DERMaL Resources of Response Phase

ONLINE Search page The NIOSH Pocket Guide to Chemical Hazards (NPG) is intended as a source of general industrial hygiene information on several hundred chemicals/classes for workers, employers, and occupational health professionals. The Pocket Guide includes the following: Chemical names, synonyms, trade names, CAS, RTECS, and DOT ID and Guide numbers Chemical structure/formula, conversion factors NIOSH Recommended Exposure Limits (RELs) Occupational Safety and Health Administration (OSHA) Permissible Exposure Limits (PELs) NIOSH Immediately Dangerous to Life and Health values (IDLHs) Physical description and chemical and physical properties of agents Measurement methods Personal protection and sanitation recommendations Respirator selection recommendations Incompatibilities and reactivities of agents Exposure routes, symptoms, target organs, and first aid information

The Emergency Response Safety and Health Database (ERSH-DB) is a rapidly accessible occupational safety and health database developed by NIOSH for the emergency response community. The ERSH-DB contains accurate and concise information on high-priority chemical, biological and radiological agents that could be encountered by personnel responding to a terrorist event.

Skin notation profiles provide information on health effects (systemic, direct -irritatant and corrosive, and sensitization potential) following dermal exposures to selected chemicals. Each skin profile contains a summary of the relevant data used in determining the hazards associated with skin exposures.

Mobile app. Mobile version of 2012 ERG. This software is available from the Apple iTunes store for iPhone, and from the Google Play website for Android.

The ERG is primarily applicable for hazardous materials transported by highway and railway, but also is applicable for materials transported by air or waterway, as well as by pipeline. The ERG "is primarily a guide to aid first responders in quickly identifying the specific or generic hazards of the material(s) involved in the incident, and protecting themselves and the general public during the initial response phase of the incident and should only be used for the "initial response phase" (about the first thirty minutes) of an incident . The ERG includes over 170 "Guides" that identify the primary hazards associated with the applicable general category of hazardous material and general guidance on how to respond to incidents involving that general category of hazardous material. The primary purpose of ERG is to direct the emergency responders to the most appropriate of these guides, based on the incident. The ERG also provides guidance regarding recommended evacuation distances, if applicable.

OSHA maintains this chemical database as a convenient reference for the occupational safety and health community. It compiles information from several government agencies and organizations. Information available in the report includes: Physical Properties Exposure Guidelines NIOSH Pocket Guide, and Emergency Response Information, including the DOT Emergency Response Guide.

PPE and Exposure limits to Blister Agents.

List of specific chemicals. Each chemical gives health effect; pre-hospital management and emergency department management.

PPE and Exposure limits to Nerve Agents.

US Army Medical Research Institute of Chemical Defense (USAMRICD). Field Management Of Chemical Casualties guidebook.

This chapter focuses on the safe decontamination of medical casualties exposed to chemical agents

CHEMM-IST is a prototype decision support tool developed by experts in medicine and emergency response as an aid for identifying the chemical a patient was exposed to in a mass casualty incident. Since CHEMM-IST is currently in the prototype phase of development, it should not be used for patient care. This tool, once thoroughly tested and validated by a wide range of potential users via case studies, is intended for use by basic life support (BLS) and advanced life support (ALS) providers as well as hospital first receivers. The focus of CHEMM-IST is only on severe cases.

ONLINE version. WISER is a system designed to assist first responders in hazardous material incidents. WISER provides a wide range of information on hazardous substances, including substance identification support, physical characteristics, human health information, and containment and suppression advice.

This report, updated in 2013 by the U.S. Army Edgewood Chemical Biological Center (ECBC), focuses on decontamination of hazards (chemical, biological, radiological, unknown). It was updated with input from community responders, Army responders, DoD medical, and DoD chemical-biological technical expertise. This report serves as the basis for doctrine and will be applicable to DoD and civilian response organizations as well.

Home page to download the program. WISER is a system designed to assist first responders in hazardous material incidents. WISER provides a wide range of information on hazardous substances, including substance identification support, physical characteristics, human health information, and containment and suppression advice.

The NIOSH Pocket Guide to Chemical Hazards is intended as a source of general industrial hygiene information on several hundred chemicals/classes for workers, employers, and occupational health professionals. The NIOSH Pocket Guide does not contain an analysis of all pertinent data, rather it presents key information and data in abbreviated or tabular form for chemicals or substance groupings (e.g. cyanides, fluorides, manganese compounds) that are found in the work environment. The information found in the NIOSH Pocket Guide should help users recognize and control occupational chemical hazards.

This chapter will focus on the process of triage in chemical agent mass casualties. Specific chemical warfare agent classes, current triage systems, and classifications of triage will be reviewed

Information for the First Responders: Responding and Training.

Goals of the initial response and responding to specific types of emergencies.

This chapter compares the current field management operations of the various military services (land-based and sea-based forces) and the civilian medical community. Although patient treatment strategies still vary, there are now many similarities in the decontamination procedures used by these various organizations, with key differences related to the platforms on which field management takes place (e.g., on land vs. on sea-going vessels) and the specific equipment used for medical care, transport, and decontamination.

Decontamination Procedures: set-up, ppe, individual and mass decontamination.

Triage Guidelines: general principles, START/JumpSTART Algorithm, and SALT Mass Casualty Triage Algorithm.

Information on PPE: Need, levels of PPE, type of protection, and limitations of PPE.

Volume 1: Emergency Medical Services: A Planning Guide for the Management of Contaminated Patients are planning guides to assist first responders in planning for incidents that involve hazardous materials. Volume II - Hospital Emergency Departments: A Planning Guide for the Management of Contaminated Patients are planning guides to assist hospital emergency department personnel in planning for incidents that involve hazardous materials. Volume III - Medical Management Guidelines (MMGs) for Acute Chemical Exposures are guides for health care professionals who treat persons who have been exposed to hazardous materials.

Firefighter Quick Reference Card.

The guides will focus on chemical and biological equipment in areas of detection, personal protection, decontamination, and communication. This document focuses specifically on assisting the emergency first responder community in the evaluation and purchase of personal protective equipment.

The Medical Management Guidelines (MMGs) for Acute Chemical Exposures were developed by ATSDR to aid emergency department physicians and other emergency healthcare professionals who manage acute exposures resulting from chemical incidents. The MMGs are intended to aid healthcare professionals involved in emergency response to effectively decontaminate patients, protect themselves and others from contamination, communicate with other involved personnel, efficiently transport patients to a medical facility, and provide competent medical evaluation and treatment to exposed persons.

Home page to download the program. CAMEO Chemicals has an extensive chemical database with critical response information for thousands of chemicals, and a tool that tells you what reactions might occur if chemicals were mixed together.

MOBILE version. Free.CAMEO Chemicals has an extensive chemical database with critical response information for thousands of chemicals, and a tool that tells you what reactions might occur if chemicals were mixed together.

ONLINE version. CAMEO Chemicals has an extensive chemical database with critical response information for thousands of chemicals, and a tool that tells you what reactions might occur if chemicals were mixed together.

Mobile App. Cargo Decoder is your guide to what is in the truck or tanker next to you on the highway. Enter the 4 digit number from the DOT placard to learn about a material . Cargo Decoder (free); Cargo Decoder Plus Module (pay). Cargo Decoder uses no network bandwidth so information will always be available even if the cell network is not. Cargo Decoder is available at the Android Market, Amazon Appstore, or Blackberry App World. Cargo Decoder Plus for iPhone is now available in the Apple iTunes App Store.

AEGLs are intended to describe the risk to humans resulting from once-in-a-lifetime, or rare, exposure to airborne chemicals.

List of types and categories of hazardous chemicals.

In order to use this guidance effectively, an employer must assess the risk of a hazardous substance release to the emergency responders and base the PPE selection on the level of knowledge relative to that risk. This kind of assessment is a typical safety and health evaluation with the unusual caveats that many of the agents are highly toxic by both skin and inhalation, typical indicators of exposure such as odor, smoke, or fume may not be present, exposure monitoring is difficult for some of the compounds, and there may be a locally limited supply of CBRN-approved respirators for a large response during initial emergency operations. Based on the hazardous substances and conditions known to be present, the Incident Commander in charge of a response shall implement appropriate emergency operations, including selection of appropriate PPE for employees who respond.

Information note on chemical release No 4. List of basic equipment for emergency decontamination; removing contaminated clothing; and using the RINSE-WIPE-RINSE technique. See the full WHO guidance document at Initial clinical management of patients exposed to chemical weapons.

MSDS of RSDL.

Information note on chemical release No 3. Table listing class of toxic chemical and common features of exposure

Provides links to Safety Management, Bloodborne Infectious Disease, Personal Protective Equipment, and Traumatic Incident Stress.

Personal protective equipment is very important for any emergency responder. There are five main types of PPE that are covered on this page: respirators and protective clothing (selection, proper use, etc.), skin exposures and eye and hearing protection.

Home page to download the program. ALOHA is an atmospheric dispersion model used for evaluating releases of hazardous chemical vapors. ALOHA allows the user to estimate the downwind dispersion of a chemical cloud based on the toxicological/physical characteristics of the released chemical, atmospheric conditions, and specific circumstances of the release. ALOHA can estimate threat zones associated with several types of hazardous chemical releases, including toxic gas clouds, fires, and explosions. Threat zones can also be plotted on maps with MARPLOT to display the location of facilities storing hazardous materials and vulnerable locations (such as hospitals and schools). Specific information about these locations can be extracted from CAMEO information modules to help make decisions about the degree of hazard posed.

The information in this user-friendly, pocket-sized publication is used worldwide as a guide for evaluation and control of workplace exposures to chemical substances and physical agents. Threshold Limit Value (TLV) occupational exposure guidelines are recommended for more than 700 chemical substances and physical agents. There are more than 50 Biological Exposure Indices (BEIs) that cover more than 80 chemical substances. Chemical Abstract Service (CAS) registry numbers are listed for each chemical. Introductions to each section and appendices provide philosophical bases and practical recommendations for using TLVs and BEIs.

Vapors, gases, and particulates from hazardous substance response activities place response personnel at risk. For this reason, response personnel must wear appropriate personal protective clothing and equipment whenever they are near the site. The more that is known about the hazards at a release site, the easier it becomes to select personal protective equipment. There are basically four levels of personal protective equipment

Home page to download the program. EPA/NOAA. CAMEOfm is a database application where you can keep track of information (such as chemical inventories and contact information for facilities in your community) to assist in emergency response and planning. It contains basic facility identification information, employee contact information, and information such as storage amounts, storage conditions, and locations for chemicals stored or used at the facility.

Gives guidelines on how to prepare and respond to different incidents: public, terrorist, transportation, industrial, or discovering an event.

Overview describing threat, immediate action, symptoms, treatment (if exposed), and contagion to certain biological, chemical, and dirty bomb attacks.

The MHMI series is a three volume set (with a video) comprised of recommendations for on-scene (pre-hospital), and hospital medical management of patients exposed during a hazardous materials incident.

The CRW predicts possible hazards from mixing chemicals and is designed to be used by emergency responders and planners, as well as the chemical industry, to help prevent dangerous chemical incidents. The chemical database and reactivity prediction tool are also included in CAMEO Chemicals; however, the datasheets in the Chemical Reactivity Worksheet have been reduced to include primarily reactivity-related information, and the CRW allows you to add your own customized chemical datasheets to the database

The U.S. Army Public Health Command (Provisional) Technical Guide 230 (TG 230) provides a standard tool to assess and characterize chemical exposures during deployments in a manner that is consistent with established joint military risk management doctrine. The USAPHC (Prov) TG 230 provides a range of military exposure guidelines (MEGs) that are toxicologically based chemical concentrations for various military exposure scenarios during deployments. The June 2010 Revision to this USAPHC (Prov) Reference Document (RD) 230 provides details associated with the methods, scientific rationale, and assumptions behind the MEGs presented in the June 2010 Revision to USAPHC (Prov) TG 230.

MARPLOT is the mapping application. It allows users to "see" their data (e.g., roads, facilities, schools, response assets), display this information on computer maps, and print the information on area maps. The areas contaminated by potential or actual chemical release scenarios also can be overlaid on the maps to determine potential impacts. The maps are created from the U.S. Bureau of Census TIGER/Line files and can be manipulated quickly to show possible hazard areas.

Chemical warfare agents are toxic weapons and emergency pre-hospital medical care providers should be well prepared, trained, and equipped to give response. Personnel need to be aware of the following medical issues regarding pre-hospital management of a chemical attack, event recognition, incident medical command and control, safety and protection, decontamination, isolation of the incident area (hot zone, warm zone, and cold zone), sampling and detection, psychological management, communication, triage, treatment, transportation, recovery activities and fatality management. During pre-hospital response, healthcare responders should provide self protection by wearing proper protective equipment and ensuring that the casualty is thoroughly decontaminated. Medical first responders are also responsible for performing triage in each zone of the incident area. Victims are triaged into four categories based on the need for medical care; immediate, delayed, minimal, and expectant. Finally, a medical emergency planning should be completed, and exercises conducted to test the system before an event occurs.

Make informed decisions and save lives with the Fire Protection Guide to Hazardous Materials. Work safely with chemicals and respond effectively to fire, accidental releases, and other emergencies with the new Fire Protection Guide to Hazardous Materials. Get up-to-date facts on all types of chemicals, plus NFPA 30/OSHA classifications for flammable and combustible liquids. This Guide lets you reference the full texts of six NFPA documents: Hazardous chemicals data, Fire hazard properties of flammable liquids, gases, and volatile solids, Hazardous locations for liquids, gases and vapors including NEC groups, Hazardous chemical reactions, Hazards of materials for emergency response, including a new worksheet with completed examples of how to develop ratings.

Contains test data on 650 chemicals and mixtures with over 200 chemical protective clothing (CPC) models--gloves, suits, boots, visors, etc. Includes the American Society for Testing and Materials (ASTM) numbering and naming system and contains results of permeation tests, including breakthrough times and variations in CPC performance.

Janes CBRN Response Handbook combines that latest procedures and guidelines with detailed reference material to deliver a convenient guide that supports effective CBRN incident planning, control and management. An expansion of the highly popular Janes Chem-Bio Handbook the standard among first responders this manual has been developed in line with current best practices and is organized to facilitate usability in the field. Janes CBRN Response Handbook provides comprehensive single-source instruction for professional first responders and anyone involved in preparing for, responding to or managing a CBRN-related incident.

For more than a quarter century, "Sittig's Handbook of Toxic and Hazardous Chemicals and Carcinogens" has proven to be among the most reliable, easy-to-use and essential reference works on hazardous materials. Sittig's remains the lone comprehensive work providing a vast array of critical information on the 2,100 most heavily used, transported, and regulated chemical substances of both occupational and environmental concern. Information is the most vital resource anyone can have when dealing with potential hazardous substance accidents or acts of terror. Sittig's provides extensive data for each of the 2,100 chemicals in a uniform format, enabling fast and accurate decisions in any situation. The chemicals are presented alphabetically and classified as a carcinogen, hazardous substance, hazardous waste, or toxic pollutant. Sittig's Handbook is a globally recognized reference source, providing full listings of the 2,000 most common hazardous chemicals - making it the essential handbook for first-line response to chemical spills and day-to-day chemical plant reference.

CHEMTREC's Operations Center is staffed 24 hour a day, 7 days a week by trained and experienced Emergency Service Specialists (ESS). CHEMTREC ESS can provide immediate guidance and information through Safety Data Sheets (SDS) and many other resources. Linked to the worlds largest on-call network of chemical, medical, toxicological and hazardous materials experts, the ESS can establish direct communication between these experts, CHEMTREC personnel and the responders at the scene to provide consistent and accurate information that is critical to the successful response to the incident.

Checklist

Jointly developed by OSHA and the USCG, the ICS Compatible Site Safety and Health Plan is designed for safety and health personnel that use the Incident Command System (ICS). It is compatible with ICS and is intended to meet the requirements of the Hazardous Waste Operations and Emergency Response regulation (Title 29, Code of Federal Regulations, Part 1910.120). Although primarily designed for oil and chemical spills, the plan can be used for all hazard situations.

The POISINDEX System is the go-to reference of choice in 100% of US poison control centers. POISINDEX is the world's most comprehensive repository of toxicity information, with ingredients for more than 350,000 commercial, biological, and pharmaceutical products and information on toxicity in plants and animals.

Poisoning & Drug Overdose, Sixth Edition delivers critical information on effective diagnosis and treatment of drug-related emergencies and chemical exposures. Divided into four sections, easily identified by dictionary-style tabs: Section I covers initial emergency management, including treatment of complications; physical and laboratory diagnosis; and decontamination and enhanced elimination procedures. Section II provides detailed information on 150 common drugs and poisons. Section III describes the use of antidotes and therapeutic drugs to treat poisoning. Section IV describes the medical management of chemical and occupational exposures, with a table of more than 500 industrial chemicals. Poisoning & Drug Overdose, Sixth Edition is enhanced by numerous tables, charts, and a comprehensive index featuring generic, chemical, and brand names, making it an essential resource for anyone responding to drug-related emergencies and chemical exposures.

Home page to download the program. Assistant Secretary for Preparedness and Response (ASPR). Chemical Hazards Emergency Medical Management to enable first responders, first receivers, other healthcare providers, and planners to plan for, respond to, recover from, and mitigate the effects of mass-casualty incidents involving chemicals.

Haz-Map is an occupational health database designed for health and safety professionals and for consumers seeking information about the adverse effects of workplace exposures to chemical and biological agents. The main links in Haz-Map are between chemicals and occupational diseases. These links have been established using current scientific evidence. The information in Haz-Map comes from textbooks, journal articles, the Documentation of the Threshold Limit Values (published by ACGIH), and electronic databases such as NLM's Hazardous Substances Data Bank (HSDB). Haz-Map staff classifies, summarizes, and regularly updates the information found in the database.

The Physicians' Desk Reference (PDR) is a commercially published compilation of manufacturers' prescribing information (package insert) on prescription drugs, updated annually. While designed to provide physicians with the full legally mandated information relevant to writing prescriptions (just as its name suggests), it is widely available in libraries and bookstores, widely used by other medical specialists, and sometimes valuable to the layman.

Home page showing table of contents. Note: links to chapters are not working

Report No. 138 (2001) provides information and recommendations regarding the radiological health and safety issues related to the threat of terrorist activities involving radioactive material. The Report identifies, evaluates, and makes recommendations regarding immediate and long-term radiological consequence-management issues, communication and coordination challenges, and public information challenges associated with these emergencies. This Report also provides recommendations on training guidelines, critical resources, and guidelines for internal and external exposure, as well as decontamination and cleanup.

Decontamination at the MTF is directed toward(1) eliminating any chemical agent transferred to the patient during removal of protective clothing;(2) decontaminating or containing of contaminated clothing and personal equipment; and (3) maintain-ing an uncontaminated MTF.

This companion document to the ACGIH Threshold Limit Values and Biological Exposure Indices book serves as a readily accessible reference for comparison of the most recently published values: 2014 Chemical Substance TLVs from ACGIH; AIHA Workplace Environmental Exposure Limits (WEELs); the OSHA Final Rule PELs; RELs from NIOSH; MAKs from the German Commission for the Investigation of Health Hazards of Chemical Compounds in the Workplace; and carcinogenicity designations from ACGIH, OSHA, NIOSH, MAK, IARC, U.S. NTP, and U.S. EPA. The book includes a CAS number index.

This practical guide provides comprehensive, yet concise, coverage of the diagnosis and management of suspected contact and occupational dermatitis--from the basic principles of allergic and irritant contact dermatitis to data collection, patient evaluation, and monitoring. Readers will find detailed discussions on patch testing, allergens, occupational skin disease, contact urticaria, contact dermatitis, and more. With a brand-new co-author, information on new antigens, and a substantially revised chapter that serves as a mini-atlas of regional contact dermatitis, this trusted resource offers complete, expert guidance.

Now in its thirteenth edition, Dreisbach's Handbook of Poisoning is long established as the definitive handbook of poisoning for all physicians, nurses, crisis and hotline workers, paramedics, and students. Rapid response is critical during the initial management of poison cases. This ready-reference guide provides antidotes, antivenins, and more for a vast number of substances. It covers medical toxicology - including prevention and management of exposures, poisonings, adverse effects, abuse and withdrawal from pharmaceuticals - and household, environmental, and natural hazards.

The Physician's Drug Handbook features alphabetically organized monographs on more than 900 generic and 2,000 trade name drugs. Each entry includes US and Canadian generic and trade names, pharmacologic and therapeutic classifications, pregnancy risk category, controlled substance schedule (when appropriate), available forms and strengths, indications and dosages, pharmacodynamics, pharmacokinetics, contraindications and precautions, patient monitoring alerts, and subsections for pregnant, breast-feeding, pediatric, and geriatric patients.

In the real-life world of emergency response, nothing is more crucial to crisis personnel than quick and decisive action. D. Hank Ellison's Emergency Action for Chemical and Biological Warfare Agents tells police, paramedics, and firefighters just what actions to take in the event of a crisis involving hazardous materials. The book contains abridged versions of the class indices from Ellison's larger Handbook of Chemical and Biological Warfare Agents. The indices deal with classes of agents (nerve, blister, etc.) instead of focusing on specific agents. Each index contains information on the toxicology/health impacts, physical characteristics, hazards from fire or reactivity, protection of personnel, and general first aid for that agent class. Designed to provide rapid access to critical emergency information at the scene of a release of chemical or biological warfare agents, this handy field guide is also ideal for facilitating the coordination with off-site personnel who have access to more comprehensive information in Ellison's larger Handbook. It differs from its larger companion, however, in that agent specific data, as well as information on evacuation distances, are listed in table format, making it the ideal tool for emergency responders deployed in the field.

Biological Monitoring Methods for Industrial Chemicals is a useful handbook for industrial hygienists, industrial toxicologists, occupational physicians and others directly involved with work-place safety. The book contains summaries of the occurrences, usages, blood concentrations, metabolism, excretion, toxicities and laboratory analyses of selected industrial chemicals.

Numerous references describe the initial treatment of the acutely poisoned patient; however, this new book is the first major critical care toxicology resource that details patient care from hospital admission and treatment all the way through stabilization, monitoring, and discharge. It presents practical, state-of-the-art treatment recommendations based on initial and subsequent presentation of symptoms, and describes when it's safe to discharge the patient.

The fourth edition of Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose is the most current, authoritative, and concise reference for information related to the clinical management of children and adults whose health has been effected or potentially effected by toxic agents, including drugs, environmental threats, and natural toxins. Presents a comprehensive treatment of poisoning through more than 100 chapters in 10 sections

Log-in Required (Free). Unified Incident Command and Decision Support (UICDS). UICDS keeps you better informed so you can make better decisions. UICDS is information sharing middleware for NIMS incident management that continuously receives and shares standardized data among many agencies during an incident. Your everyday application gets from UICDS exactly the data you need to use, visualize, process, improve, decide, and then share back through UICDS to keep everyone informed. Because UICDS is middleware, there is no new user interface to learn, no cost to obtain it, and you retain complete control over your data. You get notified when an agency has provided new or updated incident data and you share your data with whom you want instantaneously and in the background without any disruption to your operation