ABSTRACT
I. Introduction ....................................................................................................................... 675 II. Pitfalls ............................................................................................................................... 676 III. Response............................................................................................................................ 678 IV. Medical Treatment Facility ............................................................................................... 679 V. Intubation .......................................................................................................................... 682 VI. Decontamination ............................................................................................................... 683 VII. Medical Approach............................................................................................................. 686 VIII. Toxidromes........................................................................................................................ 687
A. Irritant Gases=Lung-Damaging Agents Toxidrome .................................................. 687 B. Asphyxiant Toxidrome.............................................................................................. 688 C. Cholinergic=Nerve Agent Toxidrome ....................................................................... 692 D. Corrosive Agent=Vesicants Toxidrome .................................................................... 699 E. Hydrocarbon Toxidrome........................................................................................... 702
IX. Biological Toxins .............................................................................................................. 703 X. Systematic Approach ........................................................................................................ 703
XII. Penetrating=Embedded Agents.......................................................................................... 705 XIII. Summary ........................................................................................................................... 707 References ..................................................................................................................................... 708
A true disaster is an event that overwhelms a community’s ability to respond on its own. The term is used more liberally to signify highly unusual, large-scale events. If a chemical event were to occur today, it would be a disaster for a large majority of the United States, simply because most locales are woefully unprepared for this type of event. Although many areas may have a plan, training, and some equipment available, most would buckle under the weight of a truly major chemical event. This is true of the emergency medical response and for the majority of hospitals. Although this text is designed to discuss malicious intent and chemical warfare agents (CWAs), the reality is that there are many highly toxic products produced and transported on a daily basis in this country. It is imperative that the entire medical community be ready to respond to hazardous materials (HazMat) events, be they intentional or accidental, and whether they are chemical in nature, as discussed in this text, or other hazardous substances, namely nuclear and biological.
