Pediatric Terrorism and Disaster Preparedness: A ... - PHE Home

1. Define chemical terrorism.
2. Explain how careful community planning, robust research and development (by
academic, private, and governmental collaborative efforts), and rigorous medical
education could mitigate a chemical terrorism catastrophe.
3. Explain why pediatricians need to understand the approach to mass casualty
incidents involving traditional military chemical weapons and other toxic
chemicals that might be used as “weapons of opportunity.”
4. Explain the similarities and differences between a chemical terrorist attack and a
more conventional chemical disaster in terms of the epidemiology and medical
consequences associated with each.
5. Create a management plan for decontamination and initial care of small children
by personnel wearing bulky PPE.
6. Recognize the risks and challenges to pediatric care providers posed by contact
with many exposed children who are not critically injured but have been taken by
parents to hospitals and pediatricians’ offices without prior on-scene
decontamination.
7. Describe how children have inherent physiologic, developmental, and
psychological differences from adults that may enhance susceptibility and worsen
prognosis after a chemical agent exposure.
8. Recognize the epidemiology of acute mass exposure to a toxin as an aid in
recognizing a covert chemical attack with unknown agents.
9. Formulate an approach for managing chemical injuries sustained by children from
an unknown chemical agent.
10. Describe clinical syndromes and management after exposure to various chemical
agents (nerve agents, vesicants, pulmonary agents, cyanide, and riot-control
agents).
11. Categorize chemical weapons based on the predominant symptoms they cause:
neurologic (nerve agents or cyanide); respiratory (phosgene or chlorine, high-dose
riot-control agents, or sulfur mustard with a delay of several hours from time of
exposure); and mucocutaneous syndromes (vesicants).
12. Access and alert the CDC, local public health authorities, and/or regional poison
control center.
13. Differentiate between cyanide and nerve agent attacks.
14. Plan for the initial protection of everyone in a community exposed to a hazardous
chemical using CDC Guidelines for Evacuation and for Sheltering in Place in a
Chemical Emergency.
15. Discuss treatment of contaminated victims via extrication, triage, resuscitation as
needed, and decontamination performed by rescue workers or health care
providers wearing appropriate PPE.
16. Provide cardiopulmonary and airway support, including endotracheal intubation,
and emergent intramuscular antidotal therapy as necessary and appropriate for the
specific exposure.
17. Prepare to treat potential victims of a terrorist attack involving industrial sources
of hazardous chemicals.
18. Participate in disaster management training, including stocking appropriate
antidotes, practicing decontamination strategies, and learning the use of PPE.
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