Respiratory Diseases and the Fire Service - IAFF

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xii Respiratory Diseases and the Fire Service Clinical Manifestations ..................................................................... 176 Diagnosis ........................................................................................... 177 Treatment of OSA .............................................................................. 179 Central Sleep Apnea ................................................................................ 182 Mixed Apnea ............................................................................................ 182 Upper Airway Resistance Syndrome ..................................................... 183 Narcolepsy ............................................................................................... 183 References................................................................................................ 184 Chapter 2-12 • Cough .................................................................................... 187 Mechanism of Cough .............................................................................. 187 Acute Cough ............................................................................................ 188 Acute Cough and OTC Cough and Cold Products.......................... 188 Subacute Cough ...................................................................................... 189 Chronic Cough ........................................................................................ 190 Causes of Chronic Cough ................................................................. 190 Postnasal Drip Syndrome (PNDS) ............................................. 190 Asthma ......................................................................................... 191 Non-Asthmatic Eosinophilic Bronchitis (EB) ........................... 191 Gastroesophageal Reflux Disease (GERD) ................................ 191 Other Specific Issues Relevant to Chronic Cough ................................ 193 Cigarette Smoking ............................................................................. 193 Gender ............................................................................................... 193 Medications Taken for Other Reasons ............................................. 193 World Trade Center Cough .................................................................... 194 References................................................................................................ 194 Inhalation Injuries Chapter 3-1 • Inhalation Lung Injury from Smoke Particulates, Gases and Chemicals .............................................................. 197 Inhalation Respiratory Illnesses from Aerosolized Particulates .......... 197 Inhalation Respiratory Illnesses from Gases and Vapors .................... 203 Hydrogen Cyanide ............................................................................ 203 Carbon Monoxide ............................................................................. 204 Exposure to Irritant Vapors and Gases .................................................. 206 Chlorine ............................................................................................. 206 Phosgene ............................................................................................ 206 Diagnosis and Treatment ....................................................................... 207 History and Physical Examination ................................................... 207 Diagnostic Testing ............................................................................. 208 Other Pulmonary Functions ............................................................. 208 Chest Imaging.................................................................................... 209 Invasive Diagnostic Methods ........................................................... 209 Treatment .......................................................................................... 209 References................................................................................................ 211
Chapter 3-2 • Inhalation Lung Injury and Radiation Illness ...................... 217 Radiation Doses ...................................................................................... 218 Acute Radiation Illness ........................................................................... 219 Decontamination of Radiological Casualties ....................................... 222 Internal Radiation Contamination ........................................................ 223 Reference ................................................................................................. 224 Chapter 3-3 • Inhalation Lung Injury – Nerve Agents ................................ 225 References................................................................................................ 227 Chapter 3-4 • Disaster Related Infections: Pandemics and Bioterrorism ........................................................................ 231 Pandemic ................................................................................................. 231 Epidemics Post-Disaster ......................................................................... 232 Biological Terrorism Agents ................................................................... 235 Smallpox ............................................................................................ 236 Pathogenesis and Clinical Presentation .................................... 236 Laboratory Diagnosis .................................................................. 237 Treatment .................................................................................... 238 Infection Control ......................................................................... 238 Inhalational Anthrax ......................................................................... 238 Pathogenesis and Clinical Presentation .................................... 238 Laboratory Diagnosis .................................................................. 239 Treatment .................................................................................... 239 Infection Control ......................................................................... 240 Tularemia ........................................................................................... 240 Pathogenesis and Clinical Presentation .................................... 240 Laboratory Diagnosis .................................................................. 242 Treatment .................................................................................... 242 Infection Control ......................................................................... 242 Plague ................................................................................................. 243 Pathogenesis and Clinical Presentation .................................... 243 Laboratory Diagnosis .................................................................. 245 Treatment .................................................................................... 245 Infection Control ......................................................................... 245 Botulinum .......................................................................................... 245 Pathogenesis and Clinical Manifestations ................................ 246 Treatment .................................................................................... 246 Infection Control ......................................................................... 246 References................................................................................................ 246 Chapter 3-5 • World Trade Center Respiratory Diseases ........................... 253 Introduction ............................................................................................ 253 Upper Respiratory Disease ..................................................................... 256 Reactive Upper Airways Dysfunction Syndrome (RUDS) and Chronic Rhinosinusitis ............................................................. 256 Lower Respiratory Disease ..................................................................... 256 Respiratory Diseases and the Fire Service xiii
Page 2 and 3: U.S. Fire Administration Mission St
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44 Chapter 2-2 • Respiratory Infe
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46 inhalation of an infected aeroso
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48 ill or “toxic". The chest radi
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54 Chapter 2-3 • Tuberculosis: A
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72 Drug and Duration Isoniazid (INH
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80 Chapter 2-4 • Asthma to such a
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82 Chapter 2-4 • Asthma CLINICAL
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84 Chapter 2-4 • Asthma who has p
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86 Chapter 2-4 • Asthma Long-Term
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88 Chapter 2-4 • Asthma Table 2-4
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90 Chapter 2-4 • Asthma Treatment
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92 Chapter 2-4 • Asthma 21. Natha
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94 Chapter 2-5 • Chronic Obstruct
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100 Chapter 2-5 • Chronic Obstruc
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108 Chapter 2-6 • Sarcoidosis or
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110 Chapter 2-6 • Sarcoidosis Fig
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112 Chapter 2-6 • Sarcoidosis Oth
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114 Chapter 2-6 • Sarcoidosis pri
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116 Chapter 2-6 • Sarcoidosis WTC
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118 Chapter 2-6 • Sarcoidosis 18.
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120 Chapter 2-7 • Pulmonary Fibro
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132 Chapter 2-8 • Pulmonary Vascu
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146 Chapter 2-9 • Fire Fighter Lu
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166 Chapter 2-10 • Asbestos-Relat
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178 Chapter 2-11 • Sleep Apnea Sy
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192 Chapter 2-12 • Cough ACUTE CO
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194 Chapter 2-12 • Cough cough oc
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196 Chapter 2-12 • Cough Gastroes
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198 Chapter 2-12 • Cough WORLD TR
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materials may produce smoke that is
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204 The effects of frequent smoke e
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the most intense exposure to air po
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seizures, coma and death64 . Additi
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highly water-soluble and, thus, wil
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Diagnostic Testing Initial pulmonar
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symptoms in an inhalation lung inju
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17. Musk AW, Peters JM, Wegman DW.
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42. Herbert R, Moline J, Skloot G,
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71. Kales S, Christiani D. Acute ch
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222 Chapter 3-2 • Inhalation Lung
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224 Procedure for Determining Appro
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groups have been identified to be a
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238 fever accompanied by mouth sore
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240 and Aspergillus species which a
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242 renal failure. Encephalitis and
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244 progress to severe, fulminant i
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246 may be present. A systemic dise
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248 one percent are primary pneumon
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250 gentamicin is recommended. In a
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252 9. Kilbourne E. Influenza. 1st
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254 44. Marik PE, Bowles SA. Medica
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256 74. Advisory Committee on Immun
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258 Chapter 3-5 • World Trade Cen
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262 Pulmonary function declines or
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268 (FDNY, NY/NJ consortium coordin
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278 Chapter 4-1 • Pulmonary Funct
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280 Spirometry results can usually
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282 of these conditions on spiromet
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284 Figure 4-1.4: Helium dilution t
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286 calculate a single-breath estim
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288 Chapter 4-1 • Pulmonary Funct
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Class 1, 0%-9%: No Impairment of th
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294 Chapter 4-2 • Imaging Modalit
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While most people are aware that sm
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332 Modified Fagerström Test for S
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334 nicotine gum, inhalers, or nico
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336 Common Reasons Fire Fighters Ex
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338 and while anyone can temporaril
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340 heart and lungs, increasing the
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342 your doctor, healthcare profess
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344 protection from tobacco craving
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346 cessation. The entire program i
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. drive, the neural control of brea
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350 Figure 4-5.2: The balance betwe
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352 TREATMENT OF RESPIRATORY FAILUR
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354 • Less discomfort Mechanical
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356 WEANING OR REMOVING A PATIENT F
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358 7. Esteban A, Frutos F, Tobin M
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International Association of Fire F
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