Bennett XIV 
GAS CLEANSING AND CHAIN OF EVACUATION 
Granville A, Bennett 
Surgeon (R), USPHS 
Acting Medical Gas Officer, OCD, Washington, D. C. 
My discussion this morning logically fits in between what 
Mr, Cary has already told you and what Lieutenant Commander 
Abt is going to show you.upstairs during the next hour. Owing 
to the fact that we were late in beginning this portion of the 
program I am going to abbreviate my comments somewhat. This 
will allow time for questions at the end of the discussion. 
I Y/ould like first of all to point out that the problem 
related to the gas cleansing station is still in the experi- 
mental stage. I doubt if anyone really knows the answers to 
the many questions concerning construction, distribution, and 
operation of those establishments. The problem is being con- 
sidered at the present time and I think it is safe for us to 
promise that well considered recommendations will be forth- 
coming in the near future. For the present it seems best to 
look at the problem as being one of gas cleansing, to be accom- 
plished in improvised structures that will require a minimum of 
essential materials. I am afraid that in the past there has 
been too much thought given to the kind of a building that 
should be erected, rather than to the problem of getting ready 
to do a job of cleansing of injured people. 
I would like also to call your attention to the fact that the 
newly revised edition of the manual ’’First Aid in the Pre- 
vention and Treatment of Chemical Casualtiesfl contains a dia- 
gram of a more suitable type of cleansing station than the one 
you will find in the pamphlets previously published and now in 
your possession. In these booklets the original British recom- 
mendations were followed. The British have found it necessary, 
however, to modify some of their original ideas. 
Originally in Groat Britain, decontamination stations so-called, 
v/ero sot up and distributed chiefly on the basis of population 
requirements. At first it socinod to some persons in this country 
that similar pi'©visions should bo made for cleansing stations to 
servo all persons. When one considers the great rapidity with 
which the vesicant agents act, however, it is quite obvious that 
a tremendous number of cleansing establishments would be needed 
in our cities if they arc going to be of very much service to the 
civilian population. This fact, coupled with the awareness that 
the materials needed for station construction arc exceedingly 
scarce, has led to a change in policy. It is now believed that 
our civilian population should be fully trained in first aid and 
self aid measures and in avoiding exposure to chemical agents of 
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warfare. If this educational policy is fully carried out it 
should minimize the need for fixed cleansing stations to serve 
gassed but otherwise uninjured persons. So, for the present 
at least, as Mr. Cary has told you, it is recommended that 
cleansing stations are to be placed at or near hospitals and 
casualty stations. 
It is quite obvious that there are two types of personnel that 
must be supplied with cleansing facilities. As Mr. Cary has ex- 
plained, there are, in addition to the injured and contaminated, 
certain people workin g in the protective organizations that will 
undoubtedly become contaminated. The clothing of these persons 
will have to be salvaged. It is recommended, that insofar as 
possible, the hospital cleansing stations will be used for this 
purpose after the injured and gassed have been cared for. It 
may be necessary, however, to improvise cleansing facilities, 
at school houses, in police stations, and fire departments, where 
certain protective services like the police and firemen can go 
to be cleansed. In the ordinary community the air raid wardens, 
in conjunction with the local gas officers, should pick out cer- 
tain places or certain homes that are best suited for emergency 
cleansing so that if an air raid warden or other persons in his 
precinct become contaminated, he will not have to travel nine 
or ten blocks to the casualty station to have the vesicant agent 
removed. In such a case, the contaminated person will go directly 
to his own sector station (somebody's home), remove his clothing 
outside the house and then be admitted to the basement or into 
the shower room for rapid and effective cleansing. 
The matter of defense plants should be mentioned. In the Office 
of Civilian Defense, one of the officers, Dr. Mould, is devoting 
most of his time and thought to the subject of plant protection, 
including cleansing facilities. This is a special problem that 
cannot be dealt with at this time. 
Captain Fritz in talking about protective clothing earlier this 
morning pointed to this model as an example of a fully protected 
person. The suit in which the model is dressed is intended in be 
one that has been improvised. It is not a regular issue typo of 
clothing but it is a type of clothing that may be made and used 
in a local community organization. The typo of clothing here on 
the other mannikin is the impermeable type, the only type that 
the O.C.D. expects to bo obtainable for civilian use, at least in 
the near future. This typo of clothing on the table is the per- 
meable or treated type of clothing. It is used by the Chemical 
Warfare Service but in all probability will not be available for 
civilian use since the chemicals necessary for its manufacture 
are not available in the necessary quantity. 
To summarize: In event of an attack, our population would fall 
into three main categories: (l) the average civilian who should 
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be instructed in Y/ays of avoiding exposure. If ho becomes 
contaminated he will have been trained to take care of him- 
self; (2) our Citizens Defense Corps people and the established 
protective personnel in our municipalities (police and firemen) 
for whom some special arrangements should be made. Certain 
improvised cleansing facilities should be arranged for these 
people; (3) the injured and gassed. This is perhaps the most 
important group of all. 
We must bear in mind that injured persons may be gassed with 
one or two classes of gases or with mixtures of both types. If 
they are gassed with the so-called lung irritant gases, the pro- 
blem is much simpler from the point of view of emergency medical 
service because there will be no meed for cleansing prior to 
treatment. More important for your consideration will be the 
injured persons who are contaminated with vesicant agents. A 
person with a fractured pelvis, for example, who has been splashed 
with liquid mustard becomes a real problem in medical management. 
This person is not only a chemical casualty himself but he is a 
potential hazard to everybody with whom he comes in contact. In 
order to handle him without endangering our medical personnel, 
including doctors, nurses and orderlies, or, as a matter of 
fact, without endangering all the other patients in the hospital, 
this casualty must be cleansed by properly trained persons fully 
protected against injury from the vesicant agents. It is neces- 
sary, therefore, that cleansing stations bd planned and if possible 
established for hospitals that are to receive injured persons in 
case of an attack. 
As I previously mentioned, these stations may be used after an 
attack is over for the cleansing of persons belonging to the 
Citizens Defense Corps, who have become contaminated. Still 
later they may be used for the cleansing of the dead who have 
vesicant agents on their clothes or bodies. 
I should like to digress for a moment at this point in order to 
mention the responsibilities of the various gas officers in a 
local community. Each community should have a trained gas officer 
in addition to the physician who has been trained in gas defense. 
It will bo the responsibility of these persons to establish the 
necessary cleansing stations and to initiate the necessary local 
training programs for the persons who will operate such stations. 
A considerable number of persons will be required to operate a 
cleansing station. Some one will be needed to direct traffic out- 
side of the station, perhaps a member of the emergency police or 
even a regular policeman. It would bo desirable to have a medi- 
cally trained person outside the station to supervise the unloading 
of ambulances and to aid in the sorting of casualties. In case of 
a large and devastating incident, there would be many injured per- 
sons . Some would be more seriously injured than others and these 
should, if possible, have immediate medical attention. We believe 
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that there should be two stretcher bearers, fully protected, 
whose solo duty is the unloading; and transfer of patients to 
the undressing room. The training of these persons should be 
comparatively simple since they need to be trained only in the 
proper handling of stretcher cases and in the wearing of pro- 
tective clothing. 
A considerable number of persons will bo needed inside the 
station. If it is a station designed for six stretcher cases, 
as Mr, Cary has described, it will probably bo necessary to 
assign two persons to each stretcher rack. All of these people 
will need complete protective clothing, including gas masks. 
They must bo trained to undress their patients rapidly, cutting 
away certain parts of the clothing as needed. They should also 
be taught to remove any excess liquid vesicant agent remaining 
upon the skin. Cloth or blotting material so used is deposited 
in tightly covered metal containers. Attendants in the undress- 
ing room must also be trained in the immediate first aid treatment 
of vesicant burns. 
The matter of shifting persons from a contaminated stretcher onto 
a clean one should bo thought of. Heavily contaminated stretchers 
should be removed from the undressing room as soon as possible. 
Patients on clean or relatively clean stretchers are next carried 
through the gas lock to the cleansing room. This can probably bo 
done best by two stretcher bearers who pass back and forth from 
the cleansing room to the undressing room. These attendants would 
be stationed in the cleansing room a good part of the time. They 
would pass through the gas lock and transport each suitably pre- 
pared patient back through the lock and into the cleansing room 
where they would be placed on stretcher racks to receive their 
baths. Thus each station of this capacity woul$ require 12 fully 
protected undressers. In addition, four stretcher bearers, a med- 
ical officer and perhaps a policeman would bo needed to operate 
this much of the establishment. 
After the casualty has been transported to the cleansing room the 
personnel of this room undertake the process of bathing him and 
irrigating his eyes. At the present time wo believe that attend- 
ants in this room should wear respirators or gas masks. They will 
also need a certain amount of protective clothing. Rubber gloves 
or perhaps impregnated gloves with rubber gloves over them, oil- 
skin or rubberized aprons, end rubber boots or overshoes will 
probably be necessary. There will doubtless be some gas vapors 
in the cleansing room that should be guarded against. It is the 
duty of the attendants in the cleansing room to completely cleanse 
each patient placed before them. If the patient is brought in, 
his eyes will probably have been injured. On the other hand, if 
the patient arrives wearing a properly fitted mask, his eyes will 
have been protected. In any case, prompt irrigation of the eyes 
should bo carried out as soon as the casualty arrives in the 
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cleansing room. This can be accomplished best by two persons 
working together. Nurses aides might be assigned to the task of 
irrigating the eyes. After cleansing has been completed, the 
patients ere loaded on hospital carts or stretchers, and they are 
then ready to bo taken into the hospital. 
Insofar as I know, the next point in my discussion has not been; 
referred to in any of the booklets. It would seem sensiblete 
try and separate completely the cleansing room and all its per- 
sonnel from the hospital or the dressing room. Perhaps a mechan- 
ical barrier such as a cement curbing in the floor should be set 
up. The reason for this precaution is that the persons working 
in the cleansing room will sooner or later contaminate the dress- 
ing room or hospital floor if they pass back and forth from one 
room to the other. It would, therefore, seem advisable to plan 
to have the cleansed casualty lifted onto a hospital cart by 
hospital orderlies so that the floor of the dressing room or of 
the hospital itself could be kept free of the vesicant agent. 
When the patient reaches the dressing room he should be seen by 
a physician and nurse and appropriate emergency therapy should be 
instituted. This is about the first opportunity for effective 
medical treatment. 
I had planned to talk to you briefly about first aid and self 
aid for the gassed but uninjured person. However, I will skip 
this subject for the moment and, if time permits, I will come 
back to it at the end of the hour . In case I don't have time to 
consider this important subject, I should like to have you pay 
careful attention to Operations Letter No. 46. Furthermore, I 
would recommend that you emphasize first aid and self aid in any 
subsequent courses you may give. 
In an attempt to tie this morning's exercises together, I would 
like to trace out what might bo the chain of events from the time 
the alarm was sounded until the casualties began to arrive at a 
hospital cleansing station. 
After an air raid alarm sounds, every person who has no assigned 
responsibility moves off the street and goes into an air raid 
shelter or, if ho is near his homo, ho goes to his own home. They 
go to the rooms that were previously selected and considered to be 
the safest place in the building. 
Some of the windows in private homes might be opened a little 
with the hope of preventing the shattering of glass when explosions 
occur. The air raid wardens will, of course, go out to their posts 
on the street. 
The air raid warden will have been trained to be on the alert for 
a gas attack. He v/ill listen for the type of bombs which might 
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indicate a gas attack. Ke will be on the alert for odors of gas. 
If he suspects that gas has been used in his area, he will sound 
his gas alarm. We issued to you, I think, another Operations 
Letter (No, 49) in which several types of gas alarms were sug- 
gested. It has since been decided that the wooden rattle will 
serve as the instrument to sound the gas alarm. I don’t know 
whether it will be possible to hear this signal. It is possible 
that at times the noise might be so great as to obscure any 
single audible warning. In this event some other means will be 
used by the warden to warn that gas has been used and all persons 
inside of shelters and houses will follow the recommended pro- 
cedures of escaping from the fumes and making their shelters gas 
tight. 
In any case, the air raid warden will call the control center, 
notifying the senior gas officer that he suspects that gas has 
been spread in his sector. The senior gas officer has the sus- 
pected area marked on the map and he dispatches his gas reconnais- 
sance agent—one or more as the case may indicate—to the suspected 
area. The reconnaissance agents have detector devices and are 
trained in their use. (We have a few examples of detectors hero 
and perhaps Mr, Cary will say something about them later.) The 
reconnaissance agent goes to the area in question and determines 
whether or not gas has been laid down and, if possible, the type 
of gas. 
In the meantime the senior gas officer uses his judgment in allow- 
ing or not allowing services to go through this sector. The emer- 
gency medical service representative at the control table notifies 
the hospitals and cleansing stations to be ready to receive chemi- 
cal casualties and as soon as he learns the type of gas that has 
been used, he informs the attendants at the cleansing stations of 
the type of casualty they should be prepared to treat. 
Now from the control center the emergency medical chief dispatches 
certain fully trained and properly protected personnel. Certain 
ambulances that have been assigned to this work are sent out with 
their complement of fully equipped and trained persons. In this 
way it should be possible to handle the injured and gassed casualties. 
There are many other things that are going to need attention. Some 
of these assignments are not entirely in the province of the emer- 
gency medical service, but medical advice may bo needed. What will 
bo done with persons stranded in this contaminated area? It may 
bo necessary to clean up a small passageway in order to evacuate 
those persons that have been staying upstairs in their own dwell- 
ings. The streets and buildings will have to be decontaminated in 
the manner shown in the movies last night. These responsibilities, 
for the most part, belong to the senior gas officer and his recon- 
naissance agents. They must decide upon the best and most expedient 
method of handling the local situation and give the necessary advice 
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to the protective agencies that will undertake the task of 
cleaning up the area. 
My time is nearly used up. However, before closing I should 
like to mention a few matters on self aid and first aid in which 
the teachings in this course have varied from the recommendations 
published in the pamphlets that were issued to you. The tempera- 
ture of the water for bathing was mentioned and cold soap and water 
sponging was stated to bo superior to soap and hot water baths in 
preventing burns from vesicant agents. Taking everything into 
account, such as the superior cleansing of hot water, the relative 
comfort to the patient, etc., perhaps wo should recommend the use 
of warm water. The use of "solvents”, gasoline and kerosene, is 
not recommended in the O.C.D. publications. Dr. McLean has, how- 
ever, included them as useful substances for the removal of vesi- 
cant agents. If such solvents arc to bo used, extreme care must 
bo exercised to prevent the spreading of the vesicant over a 
larger area of skin. 
All speakers have emphasized, as I am sure you hove noted, the 
need of prompt first aid and self aid measures if such treatment 
is to be at all effective. For this reason it is believed that 
the procedures for first aid should be as simple as possible and 
that the number of remedies recommended should bo limited to a 
very few that can bo found and applied quickly. Once again I should 
like to recommend that you make the maximum use of Operations 
Letter No. 46 in your subsequent teaching. 
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