A Triage+Treatment+Transport vehicle that integrates decontamination (decon is treatment) with patient transportation.

The basic idea is a Treatment vehicle that can seat a large number of ambulatory patients and decontaminate them while they are safely seated during transport.

It functions like an inverse carwash to save valuable time and lives, by putting transit time to practical use, so that contaminated ambulatory patients can be immediately admitted to hospital as soon as the vehicle arrives at the hospital.

Shoes, clothing, and other personal items are stored safely in the luggage compartment below the bus for retrieval at the hospital.

One or two washbuses (one with a tarp hanging down the middle, or separate washbuses for men and women) would work in parallel with the fixed decon facilities at the hospital, resulting in increased total throughput. A washbus might, for example, be stationed at an election, a political convention, or a similar likely terror target to ensure no delay (neither delay at the incident site nor delay at the hospital) occurs due to the need to decon patients before they are admitted to hospital.

Implementational details for the "inverse carwash":

Usually only the exteriour of a vehicle can withstand getting wet, but a specially designed vehicle could feature inward-directed spray that comes from the vehicle itself.

The major problem with wetting down the inside of a bus would be the seats (upholstery) and the seat belts (if any) which are made of fabric.


Ambulatory victims would undress themselves, stow their shoes, clothing, and personal effects in the luggage compartment below the bus, and board the bus for a sit-down shower that would occur during transport. Men and women would undress on opposite sides of the bus (the bus would be equipped with under-bus storage compartments on both sides). One gender would board, and be restrained, a tarp would drop down in the middle of the bus to create a privacy barrier, and then the other gender would board. For privacy, the windows could be frosted either permanently or temporarily with foam spray on the outside that would last until the bus was loaded and out of the way of onlookers and the media.

The showers would be timed to dispense a limited but sufficient amount of decon solution at a rate that matches the length of the journey. If the nearest hospital were some larger distance away, the showers would run longer, but with a lesser flow-rate, alternating with dry-air-jet decon.

Human waste disposal

To avoid confusion and possible spread of contamination among a potentially hysterical busload of panicky victims, consider, perhaps, means for disposal of human waste being incorporated into the seating. For example, an elongated slot running the length of the seats could receive waste that would be fed to a collection tank in the bus, along with shower runoff, vomitus, drainage, etc. (infrastructure that might already need to exist for the showerbus).

Dry decon (airwash bus)

Even without the sit-down showers, simply having the victims disrobe and "air out" for the entire duration of their trip to the hospital may prove sufficient for removal of 90 percent of any possible contamination. Additonally, air jets or "air curtains" may be used to keep clean air running in from outside (and discharged by way of a HEPA filter), so that one contaminated victim does not contaminate others who are seated in close proximity.

Clean Air

A similar configuration could be used in air traponsort of victims. However, due to weight constraints it may not be possible to carry large amounts of shower water onboard the special aircraft. In this case a large portion of decon could be by way of the "air out" method.


The bus may be divided into sections to separate quarantine and isolation, to some degree. One or more empty rows of seats may separate victims known to be contaminated to a greater degree than others (i.e. those with liquid chemical agent visibly present separated from those with vapor-only exposure). Additional dividers could be modular in design so that they could be attached to any of a large number of snap-in locations depending on specific circumstances. Properly designed vehicle restraint bars would prevent victims from wandering about the bus or attempting to flee. Restraint bars would be remotely operated (like in an amusement ride), so that everyone would be released automatically as soon as the bus was safely inside a properly secured casualty collection point. Alternatively, victim release could be timed or sequenced, e.g. ordered by gender, or by severity of exposure so that triage could be enforced so that there is not one sudden inrush of a full busload of patients running toward the hospital doors at the same time.

--S. Mann, DECONference 2002