Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Slide 20 Chemical Agents of Opportunity for Terrorism: TICs & TIMs Magnitude of Problem • Tokyo Sarin Incident 1995 – 12 died – 1,200 required some care – 5,500 sought medical care but had no exposure • Bhopal Disaster 1984 – >10,000 severe and 5000 died – 200,000 sought medical care Module One – Observed Behaviors during Mass Chemical Exposures 20 We have talked about several to one hundred individuals with these last two case studies. Consider the difficulty in managing an event of the magnitude of the Tokyo Sarin nerve agent attack by the Aum Shinryko cult and the Bhopal methylisocyanate industrial disaster in India. . The numbers of affected individuals in these cases are so large that victims overwhelm surge capacity of any system, create triage problems, and deplete scarce resources. Responders and providers are unable to focus care on the most seriously ill. Even small HazMat spills can result in many hundreds being transported to hospitals. Protocols are misguided if large numbers of unexposed “victims” are directed to acute-care hospitals just “to get checked out”. December 2008 Version 2.0 Page 446
Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Slide 21 During the 1991 United States–led Desert Storm operation, 39 Iraqi SCUD missiles landed in Israel. These attacks caused over 1000 casualties (including some traumatic injuries from explosives, shrapnel, and structural damage). However, one half of the casualties were diagnosed with acute psychologic reactions or acute anxiety. Also, because it was unknown if chemical weapons were part of the missiles’ payload, it appeared that people anticipated toxic chemicals and began to treat themselves without verification of chemical exposure or related symptoms. In one report, twenty-seven percent of the casualties were due to inappropriate autoinjection of atropine because of fear that a chemical nerve agent attack had occurred. Another 40 patients were injured while rushing to a sealed room to avoid chemical exposure. Some deaths occurred from improper use of gas masks leading to suffocation (including at least one child), while others succumbed to myocardial infarctions. Only 2 deaths were due to missile trauma. December 2008 Version 2.0 Page 447
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Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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