ABSTRACT
I. INTRODUCTION There is growing awareness by emergency medical system (EMS) personnel of the problems of managing of the injured following the release of toxic substances [1,2]. Although such incidents are relatively rare, when they do occur they may cause mass casualties and can rapidly overwhelm the existing medical services [3]. The management of toxic trauma differs from conventional physical trauma since, although many of the injuries may be immediate and accompanied by burns and blast trauma, there may be insidious development of toxic injury far beyond the site of the incident. There is also a risk of toxic injury to the EMS responders through contamination from the site and the patients themselves. Thus, EMS personnel must be familiar with the characteristics of toxic release, protocols for containment of toxic substances, individual, and site safety, safe casualty decontamination, treatment, and evacuation. They must above all be able to work as part of a coordinated response involving other emergency services.
