Table 2

 Assessment of staff performance and compliance with the SACC doctrine during the simulated chemical incident exercises

SACC criteriaChildren’s hospitalGeneral hospital
CPPE, chemical personal protection equipment; SACC, Structured Approach to Chemical Casualties.
CPPE and decontamination equipment availableYes, some delay in locating equipmentAll equipment available and ready to hand
Medical staff deployed for command, scene safety, communication, and assessmentPrompt and correct deployment of staffPrompt and correct deployment of staff Too few staff initially
Incident activation procedures and communication cascadeGoodGood, major incident control team arrived within 15 minutes
Appropriate demarcation of the hospital into clean and contaminated zonesAccomplished in six minutesAccomplished in six minutes, roles delegated Access through to the clean zone was blocked with equipment that would otherwise have been used had this not been an exercise
Correct and timely donning of CPPEDelays and practical difficulties in assembling CPPEThey were donned correctly, some difficulties in sizing, delays in assembling and donning
Triage according to triage sieveSlow as there was only one triage officerWhen triaged, the sieve was used correctly, deficiency in staff numbers led to delays
Recommended patient decontamination processEmployed correctly but inadequateEmployed correctly but inadequate
Appropriate lifesaving first aid during decontaminationDelay in finding equipmentUsed appropriately
Attempts made to minimise contamination trailsPatients not involved in the exercise crossed the decontamination area to access outpatient department that would have been closed in a real event. A “contaminated” casualty was able to enter the department potentially causing contaminationThere was no effective control of the contaminated zone
Correct procedure for staff decontaminationCorrect procedure used, but not for enough timeCorrect procedure used, but not for enough time.