Patient decontamination should occur outside the hospital. Hot, warm, and cold zones should be established and cordoned off with brightly colored tape. The hot zone is the area of the spill or chemical release (at the scene) or the hospital area where arriving patients with no prior decontamination are held. Therefore, only those trained and properly attired may enter. Only the most immediate life threats are addressed in the hot zone (opening of the airway, cervical spine immobilization, brushing off of gross contaminants, and applying pressure to stop arterial bleeding). The warm zone is an area where thorough decontamination and further medical stabilization occur. Theoretically, this area poses no risk of primary contamination (direct exposure to the toxin), but secondary contamination (transfer of the toxic material from the victim to personnel or equipment) may still occur. Access, therefore, is also restricted, and the use of protective clothing is required. The cold zone is the area to which fully decontaminated patients are transferred. There is no personnel flow between hot/warm or warm/cold areas.
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