Chemical and Biological Terrorism Research and Development to Improve Civilian Medical Response (1999) / Chapter Skim
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11 Conclusions and Recommendations
11 Conclusions and Recommendations
Pages 184-194
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From page 184... ...
There are, nevertheless, some general conclusions, some stated, some implicit, which pervade the report as a whole. 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.
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From page 185... ...
Additional units called I Local experts advise ; 185 Transport to ~ I hospitals I I treatment I major mission of public health departments is prompt identification and suppression of infectious disease outbreaks, and poison control centers deal with poisonings from both chemical and biological sources on a daily basis. It would be a serious tactical and strategic mistake to ignore (and possibly undermine)
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From page 186... ...
Strengthening existing mechanisms for dealing with unintentional releases of hazardous chemicals, for monitoring food safety, and for detecting and responding to infectious disease outbreaks, is preferable to building a new system focused solely on potentially devastating but low-probability terrorist events. Indeed, a major reason for the committee's decision to focus the report on response to aerosol attacks with the short list of agents thought to be a threat by U.S.
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From page 187... ...
Chapter 3 argues for including the medical community in the distribution of pre-incident intelligence to maximize medical response in dealing with chemical or biological incidents, but, important as that is, the time scale envisioned in those arguments is much too short for truly preventive measures like vaccination or the introduction of unfamiliar specialized equipment. A third conclusion which shaped the committee's recommendations concerned problems of scale.
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From page 188... ...
For that reason, the Metropolitan Medical Strike Teams being organized and equipped by the Public Health Service may be the most useful federal help in managing the medical consequences of a chemical attack. Similar help from deployable military teams will be optimal only if intelligence allows for predeployment or the attack occurs near the team's home base.
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From page 189... ...
The committee endorses continued testing of civilian commercial products for suitability in incidents involving chemical warfare agents, but research is still needed addressing the bulk, weight, and heat stress imposed by current protective suits, developing a powered air respirator with greatly increased protection, and providing detailed guidance for hospitals on dermal and respiratory protection. Specific R&D Needs: · Increased protection factors for respirators.
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From page 190... ...
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.
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From page 191... ...
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.
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From page 193... ...
Educational materials on chemical and biological agents are badly needed by both the general public and mental health professionals. Specific R&D Needs: · Identify resource material on chemical/biological agents and enlist the help of mental health professional societies in developing a training program for mental health professionals · Psychological screening methods for differentiating adjustment reactions after chemical/biological attacks from more serious psychological illness.
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From page 194... ...
· Information on the chemical, physical, and toxicological properties of the chemical and biological agents, in order to improve modeling of their environmental transport and fate and to better support recommendations on decontamination and reoccupation of affected property.
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