ABERDEEN PROVING GROUND, Md. -- Response from medical and emergency personnel during the recent Boston Marathon attacks has been heralded as one of the best because of the planning and practice of first responders and hospitals who handle mass casualty situations.

In mass casualty decontamination efforts, experts from the U.S. Army Edgewood Chemical Biological Center partner with industry and medical professionals to ensure that if the worst does occur, everyone is ready and able to handle the conditions, especially in situations involving the accidental release of hazardous materials and terrorist events involving weapons of mass destruction.

Pete Schulze, from the U.S. Army Chemical Biological Radiological and Nuclear School partnered with Bill Lake and Stephen Divarco, Ph.D, both of ECBC, and Robert Gougelet, M.D., from the Geisel School of Medicine at Dartmouth University, to revise an ECBC Special Report featuring new guidance on Mass Casualty Decontamination during hazardous material and weapon of mass destruction incidents.

With from community responders, Army responders, Department Of Defense and DoD chemical-biological technical experts, officials completed the report in May 2013. The public learned the results at the 2013 International Association of Fire Chiefs International HazMat Conference in Baltimore, Md., in June 2013.

The U.S. Army CBRN School develops training standards for Army personnel, equipment and units assigned to support civil authorities during a CBRN incident. A key element of any military training product or standard designed to support civil authorities is to ensure that it complements on-going civilian first responder processes and procedures.

CBRN school officials looked to ECBC to recommend and publish best practices for first responders.

"Life safety, especially in the event of a mass casualty situation like the recent Boston Marathon bombing incident, is always the highest priority," Lake said. "Mass casualty decontamination requires timely response, gaining rapid control of victims, and applying proven, life saving decontamination techniques in an efficient and timely manner. The guidelines presented in the revised ECBC Special Report provide first responders with consistent means to countermeasure the after effects of mass casualty incidents."

Lake also stressed that, "the Federal Emergency Management Agency's National Incident Management System identifies concepts and principles that first responders can use to manage emergencies from preparedness to recovery, regardless of their cause, size, location or complexity.

Much like NIMS, the revised ECBC report provides a consistent approach and vocabulary for first responders, multiple agencies, and/or jurisdictions to work together to deliver the core capabilities needed to achieve mass casualty decontamination."

Lake, a division chief, first collaborated with Schulze and Gougelet in April 2009 to publish guidelines for "Mass Casualty Decontamination during a HazMat/Weapon of Mass Destruction Incident, Volumes I and II (ECBC-SP-024)," which was an update of two, nearly eight year-old reports.

Because of recent international research and recommendations by the Mass Casualty Decontamination Integrated Project Team, ECBC was again tasked by the Army CBRN School to update to the original 2009 report, focusing on the decontamination of chemical, biological, radiological and unknown hazards based on new empirical data and technical information.

Divarco leads the ECBC effort as the organizational chief systems engineer. His previous private sector experience as a first responder and safety engineer, combined with his government decontamination engineering experience, provided critical expertise the team needed to complete the updated report.

The team has also collaborated with the U.S. Department of Homeland Security and U.S. Department of Health and Human Services, who are publishing a higher level national report, "Patient Decontamination in a Mass Chemical Exposure Incident: National Planning Guidance for Communities."

This federal level document and the ECBC report can be viewed as companion products that support both local planning and response actions for mass casualty incidents.

The team took a four-step, 360-degree approach to create the guidelines for the report incorporating scientific research and feedback from first responders. The approach consisted of think tanks with state, local and DoD first responders; research for new decontamination scientific advances/studies; latest best practices and ideas from the first responder community and a responder knowledge base review. Divarco said that despite being written by mass casualty decontamination experts, "The revised ECBC report was developed for field application by first responders. It was designed to provide technical information and suggested procedures for mass casualty decontamination following a hazardous material/WMD attack. Because of the combination of theoretical information, the inclusion of more recent findings from our international partners on the subject, and potential best practice practical applications offered, it was critical to involve a diverse group of individuals in the development and review of the revised report in order to produce a meaningful product."

"While there is no perfect solution to mass casualty decontamination and there is no single process or method that can account for all variables such as hazard, time, number of victims, environmental conditions, resource availability, etc., the information presented in Volume I and II of the revised Report provides a means to help identify a simple, consistent mass casualty decontamination process that can be applied with reasonable effectiveness to any HAZMAT/WMD incident," Lake said.

The updated guidelines include redesigning Volume I to be a quick reference book with short, concise descriptions of procedures and checklists to set up and execute mass casualty decontamination. Volume II has been revised to include an in-depth discussion of HAZMAT and WMD mass casualty decontamination and additional reasoning behind guidelines presented in Volume I. Both volumes now include high resolution graphics developed for emergency reference and follow-on training in multi-lingual communities.

"The key to successful mass casualty decontamination is to use the fastest approach that will cause the least harm and do the most good for the majority of the people. Coordination of initial assessment, decontamination, and subsequent observation procedures is critical to ensure that the health needs of victims continue to be met as the incident response evolves," Divarco wrote in a presentation for the IAFC Conference.

"The fire service is a critical resource for mass casualty decontamination and one of the purposes of this revised report is to bring them on board with the early minutes of decontamination and get their buy in on the final product," Gougelet said.

"The original ECBC special report was accepted and put into practice by nationally recognized and private firefighting organizations. Inclusion of the new information in the revised report represents the latest evolution in the approach to mass casualty decontamination and validates early HAZMAT and WMD mass casualty decontamination incident strategies," Divarco said. "It is our intent to again ensure widest dissemination of the revised report and to ensure our first responders have the best available information to use in mass casualty decontamination situations."


ECBC is part of the U.S. Army Research, Development and Engineering Command, which has the mission to develop technology and engineering solutions for America's Soldiers.

RDECOM is a major subordinate command of the U.S. Army Materiel Command. AMC is the Army's premier provider of materiel readiness -- technology, acquisition support, materiel development, logistics power projection, and sustainment -- to the total force, across the spectrum of joint military operations. If a Soldier shoots it, drives it, flies it, wears it, eats it or communicates with it, AMC provides it.