Story by U.S. Naval Hospital Guantanamo Bay Public Affairs
U.S. Naval Hospital Guantanamo Bay (USNH GTMO) personnel took part in a three-day patient decontamination training course for medical first receivers Jan. 21-23.The course is designed to educate U.S. Navy Medical First Receivers on lifesaving skills that are required to triage, initiate field treatment, decontaminate, and save victims from chemical, biological, radiological/nuclear (CBRN), and other hazardous materials. Once the training concluded, the 28 USNH GTMO staff members who took part were certified in all requirements of the Occupational Safety and Health Administration’s (OSHA) Hazardous Waste Operations course to the “Operations” level.
“The hospital’s Emergency Management (EM) program must be ready and capable of supporting the Naval Station and its residents,” said Kevin Robarge, the hospital’s new Emergency Manager. “This First Receiver Operations Training (FROT) provided a good baseline knowledge for team members. We will implement lessons learned to improve our overall readiness.”
Tom Bocek, with DECON, LLC, headquartered in Biloxi, MS, was the instructor for the training. “The decon team is the ‘shield for the hospital’,” he said. “In a CBRN event, no medical team can perform their life-saving mission without the decontamination team doing its job first. Without decontamination, the hospital’s integrity could be compromised by the hazardous material, and that could potentially shut down the facility’s ability to provide medical care.”
In addition to learning about hazardous substances, the students were also trained on the proper way to set up a decontamination shelter and the different types of personal protective equipment (PPE) required and how to wear it. The three days of training culminated in a timed and graded exercise where all the participants had to work as a team to don the PPE, erect a working decontamination shelter, and then decontaminate mock casualties injured in a terrorist attack using a chemical weapon.
“Students attending FROT get a hands-on training experience that is ‘as real as it gets’,” said Bocek. “They had to set-up a complete decontamination system, operate it to its full capacity, dress-out in their real protective gear, and both triage and decontaminate actual patients.”
He added that one of challenges facing the hospital in Guantanamo Bay is the high turn-over rate of staff. “We trained a medical decon team here a year ago, and not one of those members is left,” said Bocek. “The entire class was completely new to this, yet after receiving the training, they were demonstrating a high level of competency at their new skills.”
Lt. Cmdr. Amanda Schaffeld, one of the hospital’s nurses, was the triage team leader during the training. “As healthcare providers we are taught to look, listen and feel when assessing a patient’s airway, breathing and circulation. The thick gloves, full face mask and noise created by the respirator make assessing lung sounds, feeling the temperature of the skin, or listening to heart sounds nearly impossible,” she said. “We learned and practiced unique methods to quickly triage contaminated patients in full PPE gear and initiate the decontamination process. I gained a better understanding of the signs and symptoms, physiological effects, and initial treatments that I might encounter when triaging patients.”
Once a decontamination team is notified of an incident, they are supposed to be ‘mission capable’ in 15 minutes or less, meaning the decontamination shelter is set up, the water heater is running appropriately and four people are properly protected in PPE, ready to start processing patients. ‘Set-up complete’ is expected in 20 minutes or less, meaning all team members are appropriately suited in PPE, all supplies are in their appropriate places, and the team is fully functional.
“The FROT course was very eventful and informative,” said Hospitalman Lorne Adams, one of the team members. “It tested both our physical and mental ability in a simulated dangerous situation. It was also great information for the upcoming advancement exam.”
Hospitalman Apprentice Xavier Murray also took part in the exercise. “I personally enjoyed the training we received,” he said. “One of the major things that I will remember is that I now have a better understanding of the different chemical agents that might be involved in an incident.”
Bocek said the work is only just beginning. “Although this team is well trained now, every team gets better with practice, particularly when there are so many considerations and moving parts,” he said. “I’m leaving this team with the basic skills to succeed. Now it will be up to them to keep their equipment and skill fully mission-capable.
“This was a great opportunity to get hands-on experience and provided us with an evaluation of our current capabilities,” added Robarge. “This kind of training is exactly what we need for our staff.”