Skip to main content

Currently Skimming:

Executive Summary
Pages 1-14

The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.


From page 1...
... In addition, although the technology of producing and delivering chemical and biological weapons has existed for decades, the nerve gas attacks in Matsumoto in 1994 and Tokyo in 1995 by an apocalyptic religious cult and the subsequent revelation of the cult's attempts to acquire and use biological weapons have added a new dimension to plans for coping with terrorism. Traditional military approaches to battlefield detection of chemical and biological weapons and the protection and treatment of young healthy soldiers are not necessarily suitable or easily adapted for use by civilian health providers dealing with a heterogeneous population of casualties in a peacetime civilian setting.
From page 2...
... As a practical matter, the committee has taken as its reference point the relatively short list of chemical and biological agents that are discussed in the U.S. Army's handbooks for the medical management of chemical and biological casualties: nerve agents, cyanides, phosgene, and vesicants such as sulfur mustard; the bacteria-produced poisons staphylococcal enterotoxin B and the botulinal toxins; the plant-derived toxin ricin; the fungal metabolite T-2 mycotoxin; and the infectious microorganisms causing anthrax, brucellosis, plague, Q-fever, tularemia, smallpox, viral encephalitis, and hemorrhagic fever.
From page 3...
... The specific capabilities assessed are pre-incident intelligence (Chapter 2~; detection and identification of chemical and biological agents in the environment and in clinical samples from victims (Chapters 4 and 6~; personal protective equipment (Chapter 3~; recognizing covert exposures of a population (Chapter 5~; mass-casualty decontamination and triage procedures (Chapter 7~; availability, safety, and efficacy of drugs, vaccines, and other therapeutics (Chapter 8~; prevention and treatment of psychological effects (Chapter 9~; and computer related tools for training and operations (Chapter 10~. A list of specific R&D needs is provided at the end of each chapter.
From page 4...
... employed by medical personnel to prevent infections will generally provide protection from the biological agents under discussion, but it is difficult to say with confidence which, if any, civilian workers have suitable chemical PPE, because the testing and certification demanded by the Occupational Safety and Health Administration (OSHA) has not, until very recently, involved military nerve agents or vesicants, and military PPE that has been tested for protection against those agents generally does not have the testing and certification that would allow its use by civilian workers.
From page 5...
... DETECTION AND MEASUREMENT OF CHEMICAL AND BIOLOGICAL AGENTS Hazardous materials or "Hazmat" teams are routinely equipped with a variety of chemical detectors and monitoring kits, primarily employing chemical-specific tests indicating only the presence or absence of a suspected chemical or class of chemical. The most common detectors test for pesticides, chlorine, and cyanide, but not specifically for phosgene, vesicants, or nerve agents.
From page 6...
... Public safety and rescue personnel, emergency medical personnel, and medical laboratories all need faster, simpler, cheaper, more accurate instrumentation for detecting and identifying a wide spectrum of toxic substances, including but not limited to military agents, in both the environment and in clinical samples from patients. The committee therefore recommends adopting military products in the short run and supporting basic research necessary to adapt civilian commercial products wherever possible in the long run.
From page 7...
... · Educational/training needs of state and local health departments regarding all aspects of a biological or chemical terrorist incident. · Faster and more complete methods to facilitate access to experts and electronic disease reporting, from the health care provider level to global surveillance.
From page 8...
... R&D in decontamination and triage should concentrate on operations research to identify methods and procedures for triage and rapid, effective, and inexpensive decontamination of large groups of people, equipment, and environments. Specific R&D needs: · The physical layout, equipment, and supply requirements for performing mass decon for ambulatory and nonambulatory patients of all ages and health in the field and in the hospital; · A standardized patient assessment and triage process for evaluating contaminated patients of all ages; · Optimal solutions for performing patient decon, including decon of mucous membranes and open wounds; · The benefit vs.
From page 9...
... Conduct operations research on stockpiling and distribution of currently available antidotes for nerve agents and cyanide and give high priority to research on an effective treatment for vesicant injuries, investigation of new anticonvulsants and potential antibody therapy for nerve agents, development of improved vaccines against both anthrax and smallpox, development of a new antismallpax drug, and research on broad spectrum antiviral and novel antibacterial drugs. Specific R&D needs: · See Box 1 for a complete listing by agent and priority.
From page 11...
... A technique intended to prevent PTSD, Critical Incident Stress Debriefing (CISD) , has gained wide acceptance among field emergency workers, and it can be expected that local police, fire, and emergency medical units will be familiar with the process and have plans to use it.
From page 12...
... The committee recommends support for computer software R&D in three areas: event reconstruction from medical data, dispersion prediction and hazard assessment, and decontamination and reoccupation decisions. Specific R&D needs: · Computer software for rapid reporting of unusual medical symptomology to public-health authorities and linking that data to both toxicological information and models of agent dispersion.
From page 13...
... The most basic of these is that terrorist incidents involving biological agents, especially infectious agents, are likely to be very different from those involving chemical agents and thus demand very different preparation and response (the myriad of "chemical/biological" response teams being developed at federal, state, and local levels are, in fact, almost entirely focused on detection, decontamination, and expedient treatment of chemical casualties)
From page 14...
... The committee feels very strongly that it is important to make these existing mechanisms the focus of efforts to improve the response of the medical community to additional, albeit very dangerous, toxic or infectious materials.


This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More information on Chapter Skim is available.