The presentation and management of victims of chemical and biological agents: a survey of knowledge of UK clinicians
Introduction
The release of nerve agents in Tokyo in 1996 [1] and the terrorist events in the US in 2001 have resulted in an increased awareness of the threat posed by chemical and biological agents. Since 2001, there has been a significant increase in information in the medical literature regarding the presentation and management of people exposed to chemical or biological agents [2], [3], [4]. Several national bodies have produced guidelines to assist clinicians in the management of deliberate release. These guidelines are readily available [5], [6], [7]. This survey aimed to determine if information on the subject of chemical and biological release has been disseminated to and remembered by clinicians in the specialities likely to be involved in the initial management of victims of this type of incident.
Section snippets
Methods
A short questionnaire (Fig. 1) was prepared to assess knowledge in three main areas: the presentation and immediate management of patients following exposure to nerve agents, knowledge of where to access information when presented with a deliberate release and knowledge of the transmission of biological agents. Respondents were also asked whether they had been involved in hospital exercises dealing with chemical or biological incidents. The Department of Health in the UK issued ‘Guidelines for
Results
A total of 102 completed questionnaires were returned from the four centres. All individuals that were approached completed the questionnaire.
Forty-five (44%) respondents were aware that decontamination following exposure to nerve agents should take place at the scene of exposure. A further 25 were aware of decontamination units.
Fifty-four (53%) respondents knew that when decontaminating casualties, the addition of simple detergent to warm water is recommended.
Three key presenting features of
Discussion
The results of this survey demonstrate that clinicians in acute specialties in the UK have major gaps in their knowledge of deliberate release situations. It also shows that only one in five have participated in any relevant exercises. Those that have been involved in relevant exercises are almost exclusively from emergency medicine (19 of 21). Overall scores demonstrated that while senior house officers predictably had little knowledge of the subject, specialist registrars were as
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