Child Protection Procedures

This section outlines the following recommended protocols for drug endangered children:

1. Asymptomatic child in a lab
2. Child from a lab in school, day care, foster care
3. Child in a use only situation
4. Child in use going to school, day care, foster care
5. Baby wipes

All Children

  • Any child who is in medical distress or has been involved in an explosion or other event that has resulted in significant chemical exposure, burns, etc. should be transported to the emergency department as quickly as possible. Basic life support must take precedence over decontamination. Although decontamination should be conducted as soon as is possible, it must not delay the transportation of a critically injured child.
  • In those cases where significant chemical exposure has occurred and there is evidence of an exposure such as a chemical smell on the person, wet clothes, clothes covered with visible chemical, etc., the children involved should have the chemical residuals removed at the scene by removing their clothes and providing a warm shower with soap in a non-threatening situation. In this case, showering at the scene is preferred if it can be done without trauma to the child. If shower capability is not available at the scene, then the child should be dressed in other clothing and transported to an area where chemical residual removal can be accomplished without trauma to the child. Any clothing worn by the child should be removed at the scene for disposition by law enforcement personnel.

Asymptomatic Child in a Lab

  • In situations where an asymptomatic child has been removed from a clandestine methamphetamine laboratory and there is no sign of obvious chemical contamination on the child (odor, visible chemical, etc), significant danger to individuals coming in contact with the child is not likely. However, it is in the public health interest to minimize chemical exposures, no matter how minimal, to chemicals for which there is incomplete toxicity information. The presence of a significant chemical residual is possible since current real-time detection methodology is not available. Departments should develop a protocol, based on the capabilities of the community, to provide these children with adequate chemical residual removal. We suggest that this protocol involve the following:
    • Although full and immediate decontamination is not necessary, the clothes that the child is wearing should be removed as soon as is reasonably safe and a shower provided when conditions enable a safe and relatively trauma-free shower. It is unlikely that significant amounts of methamphetamine or other chemicals will be transferred from clothing but we believe that a cloth draped over vehicle seats will provide further protection if desired.
    • Showering the child with warm water in an expedient manner in an area where privacy is provided also protects the child from unreasonable trauma. This may be conducted at the scene, if adequate facilities are present, at a hospital, at a fire station, or any other location that is identified by local protocol.
    • After the child has showered or if the clothes are removed at the scene, a responsible agency (denoted by the protocol) should retain all of the clothes for washing, disposal or retention for evidence. Current evidence suggests that washing clothing in a washing machine using warm water and detergent will remove over 99% of the methamphetamine present.
    • Before, during, and after decontamination, care should be taken to make sure that children are kept warm during transfers to prevent hypothermia.

Children From Labs in School Day Care, Foster Homes, etc.

  • In the instance where a clandestine methamphetamine laboratory has been identified and the children that are normally associated with that laboratory are in a school, day care center, foster home, etc. at the time of the investigation, the children should be visited by the appropriate agency personnel (law enforcement, child protective services, school nurse, etc. ) and the following appropriate determination made:
    • Children that appear to be ill or chemically contaminated should be immediately transported to a medical facility for full decontamination and/or treatment. Basic life support must take precedence over decontamination. Although decontamination should be conducted as soon as is possible, it must not delay the transportation of a critically injured child. This scenario is unlikely in a school or day care situation since a chemically contaminated child will usually be identified by school staff members prior to agency personnel arrival.
    • In situations where an asymptomatic child has been located at a school, daycare center, etc. and there is no sign of obvious chemical contamination on the child (odor, visible chemical, etc), the child is not likely to present a significant danger to other children or facility personnel coming into contact with the child. However, it is in the public health interest to minimize chemical exposures, no matter how minimal, to chemicals for which there is incomplete toxicity information. We therefore suggest the following:
      • Although full and immediate decontamination is not necessary, the clothes that the child is wearing should be removed as soon as is reasonably safe and a shower provided when conditions enable a safe and relatively trauma-free shower. It is unlikely that significant amounts of methamphetamine or other chemicals will be transferred from clothing but we believe that a cloth draped over vehicle seats during transport will provide further protection if desired.
      • Showering of the child with warm water in an expedient manner that also protects the child against unreasonable trauma in an area where privacy is provided. This may be conducted at the school or daycare center, if adequate facilities are present, at a hospital, at a fire station, or any other location that is identified by local protocol.
      • After the child has showered or if the clothes are removed at the school or daycare center, a responsible agency (denoted by the protocol) should retain all of the clothes for washing, disposal or retention for evidence. Current evidence suggests that washing clothing in a washing machine using warm water and detergent will remove over 99% of the methamphetamine present.

      • Unless there is evidence that the involved children have significant chemical contamination (chemical odors, illness, etc. ) we do not believe that other children present at the school or daycare center need be involved with the cleaning process or subjected to any other cleaning activities. The extraordinary cleaning of school property associated with methamphetamine-associated children is also unnecessary under these conditions.

Children in Use Homes

  • In situations where a child has been removed from a home where methamphetamine has been only used, significant danger to individuals coming in contact with the child is not a concern. The presence of a small amount of methamphetamine residual on clothing is possible although levels will normally be very low. Departments should develop a protocol, based on the capabilities of the community, to provide these children with a shower and with clothing that is not contaminated. We suggest that this protocol involve the following:

    • The clothes that the child is wearing should be removed as when they are taken to a care facility and a shower provided. It is unlikely that significant amounts of methamphetamine will be transferred from clothing but we believe that a cloth draped over vehicle seats will provide further protection if desired.

    • After the child has showered a responsible agency (denoted by the protocol) should retain all of the clothes for washing, disposal or retention for evidence. Current evidence suggests that washing clothing in a washing machine using warm water and detergent will remove over 99% of the methamphetamine present.

Children in Use Homes: School, Day Care, Foster Care

  • In the instance where a methamphetamine use situation has been identified at a home and the children that are normally associated with that home are in a school, day care center, foster home, etc. at the time of the investigation, the children should be visited by the appropriate agency personnel (law enforcement, child protective services, school nurse, etc.)  The presence of a small amount of methamphetamine residual on clothing is possible although levels will normally be very low. Departments should develop a protocol, based on the capabilities of the community, to provide these children with a shower and with clothing that is not contaminated. We suggest that this protocol involve the following:

    • The clothes that the child is wearing should be removed as when they are taken to a care facility and a shower provided. If they are already in a facility, showering at the normal time is appropriate.

    • Current evidence suggests that washing clothing in a washing machine using warm water and detergent will remove over 99% of the methamphetamine present. Any clothing that is to be taken into the new facility should be washed in that facility or at another facility and then provided to the child for use. Any clothing currently in the new facility should be washed prior to use.

Baby Wipes

  • It is recommended that baby wipes not be used as a substitute for a warm shower since there is little added efficacy that has been demonstrated. In fact, wipes have been found to spread contamination rather than remove it. In addition, wipes will add moisture to the skin making dermal transfer into the body faster and more efficiently than will doing nothing.

  • Children should be provided a medical and developmental assessment prior to or after showering. This assessment should be in accordance with the protocols presented in the National Protocol for Medical Evaluation of Children Found in Drug Labs, available at no charge from the National Alliance for Drug Endangered Children.