Chemically contaminated casualties: Different problems and possible solutions
DOI:
https://doi.org/10.5055/ajdm.2010.0012Keywords:
mass casualties, contamination, emergency planningAbstract
The initial response to mass casualty incidents is usually informal as uninjured and injured survivors and passersby assist the injured and take them to medical centers. This creates some problems, for example, most victims go to one or two hospitals and the least injured arrive first; but, on the whole, it works. However, the same response does not work when victims are contaminated, and some of the solutions that work when victims are only injured do not work when victims are contaminated. This article suggests an approach that accepts the reality of what happens—the first receiving hospital becomes contaminated—and suggests how planning can begin with that as a starting point. It stressed that current plans are based on false assumptions and that this can lead to inadequate preparation.References
Guttenberg MG, Asaeda G, Cherson A, et al.: Utilization of ambulance resources at the World Trade Center: Implications for disaster planning. Ann Emerg Med. 2002; 40: S92 (Abstract).
Quarantelli EL: Delivery of Emergency Medical Services in Disasters: Assumptions and Realities. New York: Irvington Publisher, 1983.
Scanlon J, Hiscott R: Despite appearances: There could be a system: Mass casualties and the Edmonton Tornado. Int J Mass Emerg Disasters. 1994; 12(2): 215-239.
Morrison SE: Sicily-Salerno-Anzio, January 1943-June 1944, History of United States Naval Operations in World War II. Boston: Little Brown, 1954.
Infield GB: Disaster at Bari.Toronto: Bantam Books, 1988.
Scislowski S: Not All of Us Were Brave. Hamilton: Dundurn Press, 1997.
Saunders DM: The Bari incident. In Proceedings of the United States Naval Institute. Annapolis: United States Naval Institute, 1967: 35-39.
Southern G: Poisonous Inferno: WWII Tragedy at Bari Harbour. Shrewsbury, UK: Airlife, 2005.
Borak J, Sidell FR: Agents of chemical warfare: Sulfur mustard. Ann Emerg Med. 1992; 21(3): 303-308.
Headquarters, Departments of the Army, the Navy and the Air Force and the Commandant Marine Corps: Treatment of Chemical Agent Casualties and Conventional Military Chemical Injuries. Washington: Headquarters, Departments of the Army, the Navy and the Air Force and the Commandant Marine Corps, 1995: 4-8.
Aikens GMR: Nurses in Battledress. Halifax: Cymru Press, 1998.
Momeni AZ, Aminjavaheri M: Skin manifestations of mustard gas in a group of 14 children and teen-agers: A clinical study. Int J Dermatol. 1994; 33(3): 184-187.
Stewart CE, Sullivan JB: Military munitions and antipersonnel agents. In Sullivan JB, Krieger GR (eds.): Hazardous Materials Toxicology Clinical Principles of Environmental Health. Baltimore: Williams and Wilkins, 1992: 1007-1008.
Murray VS,Volans GN: Management of injuries due to chemical weapons. Brit Med J. 1991; 302(1): 129-130.
Kadivar H, Adams SC: Treatment of chemical and biological warfare injuries: Insights derived from the 1984 Iraqi attack on Majnoon Island. Mil Med. 1991; 156: 171-177.
Pangi R: Consequence management in the 1995 SARIN attacks on the Japanese subway system. Belfer Center for Science and International Affairs Discussion Paper 2002-4. Harvard: John F. Kennedy School of Government, 2002.
Okumura T, Suzuki K, Fukuda A, et al.: The Tokyo subway sarin attack: disaster management, Part 2: Hospital response. Acad Emerg Med. 1998; 5(6): 618-624.
Saunders P,Ward G: Decontamination of chemically contaminated casualties: Implications for the health service and a regional strategy. Prehosp Immediate Care. 2000; 4(3): 122-125.
American Medical Association: Featured Report: Medical preparedness for terrorism and other disasters, AMA, Council on Scientific Affairs, 2000.
Okumura T, Suzuki K, Fukada A, et al.: The Tokyo subway sarin attack: Disaster management, Part 1: Community emergency response. Acad Emerg Med. 1998; 6(8): 613-617.
Hogan DE, Dire DJ, Lillibridge SR: Immediate impact of the Oklahoma city bombing (Plenary Session). Presented at the 2004 International Conference on Medical Consequences of Terrorism, The Israel Trauma Society,Tel-Aviv Israel, 2004.
Orr SM, Robinson WA: The Hyatt disaster: Two physicians’ perspectives. J Emerg Nurs. 1982; 8(1): 6-11.
Thanabalasingham T, Becket MW, Murray V: Hospital response to a chemical incident: Reports on casualties of an ethyldichlorosilane spill. Brit Med J. 1991; 302: 101-102.
Center for Disease Control: Surveillance for Emergency Events Involving Hazardous Substances United States, 1990-1992. Atlanta: US Department of Health and Human Services, 1994: 3, 5.
Burgess JL, Blackmon GM, Brodkin CA, et al: Hospital preparedness for hazardous materials incidents and treatment of contaminated patients.West J Med. 1997; 67(6): 387-391.
Hoeven GJ: Situation Report No. 1 Incident No. 2002-007. Bismarck: State Capitol, 2002.
First District Health Unit and Trinity Medical Center: Interim Evaluation of Symptoms and Pulmonary Function. Minot: First District Health Unit, 2002.
Agency for Toxic Substances and Disease Registry: Hazardous Substances Emergency Events Surveillance, Annual Report. Atlanta: Division of Health Studies, 1998.
Auf der Heide E, Scanlon J: Health and medical preparedness and response. In Waugh W, Tierney K (eds.): Emergency Management: Principles and Practice for Local Government, 2nd Edition. Washington: International City Managers Association, 2007: 183-206.
Tierney KJ: Project Summary: Disaster Analysis: Delivery of Emergency Medical Care. Newark: Disaster Research Center, 1993.
Scanlon J: Planning for disaster—But not the way you’ve heard. Brit Columbia Med J. 1997; 39(11): 583-585.
Auf der Heide E: The importance of evidence-based disaster planning. Ann Emerg Med. 2006; 47(1): 34-49.
Ghilarducci DP, Pirrallo RG, Hegmann KT: Hazardous materials readiness of United States Level 1 trauma centers. J Occup Environ Med. 2000; 42(7): 683-692.
Binder S: Deaths, injuries, and evacuations from acute hazardous materials releases. Am J Public Health. 1989; 79(102): 1042-1044.
Published
How to Cite
Issue
Section
License
Copyright 2007-2023, Weston Medical Publishing, LLC
All Rights Reserved
