ABSTRACT
Although most chemical incident plans are based on known risks such as large COMAH (‘Control of Major Accident Hazards’) sites such as oil refineries, accidents involving chemicals may occur off site during transportation, or involve low risk chemical sites with single or multiple chemicals. Incidents may also occur with rogue operators. On occasions an unrelated primary event may be lead to secondary events when chemicals are accidentally (or deliberately) released. These latter events may be triggered by construction/transport/fire/weather/terrorist incidents. Patients exposed to chemicals may present to the emergency services or hospital with a known exposure but may also seek medical treatment for vague conditions which subsequently turn out to involve chemicals. Exposure to chemicals may occur via oral ingestion, direct skin contact or via aerosol/gaseous inhalation. It is essential that all patients are assumed to have been exposed at the scene of an incident until proven otherwise. Emergency service staff and hospital staff must be aware of this issue. Hospital plans need to cater for large number of patients taking into account local risks. Incidents may be prolonged and may require activation of a ‘medical’ major incident plan (as opposed to a surgical/trauma incident plan). Be prepared to be flexible and innovative.
