EMERGENCY MANAGEMENT
large- and small-animal incidents for a vast range of chemical, biological, and radioactive exposures. Decontamination procedures use both gross de- contamination and technical decontamination tech- niques. It is important to recognize that harmful effects of some contaminants is exacerbated by wa- ter and dry contamination is required. When a wet decontamination is appropriate, gross decontamina- tion removes the majority of surface contamination by using large amounts of water to rinse off loose particles from the animal’s coat. This stage ac- counts for the bulk removal of the contamination. Technical decontamination is a multi-step process that encompasses a detailed removal of the hazard- ous material from all external aspects of the ani- mal’s body. Methods utilized include “brushing, vacuuming, and washing, to eliminate the contami- nant from the animal;” however, in reality, washing remains the primary method by which materials are removed. In short, technical decontamination is an extensive process and may require repeating steps to ensure the complete removal of the hazardous materials or toxic agents. Historically, liquid dish soap has been the agent of choice for external tech- nical decontamination. The physical properties found in liquid dish soap allow for binding and emul- sification of particles and particularly oily sub- stances that may bind or attach to the oils of the skin and hair follicles (Heyer, 2011). Other agents such as hypochlorite solutions and chlorhexidine so- lutions have been utilized for biological decontami- nation, but have the drawback of time dependency and inactivation. Hypochlorite solution typically requires 15 minutes and chlorhexidine requires 6 minutes of contact time with the skin to effectively denature biological agents (Heyer, 2011). In addition, to the selection of soaps and setting
up procedures for individual decontamination of horses rescued from a disaster environment, there is a critical need to consider the protection of the per- sonnel performing the decon (personal protective equipment), protection of the environment from the contaminants (collection of waste water—itself a po- tentially massive volume), and need for a potentially very large number of personnel needed to complete the decon process (given a maximum time in per- sonal protective equipment of 20 to 30 minutes in temperatures greater than 75°F, and a minimum of 3 personnel needed for each horse (1 person for restraint and 2 for washing, lathering, and rinsing). Finally, while data on water usage and time for decon procedures in horses is lacking, if one extrap- olates from canine data, it will likely require more than 15 to 20 gal/horse and a minimum of 20 to 25 minutes per horse, thus making decontamination of a large number of horses in a disaster event ex- tremely time consuming, personnel intensive, and require a large volume of fresh water (at least pota- ble), which may be at a premium in a disaster. These data are not given to overwhelm, and it is recognized that veterinarians should not be the
10 2020 Vol. 66 AAEP PROCEEDINGS
source of manpower for these procedures, but veter- inarian oversight is critical, and the potential need for pharmaceutical restraint for those horses that are unruly or fearful, is a significant reality.
Triage in a Disaster Environment
Providing veterinary medical care during emer- gency or disaster situations is very different than the typical practice day for the following reasons:
● The number of injured or ill animals being brought to the veterinary medical facility may be much greater than the typical daily caseload.
● Animals will likely be presented by a rescuer rather than their owner.
● The owner may be unavailable to participate in decision making.
● The ownership status of the animal may often be unknown.
● Your facility may not be available or may be operating without the normal resources (power, water, ability to resupply, personnel shortages).
● Evacuation of animals to veterinary medical facilities capable of providing definitive care may be unavailable for many days or longer.
● Resources such as pharmaceuticals, supplies, and animal food may be scarce and difficult to replenish.
The issues identified above require that ground rules be set. In order to prevent a misunderstand- ing the veterinarians involved in the local animal disaster group (e.g., CART, VMRC, or other local group) need to know what the resources and expec- tations are for dealing with animal issues. For ex- ample, when the Texas A&M VET deploys into an area, county officials are asked how aggressive they want the veterinarians to be in providing veterinary medical care, develop the animal evacuation chain, and discuss with shelter partners the types and numbers of injuries they are prepared to provide continued care for. It has been the authors’ expe- rience that county officials understand the impor- tant role that animals play in their constituent’s lives and that sheltering partners are prepared to provide substantial continued veterinary medical care. However, each disaster and local resources are different, requiring clear lines of communication and expectations that are set early. It is also important to set the triage rules early in
the deployment. Triage means literally “to sort” and is a critical process in the management of ani- mals impacted by a disaster. An excellent discus- sion of triage is provided in “Veterinary Disaster Response” and is considered required reading for veterinarians and veterinary technicians wishing to participate in emergency response (Wingfield, 2009). The authors’ team uses a slightly different system that is divided into field triage and veterinary med-
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