Egan, J., and Amlot, R. (2012). Modelling Mass Casualty Decontamination Systems Informed by Field Exercise Data. International Journal of Environmental Research and Public Health. 9(10):3685-710.
The authors reviewed field exercise data collected during a mass decontamination exercise. They found that the "bottleneck" in the process was the re-dressing or re-robing of patients after they had showered. They suggested strategies for addressing this challenge, including shorter showers and more people showering at one time. ASPR TRACIE subject matter expert reviewers suggest, however, that shorter showers may be less effective, and recommend additional space for re-dressing. This article does effectively convey that “real-world” decontamination will experience bottlenecks—some of which can be anticipated and some of which will require adaptation during the event. Availability of “dry decontamination” / redress kits for those with minimal/no symptoms may help prevent bottlenecks in the gross/technical decontamination process.