Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-26T00:19:51.976Z Has data issue: false hasContentIssue false
  • English
  • Français

Personal Protection during Resuscitation of Casualties Contaminated with Chemical or Biological Warfare Agents—A Survey of Medical First Receivers

Published online by Cambridge University Press:  28 June 2012

Andrea Brinker ,
Kate Prior  and
Jan Schumacher
Andrea Brinker
Affiliation:
Resident, Department of Anaesthetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
Kate Prior
Affiliation:
Surgeon Lieutenant Commander, Royal Navy, Shock Trauma Center, University of Maryland, Baltimore, Maryland USA
Jan Schumacher*
Affiliation:
Consultant Anaesthetist and Honorary Senior Lecturer, University of London, King's College, St Thomas' Campus, London, UK
*
Consultant Anaesthetist and Honorary Senior Lecturer Guy's, King's and St Thomas Medical School, King's College London St Thomas' Department of Anaesthetics Lambeth Palace Road London SE1 7EH, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

The threat of mass casualties caused by an unconventional terrorist attack is a challenge for the public health system, with special implications for emergency medicine, anesthesia, and intensive care. Advanced life support of patients injured by chemical or biological warfare agents requires an adequate level of personal protection. The aim of this study was to evaluate the personal protection knowledge of emergency physicians and anesthetists who would be at the frontline of the initial health response to a chemical/biological warfare agent incident.

Methods:

After institutional review board approval, knowledge of personal protection measures among emergency medicine (n = 28) and anesthetics (n = 47) specialty registrars in the South Thames Region of the United Kingdom was surveyed using a standardized questionnaire. Participants were asked for the recommended level of personal protection if a chemical/biological warfare agent(s) casualty required advanced life support in the designated hospital resuscitation area.

Results:

The best awareness within both groups was regarding severe acute respiratory syndrome, and fair knowledge was found regarding anthrax, plague, Ebola, and smallpox. In both groups, knowledge about personal protection requirements against chemical warfare agents was limited. Knowledge about personal protection measures for biological agents was acceptable, but was limited for chemical warfare agents.

Conclusions:

The results highlight the need to improve training and education regarding personal protection measures for medical first receivers.

Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 24 , Issue 6 , December 2009 , pp. 525 - 528
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Clarke, SF, Chilcott, RP, Wilson, JC, et al. : Decontamination of multiple casualties who are chemically contaminated: A challenge for acute hospitals. Prehosp Disaster Med 2008;23:182–183.Google Scholar
2. Barelli, A, Biondi, I, Soave, M, et al. : The comprehensive medical preparedness in chemical emergencies: ‘The chain of chemical survival“. Eur J Emerg Med 2008;15:110–118.Google Scholar
3. Krivoy, A, Layish, I, Rotman, E, et al. : OP or not OP: The medical challenge at the chemical terrorism scene. Prehosp Disaster Med 2005;20:155–158.Google Scholar
4. Kenar, L, Karayilanoglu, T: Medical preparedness against chemical and biological incidents for the NATO Summit in Istanbul and lessons learned. Prehosp Disaster Med 2006;21:268–271.Google Scholar
5. Baker, DJ: Chemical and Biological Warfare Agents: The Role of the Anesthesiologist. In: Miller, RA, editor. Anesthesia. 6th edition. New York: Churchill Livingstone, 2004, pp 2497–2526.Google Scholar
6. Morita, H, Yanagisawa, N, Nakajima, T, et al. : Sarin poisoning in Matsumoto, Japan. Lancet 1995;346:290–293.Google Scholar
7. Okumura, T, Takasu, N, Ishimatsu, S, et al. : Report on 640 victims of the Tokyo subway sarin attack. Ann Emerg Med 1996;28:129–135.Google Scholar
8. Nozaki, H, Hori, S, Shinozawa, Y, et al. : Secondary exposure of medical staff to sarin vapor in the emergency room. Intensive Care Med 1995;21:1032–1035.Google Scholar
9. Masuda, N, Takatsu, M, Morinari, H, Ozawa, T: Sarin poisoning in Tokyo subway. Lancet 1995;345:1446.Google Scholar
10. Health Protection Agency. chemical, biological, radiological, or nuclear Incidents: A Guide to Clinical Management and Health Protection. Available at http://www.hpa.org.uk/webw/HPAweb&Page&HPAwebAutoListName/Page/1158934607980?p=1158934607980. Accessed 11 October 2008.Google Scholar
11. US Army Medical Research Institute: Medical Management of Chemical Casualties Handbook. 4th ed, McLean: US Army Medical Research Institute of Chemical Defense (USAMRICD), International Medical Publishing, Inc, 2007.Google Scholar
12. Reilly, MJ, Markenson, D, DiMaggio, C: Comfort level of emergency medical service providers in responding to weapons of mass destruction events: Impact of training and equipment. Prehosp Disaster Med 2007;22:297–303.Google Scholar
13. Wetherell, A, Mathers, G: Respiratory Protection. In: Marrs, TC, Maynard, RL, Sidell, FR (eds): Chemical Warfare Agents—Toxicology and Treatment. 2nd ed. Chichester: John Wiley and Sons Ltd, 2007, pp 157–173.Google Scholar
14. National Institute for Occupational Safety and Health: Occupational Safety and Health Guidance Manual for Hazardous Waste Site Activities. Washington, DC: Government Printing Office, 1985. DHHS publication no. (NIOSH), pp 85–115.Google Scholar
15. Martyny, J, Glazer, CS, Newman, LS: Respiratory protection. N Engl J Med 2002;347:824–830.Google Scholar
16. World Health Organization: Public health response to biological and chemical weapons. WHO guidance—Annex 4. Principles of protection. Available at http://www.who.int/csr/delibepidemics/biochemguide/en/ Accessed 11 October 2008.Google Scholar
17. Brinker, A, Gray, SA, Schumacher, J: Influence of air-purifying respirators on the simulated first response emergency treatment of chemical, biological, radiological, or nuclear victims. Resuscitation 2007;74:310–316.Google Scholar
18. Schumacher, J, Runte, J, Brinker, A, et al. : Respiratory protection during high fidelity simulated resuscitation of casualties contaminated with chemical warfare agents. Anaesthesia 2008;63:593–598.Google Scholar
19. Baker, DJ: Civilian exposure to toxic agents: Emergency medical response. Prehosp Disaster Med 2004;19:174–178.Google Scholar
20. Clarke, SF, Chilcott, RP, Wilson, JC, et al. : Decontamination of multiple casualties who are chemically contaminated: A challenge for acute hospitals. Prehosp Disaster Med 2008;23:175–181.Google Scholar
21. Weinstein, RS, Alibek, K: Biological and Chemical Terrorism. A Guide for Healthcare Providers and First Responders. New York: Thieme Medical Publishers, 2003.Google Scholar
22. Gould, G, Kerr, S, Prophet, N. Preparation for terrorist attacks. Anaesthesia 2004;59:199.Google Scholar
23. Press Release. Available at http://www.publications.parliament.uk. Accessed 11 October 2008.Google Scholar
24. Foege, WH: Should the smallpox virus be allowed to survive? N Engl J Med 1979;300:670–671.Google Scholar