injuries and poisoning
Overview of Incidents Involving Mass Casualty Weapons
Treatment of Mass Casualty Weapon Injuries
For incidents involving mass-casualty weapons, doctors and other responders aim to Protect themselves Stabilize the person's condition Stop exposure to the agent (remove people from the contaminated area, remove contamination from the people) Doctors typically first stabilize the person's airway. However, people who have been exposed to certain chemicals may need immediate decontamination. Also, for some chemicals (such as Nerve Chemical-Warfare Agents ), an antidote may also be available and needed right away. What kind of decontamination the person needs depends on the type of weapon. Skin, clothing, or both are typically contaminated in people who have been exposed to aerosols of biological or radiological agents. Because most such agents cannot quickly penetrate intact skin, disrobing and showering usually suffice for decontamination. Certain chemical agents (for example, sulfur mustard and liquid nerve agents) begin penetrating skin upon contact and may start damaging tissue immediately. People exposed to such agents need immediate decontamination to stop ongoing absorption and prevent the spread of contamination. A specially formulated commercial topical skin-decontamination product (called Reactive Skin Decontamination Lotion, or RSDL®) inactivates nerve agents and sulfur mustard on the skin (it is not yet approved for use in eyes or wounds). However, soap and water are also effective. Water alone is less effective for oily chemicals but is used when soap is unavailable. A 0.5% solution ofsodium hypochlorite(made by diluting standard 5% household bleach in a 1:9 ratio of bleach to water) is also effective but is not used in eyes or wounds. In an emergency, any available product that might soak up the chemical agent (such as paper towels, tissue, clay-rich soil, or bread) can be applied to the affected area, rubbed vigorously for up to 2 minutes, and then removed by copious flushing. Medical personnel inspect wounds and remove all debris. Wounds are then flushed with plain or salt water. The views expressed in this article are those of the author and do not reflect the official policy of the Department of Army, Department of Defense, or the U.S. Government. 