Chemical Agents of Opportunity for Terrorism: TICs & TIMs

Chemical Agents of Opportunity for Terrorism
Training Support Package
Participant Guide
Slide 16
Chemical Agents of Opportunity for Terrorism:
TICs & TIMs
Medical Personnel Responses
“Cyanide is deadly. Cyanide is bad stuff!
If it were me, I ’d go get checked out. ”
• EMTs wearing surgical masks to drive.
– Upset that patients were not decontaminated.
• Medics c/o lightheadedness and smelled ‘bitter
almonds’
Module One – Observed Behaviors during Mass Chemical Exposures
16
It is clearly a popular and correct belief that cyanide is deadly. What these statements
and actions disregard is the clinical pharmacokinetics of cyanide poisoning. The time of
onset (seconds to minutes with inhalation), clinical effects (multisystem collapse, not
simply nausea and dizziness), and lack of utility of surgical masks to prevent cyanide
exposure all went unrecognized or were ignored in the “heat of the moment”. Often in
events like this, emergency response planners and health care providers, given their
relatively prominent stature, can improve or worsen a situation by the messages they
communicate and by the cues they provide by their actions. In this case it seems the
“mass hysteria” was exacerbated, if not caused, by the medical community and
emergency response crews.
December 2008 Version 2.0 Page 442