Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-13T06:26:35.262Z Has data issue: false hasContentIssue false
  • English
  • Français

Canadian emergency department preparedness for a nuclear, biological or chemical event

Published online by Cambridge University Press:  21 May 2015

Daniel Kollek
Daniel Kollek*
Affiliation:
Emergency Medicine, McMaster University, Hamilton, Ont.; Hamilton Health Sciences Centre, Hamilton, Ont.
*
Department of Emergency Medicine, Hamilton General Hospital, 237 Barton St. E, Hamilton ON L8L 2X2; 905 527-4322 x46368, fax 905 527-7051, kollek@interlynx.net

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Since the terror attacks of September 11th, emergency departments across North America have become more aware of the need to be prepared to deal with a mass casualty terror event, particularly one involving nuclear, biological or chemical contaminants. The effects of such an attack could also be mimicked by accidental release of toxic chemicals, radioactive substances or biological agents unrelated to terrorist activity.

The purpose of this study was to review the risks and characteristics of these events and to assess the preparedness of Canadian emergency departments to respond. This was done by means of a survey, which showed a significant risk of a mass casualty event (most likely chemical) coupled with a deficiency in preparedness — most notably in the availability of appropriate equipment, antidotal therapy and decontamination capability. There were also significant deficiencies in the ability to respond to a major biologic or nuclear event.

Keywords

disasterterrorismemergency preparedness
Type
EM Advances • Innovations En MU
Information
Canadian Journal of Emergency Medicine , Volume 5 , Issue 1 , January 2003 , pp. 18 - 26
Copyright
Copyright © Canadian Association of Emergency Physicians 2003

References

1.International Convention for the Suppression of Terrorist Bombing (United Nations General Assembly Resolution, New York: 12 January 1998) [modified]; United Nations Office for Drug Control and Crime Prevention proposed definitions of terrorism. Available: www.undcp.org/odccp/terrorism_convention_terrorist_bombing.html (accessed 2002 Dec 4).Google Scholar
2.Cone, DC, Davidson, SJ.Hazardous materials preparedness in the emergency department. Prehosp Emerg Care 1997;1:85–90.CrossRefGoogle ScholarPubMed
3.Rodgers, JC.Chemical incident planning: a review of the literature. Accid Emerg Nurs 1998;6:155–9.Google Scholar
4.Rodgers, J.A chemical gas incident in London: How well prepared are London A & E departments to deal effectively with such an event? Accid Emerg Nurs 1998;6(2):82–6.Google Scholar
5.Edgell, M, James, MR.Contaminated casualties: Are we prepared to receive them? J Accid Emerg Med 1994;11:172–7.CrossRefGoogle Scholar
6.Totenhofer, RI, Kierce, M.It’s a disaster: emergency departments’ preparation for a chemical incident or disaster. Accid Emerg Nurs 1999;7:141–7.CrossRefGoogle ScholarPubMed
7.Wetter, DC, Daniell, WE, Treser, CD.Hospital preparedness for victims of chemical or biological terrorism. Am J Publ Health 2001;91:710–6.Google ScholarPubMed
8.Levitin, HW, Siegelson, HJ.Hazardous materials — disaster medical planning and response. Emerg Med Clin N Am 1996;14:327–48.Google Scholar
9.Cox, RD.Decontamination and management of hazardous materials exposure victims in the emergency department. Ann Emerg Med 1994;23:761–70.CrossRefGoogle ScholarPubMed
10.Grafstein, E, Innes, G.Bioterrorism: an emerging threat. CJEM 1999;1(3):205–9.CrossRefGoogle ScholarPubMed
11.Lubenau, JO.Unwanted radioactive sources in the public domain: a historical perspective. Health Phys 1999;76(2 suppl): S16–22.Google Scholar
12.Mettler, FA, Voelz, GL.Major radiation exposure — what to expect and how to respond. N Engl J Med 2002;346:1554–61.CrossRefGoogle ScholarPubMed
13.United Nations Office on Drugs and Crime. Conventional terrorist weapons. Available www.23.odccp.org/odccp/terrorism_weapons_conventional.html (accessed 2002 Dec 4).Google Scholar
14.Stephanson, J.Pentagon funded research takes aim at agents of biological warfare. JAMA 1997; 278:373–5.CrossRefGoogle Scholar
15.Sidell, FR.Chemical agent terrorism. Ann Emerg Med 1996;28: 223–4.Google Scholar
16.Holstege, CP, Kirk, M, Sidell, FR.Chemical warfare, nerve agent poisoning. Crit Care Clin 1997;13:923–42.Google Scholar
17.Torok, TJ, Tauxe, RV, Wise, RP, Livengood, JR, Sokolow, R, Mauvais, S, et al. A large community outbreak of Salmonellosis caused by intentional contamination of restaurant salad bars. JAMA 1996;278(5):389–95.CrossRefGoogle Scholar
18.Kolavic, SA, Kimura, A, Simons, SL, Slutsker, L, Barth, S, Haley, CE.An outbreak of Shigella dysenteriae type 2 among laboratory workers due to intentional food contamination. JAMA 1997;278(5):396–8.CrossRefGoogle ScholarPubMed
19.Zilinskas, RA.Iraq’s biological weapons. The past as future? JAMA 1997;278(5):418–24.CrossRefGoogle ScholarPubMed
20.Hirshberg, A, Stein, M, Walden, R.Surgical resource utilization in urban terrorist bombing: a computer simulation. J Trauma 1999; 47:545–0.CrossRefGoogle ScholarPubMed
21.Levi, L, Bregman, D, Geva, H, Revach, M.Hospital disaster management simulation system. Prehospital Disaster Med 1998;13: 29–34.Google Scholar
22.Israel Ministry of Health. [Prepared – a journal for emergency situations.] Prepared 1999;April.Google Scholar
23.Plante, DM, Walker, JS.EMS response at a hazardous materials incident: some basic guidelines. J Emerg Med 1989;7:55–64.Google Scholar
24.Burgess, JL, Blackmon, GM, Brodkin, CA, Robertson, WO.Hospital preparedness for hazardous materials incidents and treatment of contaminated patients. West J Med 1997;167:387–91.Google ScholarPubMed
25.Sidell, FR.What to do in the case of an unthinkable chemical warfare attack or accident. Postgrad Med 1990;88:70–84.Google Scholar
26.Treatment of nerve gas poisoning. Med Lett Drugs Ther 1995; 37(948):43–4.Google Scholar