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Table 1.1 Types of disasters Natural Disasters Hurricanes or cyclones Droughts Tornadoes Wildfires Mudslides Earthquakes Tsunamis Infestations or disease epidemics Ice or hail storms Technological Disasters Hazardous materials Transportation crashes or releases or spills derailments Unintentional explosions Power outages or collapses Terrorism, National or International Violence Bombings or explosions Multiple or mass shootings Chemical agent releases Cult-related violence Biological agent releases Riots Nuclear agent releases Arson Humanitarian Disasters, Complex Emergencies War or violent political Genocidal acts conflict Famine Shelter, feeding, or medical care of displaced populations Droughts Source: Courtesy of the American Academy of Pediatrics. From: Romig LE. Disaster Management. In APLS: The Pediatric Emergency Medicine Resource 4 th ed, Gausche-Hill M, Fuchs S, Yamamoto L (eds). Sudbury MA: Jones and Bartlett, 2003. pp 542-567. 13
Page 1 and 2: Bioterrorism and Other Public Healt
Page 3 and 4: Contents Chapter 1. Introduction ..
Page 5 and 6: Q Fever............................
Page 7 and 8: Basic Principles...................
Page 9 and 10: Chapter 9. Integrating Terrorism an
Page 11 and 12: Table 5.4 Nerve agent triage and do
Page 13 and 14: There are many gaps in knowledge, e
Page 15 and 16: injured or killed (see also Chapter
Page 17 and 18: Head injury is common in children.
Page 19 and 20: In situations of disaster, caregive
Page 21 and 22: maintaining and securing the airway
Page 23: • Schonfeld DJ. In times of crisi
Page 27 and 28: water) must be identified and made
Page 29 and 30: explosions, structural collapses, t
Page 31 and 32: State and local governments share t
Page 33 and 34: • Communication. • Technical au
Page 35 and 36: Figure 2.1 Federal Response Plan EO
Page 38 and 39: Chapter 3. Responding to a Disaster
Page 40 and 41: decontamination), and transport vic
Page 42 and 43: medical care throughout the United
Page 44 and 45: Surge capacity. Most of our medical
Page 46 and 47: their own without previous triage o
Page 48 and 49: o Public recreation administrations
Page 50 and 51: The goal of disaster life support t
Page 52 and 53: supervision, and entertainment for
Page 54 and 55: Victims that have been exposed to a
Page 56: Table 3.1 Training and competencies
Page 59 and 60: prepared for use in intercontinenta
Page 61 and 62: • An unexplained increase in the
Page 63 and 64: The paralysis eventually progresses
Page 65 and 66: hemorrhages into the skin and mucou
Page 67 and 68: are addressed in local medical resp
Page 69 and 70: • The patient should be moved fro
Page 71 and 72: • Clean, nonsterile disposable gl
Page 73 and 74: across the United States. Push pack
Page 75 and 76:
• Cutaneous. • Inhalational.
Page 77 and 78:
people. This vaccine is prepared fr
Page 79 and 80:
Diagnosis. A presumptive diagnosis
Page 81 and 82:
• Bubonic plague usually is trans
Page 83 and 84:
Signs and symptoms. An individual i
Page 85 and 86:
and waste should be discarded into
Page 87 and 88:
For additional information, see htt
Page 89 and 90:
Ricin provokes a specific antibody
Page 91 and 92:
Brucella Brucella species that infe
Page 93 and 94:
Encephalitis Viruses and Yellow Fev
Page 95 and 96:
Bibliography • Arnon SS, Schechte
Page 97 and 98:
• Centers for Disease Control and
Page 99 and 100:
Figure 4.1. Chest radiograph taken
Page 101 and 102:
Figure 4.3. Cutaneous anthrax lesio
Page 103 and 104:
Figure 4.5. Smallpox lesions Note:
Page 105 and 106:
Figure 4.7. Expected smallpox vacci
Page 107 and 108:
Figure 4.8b. Classification of risk
Page 109 and 110:
Table 4.1. Early clinical signs and
Page 111 and 112:
Table 4.3. Diagnostic procedures, i
Page 113 and 114:
Table 4.3. Diagnostic procedures, i
Page 115 and 116:
Table 4.5. Postexposure prophylaxis
Page 117 and 118:
106
Page 119 and 120:
exposed but not critically injured
Page 121 and 122:
Appropriate PPE for ED staff involv
Page 123 and 124:
ags allowing sarin vapor to escape)
Page 125 and 126:
indicated without waiting for choli
Page 127 and 128:
Toxicology Cyanide has a strong aff
Page 129 and 130:
these medications are packaged toge
Page 131 and 132:
usually for 4-6 hours. The first sy
Page 133 and 134:
patient should be intubated promptl
Page 135 and 136:
classification as Type III (systemi
Page 137 and 138:
clinically valuable information abo
Page 139 and 140:
Treatment and Control Decontaminati
Page 141 and 142:
Goldfrank’s Toxicologic Emergenci
Page 143 and 144:
Table 5.1. Pediatric vulnerabilitie
Page 145 and 146:
Table 5.2. Chemical weapons - Summa
Page 147 and 148:
Table 5.3. Representative classes o
Page 149 and 150:
Table 5.4. Nerve agent triage and d
Page 151 and 152:
Table 5.6. Riot control agents Chem
Page 153 and 154:
142
Page 155 and 156:
water consumption. Initial response
Page 157 and 158:
psychological impacts of the attack
Page 159 and 160:
useful modality for medical imaging
Page 161 and 162:
exposed population. A large area re
Page 163 and 164:
The ratio of protons to neutrons in
Page 165 and 166:
The subatomic particles that can be
Page 167 and 168:
example, alpha particles and certai
Page 169 and 170:
Biodosimetry Effective medical mana
Page 171 and 172:
exposure dose is associated with a
Page 173 and 174:
medical needs supporting biodosimet
Page 175 and 176:
Syndromes ARS is not a single syndr
Page 177 and 178:
which is revised over time as more
Page 179 and 180:
Most radioactive contaminants will
Page 181 and 182:
Medical Diagnosis: Internal Radionu
Page 183 and 184:
Radionuclides that distribute to th
Page 185 and 186:
contamination. Typically, the patie
Page 187 and 188:
• Check the batteries (most RADIA
Page 189 and 190:
The standard dosimeter for most rad
Page 191 and 192:
labeled as radioactive material. A
Page 193 and 194:
contamination. The water should be
Page 195 and 196:
finding has relevance to children,
Page 197 and 198:
cytokine therapy is recommended for
Page 199 and 200:
to pursue stem cell transplantation
Page 201 and 202:
Radioactive Cesium and Thallium: Pr
Page 203 and 204:
esponse. Precursor/stem cells are m
Page 205 and 206:
• Necrotic areas should be carefu
Page 207 and 208:
not involve radioactive iodine. The
Page 209 and 210:
material is then spread when it is
Page 211 and 212:
chemical, and physical properties t
Page 213 and 214:
Additional factors must be consider
Page 215 and 216:
washing the hands and face are espe
Page 217 and 218:
Children and Adults: Implications f
Page 219 and 220:
• Lloyd DC, Edwards AA, Moquet JE
Page 221 and 222:
• Pacini F, Vorontsova T, Molinar
Page 223 and 224:
• U.S. Food and Drug Administrati
Page 225 and 226:
• Sklar CA, Mertens AC, Mitby P,
Page 227 and 228:
Figure 6.1. Probability of radiatio
Page 229 and 230:
Figure 6.3. Generic pediatric medic
Page 231 and 232:
Figure 6.5. Pattern of a series of
Page 233 and 234:
Figure 6.7. Contamination versus ex
Page 235 and 236:
Figure 6.9. Recommended procedures
Page 237 and 238:
Table 6.1. Biological dosimetry ass
Page 239 and 240:
Table 6.3. Initial or prodromal pha
Page 241 and 242:
Table 6.5. Timing to onset of vomit
Page 243 and 244:
Table 6.7. Guidelines for bioassay
Page 245 and 246:
Table 6.9. Threshold radioactive ex
Page 247 and 248:
Table 6.11. Reduction in exposure b
Page 249 and 250:
Blast Fundamentals Understanding ho
Page 251 and 252:
espect to incident waves and the de
Page 253 and 254:
additional morbidity in the nature
Page 255 and 256:
Clinical findings and diagnosis. Th
Page 257 and 258:
• Ossicular chain fracture. • L
Page 259 and 260:
monoxide is a byproduct of napalm c
Page 261 and 262:
full-service general hospitals that
Page 263 and 264:
• The need to activate regional d
Page 265 and 266:
• Of five high-risk children (gre
Page 267 and 268:
• Phillips Y, Richmond DR. Primar
Page 269 and 270:
Table 7.1. Expected injuries at rel
Page 271 and 272:
Table 7.3 Principles of Advanced Tr
Page 273 and 274:
Table 7.4 Principles of Advanced Bu
Page 275 and 276:
Electrical burns Remove all contami
Page 277 and 278:
incidents and posttraumatic stress
Page 279 and 280:
some ways, any death may be perceiv
Page 281 and 282:
problems. New issues related to tra
Page 283 and 284:
surviving parent), rather than by p
Page 285 and 286:
• Feel free to express your own f
Page 287 and 288:
een given to children, it is helpfu
Page 289 and 290:
management of pediatric bereavement
Page 291 and 292:
definitely not as a therapy or trea
Page 293 and 294:
Blocking norepinephrine and epineph
Page 295 and 296:
It is important to find ways within
Page 297 and 298:
• Look for signs of distress in s
Page 299 and 300:
• Engage the responder or care pr
Page 301 and 302:
an information vacuum that will alm
Page 303 and 304:
Table 8.1 Concepts of death and imp
Page 305 and 306:
arrangements to share facilities wi
Page 307 and 308:
• Types of radiological terrorism
Page 309 and 310:
Collaborating Agencies Responding t
Page 311 and 312:
• Police, Environmental Protectio
Page 313 and 314:
• Leonard RB. Role of pediatricia
Page 315 and 316:
pediatric considerations and in onl
Page 317 and 318:
State, and Federal agencies and com
Page 319 and 320:
308
Page 321 and 322:
Vulnerable Populations In a disaste
Page 323 and 324:
• MPERTS should be able to mobili
Page 325 and 326:
Table 11.2 Pediatric medical compla
Page 327 and 328:
Table 11.2 Pediatric medical compla
Page 329 and 330:
Challenges Adaptations to usual car
Page 331 and 332:
FRP G-CSF GI GIS G-M GM-CSF Gy HEIC
Page 333 and 334:
322
Page 335 and 336:
Chapter 3. Responding to a Disaster
Page 337 and 338:
1. Define chemical terrorism. 2. Ex
Page 339 and 340:
13. Record radiation-induced signs,
Page 341 and 342:
Chapter 8. Mental Health Issues Goa
Page 343 and 344:
2. Work with community, State, and
Page 345 and 346:
Systems Issues Section Editors Mari
Page 347 and 348:
James M. Madsen, MD, MPH Colonel, M
Page 349 and 350:
Horace Tsu, MD Lieutenant Colonel,
Page 351 and 352:
Irwin Redlener, MD, FAAP President
Page 353 and 354:
Carden Johnston, MD, FAAP, FACEP, F
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