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Toxic Trauma

Published online by Cambridge University Press:  28 June 2012

T.M. Moles  and
D.J. Baker
T.M. Moles
Affiliation:
Oral and Maxillofacial Surgery, University of Hong Kong, China
D.J. Baker
Affiliation:
SAMU de Paris, Hopital Necker Enfants-Malades, 75015 Paris, France.
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Abstract

Hazardous materials (HAZMAT) carry many inherent dangers. Such materials are distributed widely in industrial and military sites. Toxic trauma (TT) denotes the complex of systemic and organ injury caused by toxic agents. Often, TT is associated with other injuries that also require the application of life-support techniques. Rapid onset of acute respiratory failure and consequent cardiovascular failure are of primary concern. Management of TT casualties is dependent upon the characteristics of the toxic agents involved and on the demographics surrounding the HAZMAT incident.

Agents that can produce TT possess two pairs of salient characteristics: (1) causality (toxicity and latency), and (2) EMS system (persistency and transmissibility). Two characteristics of presentations are important: (1) incident presentation, and (2) casualty presentation. In addition, many of these agents complicate the processes associated with anaesthesia and must be dealt with. Failure of recognition of these factors may result in the development of respiratory distress syndromes and multiorgan system failure, or even death.

Keywords

anaesthesiacardiovascular failureemergency medical serviceshazardous materialsinjurieslife supportrespiratory failuretoxic chemicalsweapons of mass destruction
Type
Comprehensive Review
Information
Prehospital and Disaster Medicine , Volume 16 , Issue 2: T. Michael Moles Memorial Issue , June 2001 , pp. 78 - 80
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2001

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References

1. Organisation of Economic Cooperation and Development: Health aspects of chemical accidents: guidance on chemical accident awareness, preparedness and response for health professional and emergency responders. OECD environment monograph No 81 (OECD/GD(94)1): Paris; OECD 1994.Google Scholar
2. Moles, TM: Emergency medical services systems and hazardous materials major incidents. Resuscitation 1999;42:103–116.CrossRefGoogle ScholarPubMed
3. Okumura, T, Suzuki, K, Fukuda, A, Kohama, A, Takasu, N, Ishimatsu, S, Hinohara, S: The Tokyo subway sarin sttack: Disaster management, Parts 1,2,3. Academic Emergency Medicine 1998;5:613–628.CrossRefGoogle Scholar
4. Baker, DJ: Advanced life support for toxic injuries (TOXALS). Eur J Emerg Med 1996;3(4):327–348.CrossRefGoogle ScholarPubMed
5. ILCOR: Advisory statement: Special resuscitation situations. Resuscitation 1997:34:129–141.CrossRefGoogle Scholar
6. American College of Surgeons Committee on Trauma: Advanced Trauma Life Support Course, Instructor Manual. Chicago: The College, 1998.Google Scholar
7. Moles, TM: Mass casualties, traumatic and toxic injuries and advanced life support—An anaesthesiology perspective and paradigm shift. Trauma Care 1996;6:12–17.Google Scholar
8. Baker, DJ: Management of respiratory failure in toxic disasters. Resuscitation 1999;42:125–131.CrossRefGoogle ScholarPubMed
9. Lipp, M, Baker, DJ, Paschen, H, Carli, P et al. : BASE: Breathing Assessment Score in Emergencies — first results of an international, multi-centre study. Proceedings of International Trauma and Anaesthesia Critical Care Society Annual Trauma Anaesthesia and Critical Care Symposium 1998.Google Scholar
10. Baker, DJ: Anaesthesia in extreme environmental conditions; Part 2:Chemical and biological warfare. In: Grande, CM (ed), Textbook of Trauma Anaesthesia and Critical Care. St Louis: Mosby Year Book. 1993. pp 1300–1330.Google Scholar
11. Lambert, Y, Carli, P, Cantineau, JP: Smoke Inhalation Injury. In: Grande, CM (ed) Textbook of Trauma Anaesthesia and Critical Care. St Louis: Mosby Year Book 1993:583–593.Google Scholar
12. Fisher, JA, Sommer, LZ, Rucker, J, Vesely, A, Lavine, A, Greenwald, Y et al. : Isocapnic hyperpnea accelerates carbon monoxide elimination. Am J Respi Crit Care Med 1999;159:1289–1292.CrossRefGoogle ScholarPubMed
13. Berkenstadt, H, Marganitt, B, Atsmon, J: Combined chemical and conventional injuries—pathophysiological, diagnostic and therapeutic aspects. Isr J Med Sci 1991;27:623–626.Google ScholarPubMed