New Evidence-Based Planning Guidance for Patient Decontamination Released

Every day large quantities of hazardous materials are made, transported, stored, and used in communities throughout the United States. With nearly 25 million people living near chemical facilities in the nation, many could be exposed to chemicals following a catastrophic incident. To protect health and save lives in such catastrophic incidents, first responders, medical providers, and public health officials will want to make decisions about how to decontaminate patients based on scientific evidence.

To assist with this, the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response and the U.S. Department of Homeland Security’s Office of Health Affairs recently released new evidence based guidance for Patient Decontamination in a Mass Chemical Exposure Incident.

The guidance, which draws on expertise in emergency response, emergency medicine, toxicology, risk communication, behavioral health, and other relevant fields from academic and non-government organizations and federal, state, and local agencies, covers mass casualties, chemical release, external contamination, and decontamination of people.


  • Determining the need for decontamination of an individual patient: Responders and receivers should make risk-based decisions on whether and how to decontaminate a patient, using their estimations of the type and extent of contamination, the risk posed by the contaminated patient to responders and receivers, and potential adverse effects to the patient from the decontamination process itself.
  • Choosing patient decontamination methods: Each incident creates a unique set of demands.  A flexible response plan allows the most appropriate patient decontamination methods to be applied to meet those demands.
  • Determining the effectiveness of decontamination: Clinical signs and symptoms, other observable indicators, and the execution of reliable protocols are the most important and accessible tools to aid decisions on when a patient has been decontaminated sufficiently.
  • Prioritizing patients for decontamination in a mass exposure incident: Patients should be prioritized according to relative risk, with patients at greatest risk of severe health effects decontaminated soonest. If resources allow, life-saving medical care should not be delayed for decontamination.
  • Coordinating the entire system-wide response: Communication among all response organizations prior to and during an incident is essential in order for all affected individuals to receive appropriate and consistent care.
  • Communicating crisis and emergency risk messages to the community: A strategic communications plan can support the effective utilization of patient decontamination as a medical countermeasure.  Pre-incident planning should include the identification of message topics and their audiences, drafting of pre-scripted messages, and assignment of appropriate spokespeople to deliver each message.

Learn more at the Assistant Secretary for Preparedness and Response blog. 

About Justin Snair

Justin serves as a Senior Program Analyst for Critical Infrastructure and Environmental Security at NACCHO. Prior to coming to NACCHO, Justin worked as an environmental health officer for a local heath department in Massachusetts. Twitter: @JustinSnair

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