“You have 20 minutes.”

On the right shoulder of her suit, the numbers “8:32” are scribbled on by an Emergency Medical Response Team (EMRT) member. From here, the clock begins to tick.

“You have 20 minutes.”

The team leader with VA Tennessee Valley Healthcare System’s (TVHS) EMRT shouts as the hazmat-clad team members move forward to respond to a decontamination simulation, with every second counting.

“Today was an exercise for our first receiver decontamination team,” said Charles Pickett, an emergency management specialist with TVHS. “The training scenario is a simulated aircraft mishap at [Nashville International Airport], and casualties were covered with an unknown chemical.”

The Veterans Health Administration (VHA) First Receiver Decontamination Program trains VA employees to respond effectively to incidents involving contaminated patients. This program equips VA medical centers with staff who are prepared to collaborate with county, state, and federal agencies in the event of a potential chemical, biological, radiological, or nuclear incident. This essential training is part of VA’s fourth mission. It enhances the capabilities of TVHS to coordinate and respond to emergencies, ensuring that Veterans and the community receive safe medical care during real-world crises or natural disasters.

In the case of the training, the decontamination team is responding to a scenario of contaminated patients being transported to Nashville VA Medical Center.

“When we receive contaminated patients, the first thing we want to do is decontaminate them and get them as clean as we can at the fire hydrant. Although they get decontaminated in the field, we still repeat the process here so that we can make sure nothing was missed before we take them through a thorough wash,” said Pickett.

Each patient is walked through a multi-nozzle spray at a fire hydrant to decontaminate the patient’s clothes and skin. A member of the emergency management team, wearing a Tychem suit, guides the patient through the process to ensure the steps are completed safely and quickly, underscoring the importance of the timestamp on the Tychem suit.

After the patient is decontaminated at the fire hydrant, they change into a gown and are escorted into a decontamination tent, where they are washed with soap and thoroughly scrubbed head to toe. This checkpoint allows any harmful contamination to be washed off and safely contained and drained away. The patient then exits the decontamination tent to change into a new clean gown and has their vitals checked before being escorted to the Nashville VA emergency room.

During each step of the decontamination process, a member of TVHS’ emergency management team provides guidance and ensures that the patients are well cared for.

“…We can't have a rescuer taken out of the fight.”

Decontamination is a systematic process aimed at reducing the risk of contamination for both the emergency management team and the hospital. The team is responsible for ensuring that every step, including the proper sealing of Tychem suits for team members working in contaminated areas, is carried out according to established standards to minimize risks.

“Attention to detail is absolutely paramount. If the slightest bit of chemical touches one of our team members, now they're contaminated, and we can't have a rescuer taken out of the fight,” said Pickett.

Practicing this type of training every few years is essential. Suiting up and conducting operations in the field ensures that all team members are ready for real-life scenarios. Liu, who joined EMRT in 2020, feels confident in her ability to respond to crises thanks to the comprehensive training and exercises organized by the emergency management leadership.

“I feel good, and I can breathe normally,” said Liu. “It's normal to me since this is my second or third time donning the suit.”

From Liu’s perspective, the team can rapidly respond because of the success of their training together. And she believes that given a real-world scenario, they would be ready when the clock starts.
 

“We have been training together for a while. We know what we're doing, how we should suit up, and how we are supposed to decontaminate the patients. Everybody knows their job,” said Liu.
 

Similar to today’s decontamination training, the emergency management team conducts training events throughout the year with county and state agencies to maintain its readiness to support the National Disaster Medical System.

For those interested in learning more about emergency management, visit TVHS Office of Emergency Management’s website.