PREHOSPITAL CARE

Prehospital management and medical intervention after a chemical attack

L Kenar and T Karayilanoglu

Department of NBC Defence, Gulhane Military Medical Academy, Ankara, Turkey

Correspondence to:
Correspondence to:
Dr L Kenar
Department of NBC Defence, Gulhane Military Medical Academy, 06018 Etlik, Ankara, Turkey; lkenar{at}gata.edu.tr

Chemical warfare agents are toxic weapons and emergency prehospital medical care providers should be well prepared, trained, and equipped to give response. Personnel need to be aware of the following medical issues regarding prehospital management of a chemical attack, event recognition, incident medical command and control, safety and protection, decontamination, isolation of the incident area (hot zone, warm zone, and cold zone), sampling and detection, psychological management, communication, triage, treatment, transportation, recovery activities and fatality management. During prehospital response, healthcare responders should provide self protection by wearing proper protective equipment and ensuring that the casualty is thoroughly decontaminated. Medical first responders are also responsible for performing triage in each zone of the incident area. Victims are triaged into four categories based on the need for medical care; immediate, delayed, minimal, and expectant. Finally, a medical emergency planning should be completed, and exercises conducted to test the system before an event occurs.

Keywords: chemical terrorism; medical management; chemical casualty; decontamination; triage

Abbreviations: CWA, chemical warfare agent; CB, chemical and biological

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