Biological and Chemical Terrorism

1

What is the importance of preplanning regarding chemical and biological terrorism?

Without preplanning, the risk of injury or death to first responders is greatly increased. Each responding organization should develop standard operating procedures (SOPs) to implement personal protective equipment (PPE) use, decontamination of casualties, and technical decontamination of first responders. Individual SOPs should be part of the overall incident response plan. Frequent multiagency training is necessary to unify resources, decision-making, and information exchange.

2

List examples of PPE regarding chemical and biological terrorism.

Organizations must identify potential threats and have appropriate PPE to address these threats. Gowns, gloves, air-purifying respirators (APRs), self-contained breathing apparatus (SCBA), or supplied air respirators (SARs) are all examples of PPE. Frequent training with all required PPE is necessary to surmount real-world limitations in delivering care.

3

What chemical agents are most likely to be used in a terrorist attack?

Table 49.1 lists the chemical agents most likely to be used in a terrorist attack.

4

What steps can hospitals take to prepare for a biochemical attack?

See Table 49.2 .

5

What type of dissemination techniques are most likely to be used for chemical terrorism?

Chemical agent release is most likely to occur using a recognized dissemination device precipitated by a fire or explosion, also known as point source dissemination. The chemical agent could also be aerosolized from a point of elevation, from an airplane or helicopter, also known as line source dissemination. Regardless of dissemination, such an event would be recognizable by a large group of casualties presenting simultaneously.

6

What symptoms do nerve agents cause?

Nerve agents cause DUMBELS—defecation, urination, myosis, bronchorrhea, emesis, lacrimation, and salivation. This could be better pictured as liquids pouring from every part of the body. Neurological manifestations include muscle twitching, seizures, and coma. Treatment includes atropine, pralidoxime, decontamination, and supportive care.

7

What symptoms do pulmonary agents cause?

Pulmonary agents cause mucosal irritation (burning eyes, throat, mouth) in small doses but choking and dyspnea can occur in higher doses related to pulmonary edema. Phosgene has a pleasant odor at low concentrations, like corn or freshly cut hay. Chlorine gas smells like bleach and is very irritating. Treatment is decontamination and supportive care.

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