Victim management

Gathering together all this technical knowledge introduces a new philosophy in the approach to chemical ocular bum lesions, in particular at the initial stage of victim management with increased practicality, specificity, and efficacy. 

V. Victim management Victim management includes rapid stabilization and removal from the Exclusion Zone, initial decontamination, delivery to emergency medical services personnel at the Support Zone perimeter, and medical assessment and treatment in the support area. Usually only the HazMat team or other fire department personnel with appropriate training and protective gear will be responsible for rescue from the hot zone, where skin and respiratory protection may be critical. Emergency medical personnel without specific training and appropriate equipment must not enter the hot zone unless it is determined to be safe by the Incident Commander and the medical officer. 

The role of cytokine therapy in the management of radiation accident victims has been summarized (152). In GoiBnia in Brazil in 1987, eight radiation accident victims were treated with GM-CSF one month after radiation exposure. Marked increases in granulocyte production were induced in five persons, although this did not prevent death. 

In the veterinary as in the human patient, neoplasms are often metastatic and widely disseminated throughout the body. Surgery and irradiation are limited in use to weU-defined neoplastic areas and, therefore, chemotherapy is becoming more prevalent in the management of the veterinary cancer victim (see Chemotherapeutics, anticancer). Because of the expense and time involved, such management must be restricted to individual animals for which a favorable risk—benefit evaluation can be made and treatment seems appropriate to the practitioner and the owner. In general, treatment must be viewed not as curative, but as palliative. 

In the past few years, the insurance industry has developed financial products suitable for dealing with climate change-related risks in the direction to play a role far beyond simply compensating climate change s victims for their losses ex post. The activity of the insurance has become relevant as a political economic instruments within an ex ante strategy to financially manage large-scale catastrophes, as a complement of ex post instruments for the compensation of disaster losses. 

The nowadays system for supply and receipt of information does not always answer the current needs. In such conditions, it is impossible to consider the information on the concerned subject of management as being objective, since it is coming in too late. Unreliable untimely information sometimes results in errors during the decision-making administrative process and in extraordinary situations can cost the life or be the instrument for worsening the condition of victims. As a result, the necessity becomes clear to develop and... 

Isolation Procedures Once a victim of chemical or biological agents or weapons gets to the hospital or another healthcare facility, that person may have to abide by patient isolation procedures. These include Standard Precautions, Airborne Precautions, Droplet Precautions, and Contact Precautions. These precautions are spelled out in the third edition of Medical Management Of Biological Casualties Handbook published by the U.S. Army Medical Research Institute of Infectious Disease located at Fort Detrick in Frederick, Maryland. 

Medical Management Victims may have a feverish respiratory syndrome without chest x-ray abnormalities, and diagnosis is usually clinical. Medical and emergency medical services personnel should be aware of and should report any number of victims showing up within a limited amount of time presenting typical symptoms and instances of SEB pulmonary exposure as being indicative of being an intentional attack with SEB toxin. 

Medical Management No specific viral therapy exists so treatment is supportive only. Treat patients with uncomplicated VEE infection with analgesics to relieve headache and myalgia. Patients who develop encephalitis could require anticonvulsants and intensive care to maintain fluid and electrolyte balance, ensure adequate ventilation, and avoid complicating secondary bacterial infections. Patients should be treated in a screened room or in quarters treated with residual insecticide for at least five days after onset, or until afebrile (without fever) to foil mosquitoes since humans may remain infectious for mosquitoes for at least seventy-two hours. Isolation and qaurantine is not required. Standard Precautions should be practiced when dealing with infection control for VEE victims as shown below ... 

U.S. civilian populations who may be contaminated by nuclear, biological, or chemical (NBC) agents. In a worst case terrorist, criminal, or accidental event, the CBIRF provides a standing, highly trained consequence management force tailored for short notice response to civilian victims of NBC materials or weapons of mass destruction. 

Medical Management Immediate decontamination after exposure is the only way to prevent damage to victims, followed by symptomatic management of lesions. Hospital care tends to be supportive. It should be repeated that liquid arsenical vesicants produce more serious lesions on dermal surfaces than do liquid mustard. In toxic victims, liberal fluids by mouth or intravenous, and high-vitamin, high-protein, high-carbohydrate diets could be indicated. For those victims where shock is in evidence, provide the usual supportive measures such as intravenous administration, blood transfusions, or other vascular volume expanders should be indicated. 

Decontamination immediately after exposure is the only way to present damage, with symptomatic management of lesion/blisters thereafter. All victims and first responders shall be decontaminated when leaving the Hot Zone. Clothes should be removed if at all possible, and no one should be transported to a hospital until he of she has been thoroughly decontaminated. Care in a hospital is strictly supportive. First responders have to ensure that every one contaminated goes through an efficient decontamination procedure. 

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