Casualty Priorities
It will often be necessary to decide whether to handle the surgical condition or the chemical hazard first. If the situation and the condition of the casualty permit, decontamination should be carried out first. The longer the chemical remains on the body, the more severe will be the danger of spreading the chemical to other personnel and equipment.

The following order of priority for first aid and decontaminating casualties is recommended:

1. Control of massive hemorrhage
2. First aid for life-threatening shock and wounds
3. Decontamination of exposed skin and eyes
4. Removal of contaminated clothing and decontamination of body surfaces (if not in a toxic environment)

5. Adjustment of patient's mask, if mask is necessary

6. First aid in less severe shock and wounds The basic steps in sorting and handling casualties are indicated in figure 8-3. This plan should be modified to fit specific needs.

Figure 8-3.-Basic steps in sorting and handling casualties.

Decontamination Station Organization
In general, the decontamination station, or "dirty" area, receives casualties contaminated with a chemical agent. The arrangement of this area will vary with the site of the medical unit and the facilities available for decontamination.

Each ship will have a minimum of at least two decontamination stations, insofar as the hull design permits. The "dirty" areas should be topside or in some well-ventilated space. Personnel manning these areas should be provided with protective equipment.

In the "dirty" area, casualties will be decontaminated, undressed, showered, and passed along to clean areas. Both areas should be clearly marked as either "clean" or "contaminated," as appropriate. Decontamination kits, protective ointment, and an abundant supply of soap and water must be provided. In addition, standard first-aid items should be on hand. When possible, improvise supports (e.g., small boxes, blocks of wood, etc.) for stretchers to keep them raised off the deck.

Handling of Contaminated Casualties
The spread of contamination to uncontaminated personnel or to spaces not set aside to receive contamination must be avoided. Contaminated personnel, clothing, or equipment must be kept out of uncontaminated areas since the subsequent decontamination of such spaces is quite difficult. Contaminated clothing and gear must be placed in designated dump areas and, whenever practically possible, kept in metal cans with tightly fitting covers.

Supplies
The Medical Officer or Senior Medical Department Representative (SMDR) is responsible for maintaining adequate supplies for decontamination and treatment of CBR casualties. Medical decontamination supplies are supplied to ships on a personnel -strength basis, as listed in current Authorized Medical Allowance List (AMAL).

The decontamination supply cabinets will be kept locked, and the keys will be in custody of the Damage Control Assistant (DCA). Cabinets and chests will be stenciled with a red cross and marked "DECONTAMINATION MEDICAL SUPPLIES."