Pediatric emergency medicine trisk 4586 4586
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The prospect of a mass casualty incident from a terrorist release of biologic or
chemical agents is more likely now than ever before. Although the impact of such
an event is almost unimaginable, at the same time, efforts must be made to
prepare for this possibility. Such preparedness requires highly coordinated
responses involving local and regional EMS systems, HAZMAT teams, police
and fire departments, hospital EDs, local and federal public health agencies, and
civilian and military medical specialists. In particular, EDs must consider
important issues, including (i) the early recognition, triage, stabilization,
decontamination, treatment, and disposition of multiple casualties of such an
attack; (ii) protection of healthcare workers and existing patients; and (iii) the
integrity of the ED itself to provide ongoing care to later-arriving casualties and
to continue to meet normal patient demands. Fortunately, our pediatric emergency
care providers, academic medical centers, regional health departments, and
several federal agencies, including the U.S. Departments of Health and Human
Services, Homeland Security, and Defense, are actively engaged in confronting
these vital public health and national security challenges.
Suggested Readings and Key References
General
American Academy of Pediatrics. Chemical and biological terrorism and its
impact on children: a subject review. Pediatrics 2000;105:662–670.
Henretig F. Biological and chemical terrorism defense: a view from the “front
lines” of public health. Am J Public Health 2001;91:718–720.
Henretig FM, Cieslak TJ, Eitzen EM Jr. Biological and chemical terrorism. J
Pediatr 2002;141:311–326.
Henretig FM, McKee MR. Preparedness for acts of nuclear, biological and
chemical terrorism. In: Gausche Hill M, Fuchs S, Yamamoto L, eds. APLS:
The Pediatric Emergency Medicine Resource. Sudbury, MA: Jones and
Bartlett, American Academy of Pediatrics and American College of
Emergency Physicians; 2004:568–591.
Macintyre AG, Christopher GW, Eitzen E Jr, et al. Weapons of mass destruction
events with contaminated casualties: effective planning for health care
facilities. JAMA 2002;83:242–249.
Biologic Terrorism
Breman JG, Henderson DA. Diagnosis and treatment of smallpox. N Engl J Med
2002;346:1300–1308.
