# HAZMAT



## daniduck (Apr 12, 2015)

How do i study the HAZMAT to prepar for the NREMT exam... there are some chemicals and gases that I know of based on just the HAZMAT course i took for my training course... however... what some tips in studying the Hazardous Material for the NREMT?


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## STXmedic (Apr 12, 2015)

There's hazmat on NREMT? I'm guessing it's just general ops questions, so know what an ERG is and how to use it would probably be sufficient.


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## OnceAnEMT (Apr 13, 2015)

STXmedic said:


> There's hazmat on NREMT? I'm guessing it's just general ops questions, so know what an ERG is and how to use it would probably be sufficient.



And where it is supposed to be kept!

Some other keys are parking location on a hazmat scene, where to stand, whether to use binocs or walk up to it, that kind of simple, awareness level stuff. Don't bog yourself down with chemicals. Understanding why CO isn't your friend is probably the most needed, if that.


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## COmedic17 (Apr 13, 2015)

I have my hazmat operations and even I only know the bare minimum on hazmat. 
Hazmat might quite possibly be the most boring subject ever. 


As far as EMS- carbon monoxide is bad and will give false spo2 readings, don't approach an accident when stuff spills until hazmat arrives, don't touch said stuff, stay in the cold zone, bleach is alkali - make them drink milk, SLUDGEM, etc etc. it shouldn't be to in depth.


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## OnceAnEMT (Apr 13, 2015)

COmedic17 said:


> Hazmat might quite possibly be the most boring subject ever.



I know some glow sticks that would disagree.


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## COmedic17 (Apr 13, 2015)

Grimes said:


> I know some glow sticks that would disagree.


You deem a glow stick to be hazardous?


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## OnceAnEMT (Apr 13, 2015)

COmedic17 said:


> You deem a glow stick to be hazardous?



Sorry, nickname for HazMat guys. Maybe its just a local thing.


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## COmedic17 (Apr 13, 2015)

I despise hazmat with a fiery passion.


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## RedAirplane (Apr 14, 2015)

Make them drink milk?


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## RedAirplane (Apr 14, 2015)

For liquid yuck, park uphill.

For gaseous yuck, park at the same altitude but upwind (I think).

The role of the EMT-- treating patients in the cold area, and possibly treating/monitoring (vitals, temperature) of the crews that go in. There's a cutoff for when you have to say they can't go back in (temperature over 100F I think), but check in your EMS Operations chapter of the EMT textbook.

It shouldn't be complex chemical reaction balancing. Just the stuff in the EMT textbook worded strangely.


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## COmedic17 (Apr 14, 2015)

Ishan said:


> Make them drink milk?


Yes. 



Have you really never heard of this?


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## RedAirplane (Apr 14, 2015)

COmedic17 said:


> Yes.
> 
> 
> 
> Have you really never heard of this?



If I did, my memory is being terrible right now.


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## OnceAnEMT (Apr 14, 2015)

Can't say I have either. Do explain.


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## EMDispatch (Apr 14, 2015)

The biggest thing is if you aren't trained to play in the hot zone, stay back and let us "glow worms", "glow sticks", or what ever you want to call us play. I think I may have had a question on that back when I took my NREMT.
-Park Units upwind and uphill
-Don't do this:


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## COmedic17 (Apr 14, 2015)

@Grimes what does dairy do in the stomach?

Hint- it has to do with the way lactase digests lactose.


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## Carlos Danger (Apr 14, 2015)

Ishan said:


> Make them drink milk?





COmedic17 said:


> Yes.
> 
> 
> 
> Have you really never heard of this?



Actually, current guidelines recommend against that.


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## COmedic17 (Apr 14, 2015)

@Remi 


Current guidelines recommend against it if the patient is actively vomiting or unconscious (when one couldn't drink milk anyways).

It is still recommended in patients whom drink bleach, are conscious, and not actively vomiting.


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## OnceAnEMT (Apr 14, 2015)

I guess I am confused on why we are saying drink milk when there is an NG tube in your tool box.


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## Carlos Danger (Apr 14, 2015)

COmedic17 said:


> @Remi
> 
> 
> Current guidelines recommend against it if the patient is actively vomiting or unconscious (when one couldn't drink milk anyways).
> ...



The MSDS for Clorox bleach does recommend drinking milk or water as layperson first aid, but because bleach is not even particularly toxic and ingestion generally requires no treatment at all, this is really a moot point. Give it or not, it doesn't matter.

If we are talking about more caustic agents - the kind that actually do require medical treatment - attempts at dilution or neutralization are contraindicated because it increases the risk of aspiration and thermal injury. 

This article from Medscape is well-referenced:



> *Do not induce emesis or attempt to neutralize the substance by using a weak acid or base*. This induces an exothermic reaction, which can compound the chemical injury with a thermal injury. It may also induce emesis, re-exposing tissue to the caustic agent.
> 
> Small amounts of a diluent may be beneficial if administered as soon as possible after a solid or granular alkaline ingestion, to remove any particles that are adhering to the oral or esophageal mucosa. Water or milk may be administered in small amounts. It is very unlikely to be of any benefit after more than 30 minutes. This practice is controversial: Some of the literature available on this topic discourages the use of diluents because of the concern of inducing emesis resulting in re-exposure of tissue to caustic agent.
> 
> *Diluents should not be used with any acid ingestion or liquid alkaline ingestion.* The risk of vomiting with re-exposure of the oral or esophageal mucosa to the offending substance can result in worsening injury or perforation.


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## COmedic17 (Apr 14, 2015)

Grimes said:


> I guess I am confused on why we are saying drink milk when there is an NG tube in your tool box.


Because there is not an NG tube in my tool box, if that solves your confusion.


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## COmedic17 (Apr 14, 2015)

Remi said:


> The MSDS for Clorox bleach does recommend drinking milk or water as layperson first aid, but because bleach is not even particularly toxic and ingestion generally requires no treatment at all, this is really a moot point. Give it or not, it doesn't matter.
> 
> If we are talking about more caustic agents - the kind that actually does require medical treatment - attempts at dilution or neutralization are contraindicated because it increases the risk of aspiration and thermal injury.
> 
> ...





Poison control, the CDC, and other government websites say to consume milk, but not induce vomiting.


 And milk is not used to counteract a base or acid, or to simply dilute. Perhaps your confused why it's recommended. It coats the stomach, which needs lactase to digest lactose, which in turn slows down absorption in the stomach (since this digestion requiring the enzyme lactase takes longer), this slowing down absorption of what is swallowed. Hence why it's used for chlorine ingestion as well. Here's some resources recommending milk for ingestion poisonings.



http://m.medlineplus.gov/ency/article/002488.htm


http://azpoison.com/sites/default/files/poisonology_bleach.pdf


http://www.atsdr.cdc.gov/MMG/MMG.asp?id=927&tid=192


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## Carlos Danger (Apr 15, 2015)

COmedic17 said:


> Poison control, the CDC, and other government websites say to consume milk, but not induce vomiting.
> 
> 
> And milk is not used to counteract a base or acid, or to simply dilute. Perhaps your confused why it's recommended. It coats the stomach, which needs lactase to digest lactose, which in turn slows down absorption in the stomach (since this digestion requiring the enzyme lactase takes longer), this slowing down absorption of what is swallowed. Hence why it's used for chlorine ingestion as well. Here's some resources recommending milk for ingestion poisonings.
> ...



You are just repeating what I already said. All those links did was restate what I already wrote about the MSDS for bleach. That is not a true caustic ingestion.

But, I suppose your references to outdated layperson first aid recommendations trump my references to professional clinical recommendations based on current research. Did you even look at the references in the Medscape article?

What would I know?

And milk "coats" the stomach? Lol


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## 46Young (Apr 15, 2015)

EMDispatch said:


> The biggest thing is if you aren't trained to play in the hot zone, stay back and let us "glow worms", "glow sticks", or what ever you want to call us play. I think I may have had a question on that back when I took my NREMT.
> -Park Units upwind and uphill
> -Don't do this:



That's hilarious, that's where I work. Rt. 50 and West Ox Rd is right up the road from the fire academy. 

I'm a Hazmat Tech, this thread caught my attention


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## 46Young (Apr 15, 2015)

As far as questions, I haven't taken an EMT cert exam since 2002, and I took my NR-P in 2007. Having said that, I would think that the questions would be on the ERG and an awareness of what a MSDS is.

I have an app for the ERG. Surprisingly, it's called "ERG 2012." You can download the app and reference the yellow, green, blue sections, etc, as well as placards and the different types of trailers, inter modals, etc.

If I had to guess, I would think that the focus would be to know what the hot/warm/cold zones mean, what a decon line is and how it functions, what a BLEVE is, that IDLH in Hazmat means respiratiory protection (SCBA, PAPR, etc.), what PPE lvl A/B/C means, Alpha/Beta/Gamma radiation and what protects against each one, how to determine isolation distance for day and night if given the reference page, what the hazards are (respiratory, flammability, etc.), and perhaps the general hazard classifications and what they mean, class 1-9 and its divisions. That's getting deep into the weeds for an EMT exam; that material is what you would cover in a Hazmat Ops class, which you would get OTJ, which is more intensive than what you would be expected to see in EMT school.

Hope this helps.


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