Narrative:

We departed our base for an 8 minute flight to the west. Once airborne; dispatch notified us that we were responding for a burn victim and the medical crew was given the normal medical information; but no details about the incident. Upon landing the medical crew departed the aircraft and entered the ambulance; which had just arrived.once the medical crew started patient treatment they were notified that the patient was a victim of a methlab explosion. They discussed with the ambulance crew and fire department about the possibility of contamination and were reassured that the patient was not in the immediate area of the methlab. Patient clothes had been burned off and/or removed. The medical crew was comfortable with transporting the patient. They wrapped the patient in a thermal blanket and placed them on the aircraft. There were no powders or fluids on the patient.once arriving at the medical center the hospital refused to allow the patient or crew entry into the er without the patient/crew being cleared/decontaminated of any anhydrous ammonia. The hospital notified the fire department and they were dispatched to the medical center in order to decontaminate/clear the patient. Upon arrival the fire department tested the patient; crew; and aircraft. There were no traces of anhydrous ammonia. The patient was cleared for admittance. According to the crew their manual states that decontamination for this type incident involves removing the patient's clothes and flushing if necessary.when I returned to base I reviewed the safety manual and could not find any areas that specifically mentioned transporting methlab patients. This made me question how a crew can be completely certain the patient is completely decontaminated. And I question whether simply removing clothing and flushing the wounds is enough of a safe guard. The fire department used a simplistic test to confirm whether or not the patient was contaminated. A litmus paper was used to detect acids or base and they matched the paper with a chart to determine the individuals ph. This is a very simple test that can be performed by one of the medical crewmembers before the patient is loaded. This would insure the safety of the crew and prevent the aircraft from being contaminated. With the number of methlabs increasing throughout the united states this will become a more prevalent issue and I feel it should be specifically mentioned in the operating manual and safety manual. [The industry should] develop a power point training program that can be added to the osha training on how to deal with methlab victims and the dangers of anhydrous ammonia. I'm sure the dea; atf; and or a local law enforcement agency would be glad to assist.2. Establish a section within the operations and safety manual outlining a specific policy. Maybe the policy should be to determine whether we should even carry a methlab patient.3. Provide the medical crews with the litmus paper; this would ensure that they can verify that the patient has been decontaminated within the standards necessary to be flown. This would prevent the crew and aircraft from being contaminated. This would be the last line of defense.4. Train dispatch to notify all customers that if the patient is a methlab victim they must be decontaminated prior to being flown. This would speed up the departure time from the scene.

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Original NASA ASRS Text

Title: Air Ambulance pilot transports methlab explosion victim to hospital. When patient is refused entry until tested for decontamination; pilot recommends air ambulance procedures for methlab explosion patients be developed.

Narrative: We departed our base for an 8 minute flight to the west. Once airborne; Dispatch notified us that we were responding for a burn victim and the medical crew was given the normal medical information; but no details about the incident. Upon landing the medical crew departed the aircraft and entered the ambulance; which had just arrived.Once the medical crew started patient treatment they were notified that the patient was a victim of a methlab explosion. They discussed with the ambulance crew and fire department about the possibility of contamination and were reassured that the patient was not in the immediate area of the methlab. Patient clothes had been burned off and/or removed. The medical crew was comfortable with transporting the patient. They wrapped the patient in a thermal blanket and placed them on the aircraft. There were no powders or fluids on the patient.Once arriving at the Medical Center the hospital refused to allow the patient or crew entry into the ER without the patient/crew being cleared/decontaminated of any anhydrous ammonia. The hospital notified the fire department and they were dispatched to the Medical Center in order to decontaminate/clear the patient. Upon arrival the fire department tested the patient; crew; and aircraft. There were no traces of anhydrous ammonia. The patient was cleared for admittance. According to the crew their manual states that decontamination for this type incident involves removing the patient's clothes and flushing if necessary.When I returned to base I reviewed the safety manual and could not find any areas that specifically mentioned transporting methlab patients. This made me question how a crew can be completely certain the patient is completely decontaminated. And I question whether simply removing clothing and flushing the wounds is enough of a safe guard. The fire department used a simplistic test to confirm whether or not the patient was contaminated. A litmus paper was used to detect acids or base and they matched the paper with a chart to determine the individuals Ph. This is a very simple test that can be performed by one of the medical crewmembers before the patient is loaded. This would insure the safety of the crew and prevent the aircraft from being contaminated. With the number of methlabs increasing throughout the United States this will become a more prevalent issue and I feel it should be specifically mentioned in the Operating Manual and Safety Manual. [The Industry should] develop a power point training program that can be added to the OSHA training on how to deal with methlab victims and the dangers of anhydrous ammonia. I'm sure the DEA; ATF; and or a local law enforcement agency would be glad to assist.2. Establish a section within the operations and Safety Manual outlining a specific policy. Maybe the policy should be to determine whether we should even carry a methlab patient.3. Provide the medical crews with the litmus paper; this would ensure that they can verify that the patient has been decontaminated within the standards necessary to be flown. This would prevent the crew and aircraft from being contaminated. This would be the last line of defense.4. Train dispatch to notify all customers that if the patient is a methlab victim they must be decontaminated prior to being flown. This would speed up the departure time from the scene.

Data retrieved from NASA's ASRS site as of April 2012 and automatically converted to unabbreviated mixed upper/lowercase text. This report is for informational purposes with no guarantee of accuracy. See NASA's ASRS site for official report.