Chemical exposures disasters

It is also important to consider the issue of patient decontamination. Many hospitals rely on local fire or HAZMAT resources to decontaminate patients prior to arrival at the emergency department. This model is almost always effective as the typical HAZMAT or chemical exposure is an isolated event in which a limited access/egress quarantine can be established, and in which patients can be controlled and decontaminated. However, as was demonstrated during the sarin gas attack in Tokyo, in a disaster, there is no control over the scene or scenes. Patients will self-refer to emergency departments without being decontaminated (Auf der Heide, 2006 Okumura, Suzuki, Fukuda, 1998 Okumura, Takasu, Ishimatsu, 1996). 

Children with special health care needs will require additional considerations during mass casualty or disaster care. These considerations include decontamination procedures following radiation or chemical exposure for children using wheelchairs, ventilators, or oxygen and decontamination procedures for children with gastrostomy tubes, tracheostomy tubes, indwelling bladder catheters, and indwelling central venous catheters. Replacement supplies would be needed once the cutaneous decontamination is completed. Such supplies may not be readily available, so provisions must be made to secure these items or to have comparable clean or sterile supplies on hand. 

Public awareness of neurotoxic chemicals comes from media descriptions of mass chemical disasters involving hundreds, if not thousands, of victims. Many mass chemical disasters fueled environmental movements, forced legislation of new laws, changed public perceptions of government and industry, and caused adverse health outcomes for many individuals. Most of my top 10 mass chemical disasters of psychiatric importance listed on p. xii (see box) produced significant psychosocial effects on communities, regions, nations, and even international relations. Other events affected fewer individuals but showed the importance of psychiatric assessment and treatment of chemical exposures. In some disasters, stress caused the... 

The third of the major hazards and the one with the greatest disaster potential is the release of toxic chemicals. The hazard posed by toxic release depends not only on the chemical species but also on the conditions of exposure. The high disaster potential from toxic release arises in situations where large numbers of people are briefly exposed to high concentrations of toxic material, i.e., acute exposure. However, the long-term health risks associated with prolonged exposure at low concentrations, i.e., chronic exposure, also present serious hazards. 

As a consequence, much of the public has come to believe that most chemicals are hazardous. A recent poll by the Roper Organization revealed that two out of three American citizens expect a major chemical disaster, resulting in thousands of deaths, within the next 50 years. The poll also found that a high proportion of the public lacked confidence that industry would deal openly with them. A public attitude toward exposure to chemicals is developing that can be summed up by the words, "no risk." But, as a judge recently stated, "In the crowded conditions of modem life, even the most careful person cannot avoid creating some risks and accepting others. What one must not do, and what I think a careful person tries not to do, is to create a risk which is substantial." ... 

Describe the assessmentand treatment of children following nafural disasters and exposure to nuclear, biological, or chemical agents in the field, emergency department, and hospital setting. 

Exposure to various nuclear, biologic, and chemical agents, as well as exposure to natural and man-made disasters, can have genetic implications for children and their future offspring. Following the aftermath of Hurricane Gilbert in Jamaica on September 12, 1988,... 

Chemical disasters may result from accidental exposure, industrial accidents, or an intentional terrorist act. 

Since 9/11, Americans feel an increased vulnerability to terrorism or exposure to acts of war, including the use of biological and chemical agents. As evident here, previous, and current, research conducted by military nurses lends an initial understanding of nursing practice in austere environments, primarily during wartime. To date, however, there has been less research into biochemical defense for both the provider and the patient under these conditions. More research is needed so that nurses and other health care providers can provide quality care for patients, families, and communities in disaster situations. 

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