QUICK GUIDE:

Escape in case of a CBRN Emergency

Médecins Sans Frontières

• EMACC and CBRN intersection WGs

EN_2022_MSF_Quick_Guide_Escape_CBRN_Emergency_V2022-04. Validated by C. Rieux, DirMed and by

MSF EMACC Working Group for intersectional use .
1
2022

ESCAPE Quick guide in case of a CBRN emergency

Quick guide: Escape in
case of a CBRN
emergency

CONCLUSION

1-RECOGNIZE THREAT
2-PROTECT yourself
- PPE
- Escape
- or seek shelter

3 - DECONTAMINATE
 2022

2 Immediate safety and protective measures in case of a CBRN emergency

Quick guide: Escape in
case of a CBRN
emergency

RECOGNIZE the risk of primary exposure

TO RADIOACTIVITY

Announcement

The radiometer detects radiation:

Above 100 microSv/hr
 2022

3 Immediate safety and protective measures in case of a CBRN emergency

Quick guide: Escape in
case of a CBRN
emergency

RECOGNIZE the risk of primary exposure

TO A CHEMICAL AGENT
Indicators of alert
• Activated emergency warning systems ,
Emergency personnel activity and
announcements.
• People wearing personal protective equipment.
Discarded personal protective equipment.
• Explosion(s) with little or no structural damage.
• Droplets of oily film on surfaces. Unusual
liquids, sprays or vapors.
• Low-lying clouds or fog unrelated to weather;
dust clouds; suspended – possibly colored –
particles.
• Unusual or unauthorized spraying in the area.
• Unexplained odors (e.g., garlic, bitter almonds,
peach pits, newly mown hay or grass,
horseradish).
• Unusual number of dead or dying animals in
the area.
 2022

5 Immediate safety and protective measures in case of a CBRN emergency

Quick guide: Escape in
case of a CBRN
emergency

PROTECT YOURSELF
If a CBRN release occurs outdoors
Move away perpendicular
Wear an escape hood to the wind (in a closed car
And cover any exposed if possible) wind
skin (roll down sleeves, direction
button up coat/jacket).

Full PPE if If unsafe to run, seek shelter.

safe to do
so
 2022

6 Immediate safety and protective measures in case of a CBRN emergency

Quick guide: Escape in
case of a CBRN
emergency

PROTECT YOURSELF
The escape kit – Personal backpack
- Escape hood
- Coveralls, overshoes, double gloves,
- Dry decontamination materials (RSDL sponge)
- Neutralizing agent - antidote
 2022

6 Immediate safety and protective measures in case of a CBRN emergency

Quick guide: Escape in
case of a CBRN
emergency

PROTECT YOURSELF
The escape kit – Personal backpack
- Escape hood
- Coveralls, overshoes, double gloves,
- Dry decontamination materials (RSDL sponge)
- Neutralizing agent - antidote
 2022

7 Immediate safety and protective measures in case of a CBRN emergency

Quick guide: Escape in
case of a CBRN
emergency

PROTECT YOURSELF

The escape hood protects against any chemical agent for around 20 minutes.
1 2 3 4

Unseal the double reinforced pouch and Don the hood and evacuate.
deploy the hood.
 2022

8 Immediate safety and protective measures in case of a CBRN emergency

Quick guide: Escape in
case of a CBRN
emergency

PROTECT YOURSELF
If a CBRN release occurs indoors
• Exit the building and avoid passing through the
contaminated area.
• Exit through a window, if necessary.

•If you suspect you have been contaminated by a CBRN agent

•Avoid contact with others to prevent secondary contamination.

•WIPE YOUR FACE CLEAN if possible and Put on the escape hood
•Move away from the ²point of release as quickly as possible.
•Keep the hood or mask until being sure that there is no further inhalation risk
•Self-decontaminate through dry and/or wet decontamination
 2022

9 Immediate safety and protective measures in case of a CBRN emergency

Quick guide: Escape in
case of a CBRN
emergency

PROTECT YOURSELF
Not in the escape kit
In the hospital decontamination kit
The NBC mask + Canister protects against any chemical agent for 1 hour.
1 2 3 4 5

Check seal by
Tighten neck and temple straps inhaling while
Remove seal from canister, thread
the canister into the facepiece, by pulling backwards. Tighten blocking inlet
top strap if necessary. with your hand
extend straps, place chin in
facepiece, and pull harness over
head.
 2022

9 Immediate safety and protective measures in case of a CBRN emergency

Quick guide: Escape in
case of a CBRN
emergency

PROTECT YOURSELF
Not in the escape kit
In the hospital decontamination kit
The NBC mask + Canister protects against any chemical agent for 1 hour.
1 2 3 4 5

Check seal by
Tighten neck and temple straps inhaling while
Remove seal from canister, thread
the canister into the facepiece, by pulling backwards. Tighten blocking inlet
top strap if necessary. with your hand
extend straps, place chin in
facepiece, and pull harness over
head.
 2022

10
Quick guide: Escape in

Immediate safety and protective measures in case of a CBRN emergency

case of a CBRN
emergency

PROTECT YOURSELF

DECISION-MAKING : Should I stay or should I go now ?

Your BEST OPTION IS TO FLEE, perpendicular to the wind – With PPE on.

11 Km
> 30 Km

If it is considered too unsafe to leave the area, SEEK SHELTER!

-You are in a chemical cloud.

-You are under a nuclear plume.
- It is considered too suspicious
to move wearing PPE
After you have received information that immediate threat has
passed, relocate to a non contaminated area wearing PPE .
 2022
Quick guide: Escape in

11 Immediate safety and protective measures in case of a CBRN emergency

case of a CBRN
emergency

DECONTAMINATE
Decontamination is the first and most important step.
1- Remove clothes (gently – protocol)

2- Dry decontamination

Reactive Skin
Decontamination Fuller’s earth Bicarbonate Flour
Lotion (RSDL)

3- Wet decontamination,
using water and soap.

Dry decontamination is chosen if there is no access to wet decontamination (water and soap), or before
wet decontamination. When done properly with RSDL, it is very effective.
 2022
Quick guide: Escape in

12 Immediate safety and protective measures in case of a CBRN emergency

case of a CBRN
emergency

DECONTAMINATE
FIRST step: Remove your clothes according the following protocol (dry decontamination) :
1
Put jewelry and
wallet in small
plastic bag and
close it

Wipe bare skin with RSDL After 2 min wipe Double glove Remove shoes, Remove clothing gently. Do not pass articles over
excess off stand on drop sheet your head. Use scissors. Put clothes and outer
gloves in waste bag and seal it.

2 3 Seal the bag, Store sealed bags

remove inner until arrangement
gloves, and put for proper
them in last decontamination
small plastic bag

Wipe groin, armpits, and mask with Remove Hood

RSDL. and wipe off excess after 2 min leaning forward Put mask, RSDL and drop sheet in 2nd bag

In the shower, You should then seek

After doffing, if possible, take a shower proceed to do medical attention
IMMEDIATELY (wet decontamination) – if TWO shampoos
not, put on clean clothes and take a of hair and A decontaminated patient cannot
shower at earliest opportunity, and body hair and contaminate someone else and can enter
change your clothes one last time. ONE body soap any health care facility with no specific
wash and rinse. precautions form the staff.
 2022
Quick guide: Escape in

13 Immediate safety and protective measures in case of a CBRN emergency

case of a CBRN
emergency

Medications and antidotes

Potassium Iodine (KI)

WHY: Prevention of thyroid cancer

WHEN: radiometer level > 100 μSv/hr.

HOW: One time dose sufficient

- Potassium iodide 130 mg (one tablet)
- or Lugol Solution 1% 3.9 mL = 80 drops.
At best one hour before passing of the plume
Efficient up to 4 hours after.
 2022
Quick guide: Escape in

13 Immediate safety and protective measures in case of a CBRN emergency

case of a CBRN
emergency

Medications and antidotes

Ineurope auto injector (or other model)

WHY: nerve agent poisoning

WHEN:
• Symptoms on you or surrounding : Eye and nose irritation – Hyper-salivation
– Difficulty breathing – Pin-point pupils - Seizures – Sudden collapse
• Probable chemical exposure of skin or airway before protection, and no
obvious orientation as per the chemical agent itself. In doubt: Inject Ineurope.

HOW (for the Ineurope device )

3 4 5

Inject through the clothing

Twist the syringe to mix Remove the injection guard. Inject by pressing the end of the
Pull the red tab to disengage the safety Hold pressure
between compartments
the dilutant with the meds. device into contact with the for 10 seconds
outer aspect of thigh
1
2022

ESCAPE Quick guide in case of a CBRN emergency

Quick guide: Escape in
case of a CBRN
emergency

CONCLUSION

1-RECOGNIZE THREAT
2-PROTECT yourself
- PPE
- Escape
- or seek shelter

3 - DECONTAMINATE