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Decontamination of Mass Casualties — Re-evaluating Existing Dogma

Published online by Cambridge University Press:  28 June 2012

Howard W. Levitin ,
Henry J. Siegelson ,
Stanley Dickinson ,
Pinchas Halpern ,
Yoshikura Haraguchi ,
Anthony Nocera  and
David Turineck
Howard W. Levitin*
Affiliation:
Clinical Assistant Professor of Medicine, Indiana University School of Medicine and Emergency Physician, St. Francis Hospital and Health Centers, Indianapolis, Indiana, USA
Henry J. Siegelson
Affiliation:
Clinical Assistant Professor of Emergency Medicine, Emory University, Emergency Physician, Apollo MD, We llStar Hospital System, Atlanta, Georgia, USA
Stanley Dickinson
Affiliation:
Hazardous Materials Specialist, Indianapolis, Indiana, USA
Pinchas Halpern
Affiliation:
Chair, Department of Emergency Medicine, Tel Aviv Medical Center, Tel Aviv, Israel
Yoshikura Haraguchi
Affiliation:
Head of Division of Pathophysiology Clinical Research Institute, National Hospital, Tokyo Disaster Medical Center, To kyo, Japan
Anthony Nocera
Affiliation:
Emergency Physician, Mt. Louisa, Australia
David Turineck
Affiliation:
Chair, Department of Emergency Medicine, Greater Niagara General Hospital, Niagara Health System, Ontario, Canada
*
5732 West 71st Street, Indianapolis, Indiana 46278 USA, E-mail: hwlevi@hazmatdqe.com
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Abstract

The events of 11 September 2001 became the catalyst for many to shift their disaster preparedness efforts towards mass-casualty incidents. Emergency responders, healthcare workers, emergency managers, and public health officials worldwide are being tasked to improve their readiness by acquiring equipment, providing training and implementing policy, especially in the area of mass-casualty decontamination. Accomplishing each of these tasks requires good information, which is lacking. Management of the incident scene and the approach to victim care varies throughout the world and is based more on dogma than scientific data. In order to plan effectively for and to manage a chemical, mass-casualty event, we must critically assess the criteria upon which we base our response.

This paper reviews current standards surrounding the response to a release of hazardous materials that results in massive numbers of exposed human survivors. In addition, a significant effort is made to prepare an international perspective on this response.

Preparations for the 24-hour threat of exposure of a community to hazardous material are a community responsibility for first-responders and the hospital. Preparations for a mass-casualty event related to a terrorist attack are a governmental responsibility. Reshaping response protocols and decontamination needs on the differences between vapor and liquid chemical threats can enable local responders to effectively manage a chemical attack resulting in mass casualties. Ensuring that hospitals have adequate resources and training to mount an effective decontamination response in a rapid manner is essential.

Keywords

decontaminationdecontamination methodsexposurehazardous materialsmass-casualty decontaminationmass-casualty incidentsvapor exposure
Type
Special Reports
Information
Prehospital and Disaster Medicine , Volume 18 , Issue 3: Terrorism-II: Special Reports , September 2003 , pp. 200 - 207
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2003

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