Hazardous materials accidents: initial scene assessment and patient care.

Hazardous materials, i.e., chemicals that are toxic, corrosive, flammable, or explosive, are a ubiquitous aspect of modern life. They are manufactured throughout the United States, shipped by truck, train, barge, and pipeline, and stored at a wide variety of locations, including factories, military bases, and warehouses. Accidents involving hazardous materials present an added dimension of danger to emergency personnel arriving first at the scene, and have the potential to produce chemically contaminated patients who require special medical treatment. Personnel arriving first at the scene must understand how to evaluate the scene for fast and safe mitigation without endangering themselves. Chemically contaminated patients require prompt treatment, which, for optimal outcome, must begin at the scene. Although frequently the identification of the hazardous materials involved is not known initially, emergency personnel may safely provide medical care to the victims by understanding and following the principles of hazardous materials accidents and the pathophysiology of chemical injuries as presented in this paper.