Triage casualties

There are no recommendations for triaging casualties exposed to bicyclophosphates. However, in general, anyone who has been exposed should be transported to a medical facility for evaluation. Individuals who are asymptomatic and have not been directly exposed to the agent can be discharged after their names, addresses, and telephone numbers have been recorded. They should be told to seek medical care immediately if symptoms develop. 

Knowledge beforehand that patients are victims of a CB attack would, of course, be useful in order to anticipate and triage casualties, as well as to plan for long-term treatment modalities. But the fact that casualties were deliberately caused by a terrorist attack involving Category C or B agents may go unrecognized for some time. Two examples illustrate this latter point. 

A casualty with onset of symptoms (pulmonary edema, cyanosis, and hypotension or persistent hypotension despite intensive medical care) less than 4 hours postexposure. This triage classification is resource dependent. 

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