Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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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
Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Slide 17 Chemical Agents of Opportunity for Terrorism: TICs & TIMs Case 2: Cyanide (Continued) • 12:30 pm media coverage – Footage and interviews from Hospital 1 • Calls to Poison Center from: – Previously treated and released employees concerned they had not received “appropriate treatment ” – Hospitals 2 and 3 because several patients returned for “appropriate treatment ” Module One – Observed Behaviors during Mass Chemical Exposures 17 As soon as the noon news aired the story and showed the “appropriate treatment”, the regional poison center began to receive multiple calls from employees already released by the other hospitals. Because of the media coverage at Hospital #1, many who were treated at Hospitals #2 and #3 returned for decontamination. Some patients returned to ED for additional care despite not having any symptoms. December 2008 Version 2.0 Page 443
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Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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