepared for chemical contamination

UK hospital trusts are better prepared to deal with chemical incidents than they were five years ago, but the design of protective suits and tents still needs work, claim researchers from Birmingham Heartlands Hospital.

A training package was launched in 2001 in all UK acute hospital and ambulance trusts. This comprised a standard chemical personal protective equipment suit (CPPE) and a half-day training course. However, staff are still struggling with the CPPE suits and this is delaying care of the casualties and the integrity of clean areas within the hospitals write specialists in the Emergency Medical Journal (2005; 22: 347-350). The suits were fiddly and cumbersome to assemble and trained staff took 15 minutes to prepare, test and put them on. Other problems included battery failures, insufficient flexibility of the suits at the knees and elbows and leaks in the suits’ feet.

More success was found erecting the inflatable decontamination shelters where hospital staff receive casualties, which on average took four minutes to establish.

Although the two hospitals outlined in the study began the full Structured Approach to Chemical Casualties (SACC) protocols quite well, both demonstrated significant failings such as patients crossing from contaminated to decontaminated zones, and the protocols were not in place for sufficient time. 

Of the six ambulance trusts surveyed, the average number of chemical incidents handled in the previous year was 74, although the range was from zero to 371. Surveys were returned from 49 hospital emergency departments, which averaged one chemical incident in the previous 12 months, ranging from zero to four incidents.

The authors recommend that the next generation of CPPE suits should be designed to minimise the number of steps in preparation, testing and donning the kit to improve the response to treating chemically contaminated casualties. 

Fiona Salvage