Health care facility-based decontamination of victims exposed to chemical, biological, and radiological materials.

Since the US terrorist attacks of September 11, 2001, concern regarding use of chemical, biological, or radiological weapons is heightened. Many victims of such an attack would present directly to health care facilities without first undergoing field decontamination. This article reviews basic tenets and recommendations for health care facility-based decontamination, including regulatory concerns, types of contaminants, comprehensive decontamination procedures (including crowd control, triage, removal of contaminated garments, cleaning of body contaminants, and management of contaminated materials and equipment), and a discussion of methods to achieve preparedness.

Health care facilities' "war on terrorism": a deliberate process for recommending personal protective equipment.

The protection of health care facility (HCF) staff from the effects of weapons of mass destruction has gained heightened attention since the 9-11 terrorist attacks. One critical component of protection is personal protective equipment (PPE). No universal standard exists for an "essential" level of PPE for HCF staff. The absence of such a standard raises the need for development of national policy for PPE levels, particularly in HCFs. We describe a process used by the Veterans Health Administration for recommending policy for "essential" PPE levels. Although the recommendations are specific for Veterans Health Administration, the process, findings, and applications may be useful to other institutions as they attempt to resolve this critical issue. This descriptive account will serve to generate practical scientific debate in the academic community and lead to definitive public policy recommendations for the Nation's HCFs in executing their roles in the event of a terrorist attack.