A collaboration between the University of Hertfordshire in the United Kingdom and the Biomedical Advanced Research and Development Authority (BARDA), part of the Office of the Assistant Secretary for Preparedness and Response (ASPR) within the U.S. Department of Health and Human Services, has resulted in the development of a decontamination decision tool and updated guidance for mass casualties. PRISM introduces the “triple protocol” of dry, wet, and technical (specialist) decontamination.
Updated in October 2012, this tool was developed to be a comprehensive resource for clinical personnel by providing information on various aspects of biological, chemical, and radiological terrorism. It is intended to serve as an emergent guide book on what to do and where to seek information in the event of an attack.
CHEMM-IST is an interactive decision support tool which can aid inidentifying which chemical exposure has taken place in a mass casualty incident.
CHEMM-IST is still under development and should not be used for patient care. Once thoroughly tested and validated it will be used for use by basic life support (BLS) and advanced life support (ALS) providers as well as hospital first receivers.
The Chemical Hazards Emergency Medical Management website offers a comprehensive, user-friendly, web-based resource that is also downloadable in advance, so that it would be available during an event if the internet is not accessible.
This resource was developed to enable first responders, first receivers, other healthcare providers, and planners to plan for, respond to, recover from, and mitigate the effects of mass-casualty incidents involving chemicals.
If used as a chemical weapon, sarin could be used as a gas that is inhaled, as a liquid placed into food or water, or as a substance placed onto something that is touched. Sarin is a clear liquid with no color, taste or smell and turns quickly into a gas.
Manifestations of nerve agent exposure include rhinorrhea, chest tightness, pinpoint pupils, shortness of breath, excessive salivation and sweating, nausea, vomiting, abdominal cramps, involuntary defecation and urination, muscle twitching, confusion, seizures, flaccid paralysis, coma, respiratory failure, and death. Nerve agents are potent acetylcholinesterase inhibitors causing the same signs and symptoms regardless of the exposure route. However, the initial effects depend on the dose and route of exposure.
Exposure to high levels of cyanide harms the brain and heart, and may cause coma and death. Exposure to lower levels may result in breathing difficulties, heart pains, vomiting, blood changes, headaches, and enlargement of the thyroid gland.
Developed by the U.S. Department of Health and Human Services Public Health Service – Agency for Toxic Substances and Disease Registry Division of Toxicology and Environmental Medicine Applied Toxicology Branch.