Chemical agents: Epidemiology and clinical characteristics

Question 1

objectives

Answer 1

• what is a chemical attack

- how do attacks occur

Question 2

what is chemical attack

Answer 2

-the purposeful use of chemical substance to harm people, cause economic or property damage or instill fear or panic

Question 3

geneva protocol

Answer 3

• banning the use of chemical

- treaty

Question 4

why the use of chemical weapons

Answer 4

• materials accessible
• easy to breach security barriers
• simple delivery systems
• greater psychological impact
• status “WMD” -poor mans nuclear weapon -> anyone can do

Question 5

disadvantages of chemical weapons

Answer 5

• requires large quantities
• production and deployment hazardous to terrorist too
• easier to prepare for

Question 6

how chemical could be used

Answer 6

• the severity of an attack is related to the toxicity of the chemical and its concentration when it reaches people
• during the day -> heat convection currents make the gases disperse
• during the night -> more concentrated in one area
• concentration variable include:
• wind
• volatility
• closed or open spaces

Question 7

methods of disseminating chemical weapons

Answer 7

• ventilation systems
• misting, aerosolizing devices, or sprayers
• passive release (container of chemical left open)
• bombs, mines, or other explosive devices
• sabotage of plants or vehicles containing chemicals
• introduction of toxins in the food and water supply
• improvised chemical devices that combine readily available chemicals to produce a dangerous chemcial

Question 8

detection

Answer 8

-many chemicals at high concentration can be readily detected with hand held detection equipment carried by many emergency responders

Question 9

responding to exposures

Answer 9

• response can be confusing
• require rapid response
• protect staff from secondary exposure*
• differentiate between significant trivial exposures
• decontaminate (based on agent involved)
• notify appropriate agencies (poison control, public health and safety)
• removing clothing - 80% of contamination

Question 10

warning signs

Answer 10

• abandoned containers
• devices containing suspect items
• strong chemical odors
• incident preceded by a written or verbal threat
• multiple patients exhibiting similar signs and symptoms

Question 11

ways of contracting

Answer 11

• inhalation
• ingestion
• absorption (touch)
• injection

Question 12

personal protection

Answer 12

• tactical withdrawal from contaminated area
• time
• distance
• shielding
• 1. blot- blot off the agent
• 2. strip- strip off all clothing (80%)
• 3. flush- flush affected area with large amount of water
• 4. cover- cover the affected area

Question 13

chlorine gas

Answer 13

• choking agent
• severe coughing
• frothing sputum
• convulsions
• pulmonary edema

Question 14

mustard gas / odor of garlic

Answer 14

blister agents

• effects:
• eyes
• lungs
• skin
• 2-24 hours onset

Question 15

blood agents

Answer 15

• interferes with hemoglobin and o2
• hypoxia leading to:
• AMS
• seizures
• respiratory arrest
• cardiac arrest
• can spread through fire
• hydrogen cyanide
• oder: bitter almonds

Question 16

nerve agents

Answer 16

• nerve agents affect the nervous system
• do not occur naturally
• the first know nerve agent was created in the 1930s- tabun (GA)
• new agents known as g-agents were stockpile by Germany during WW2- sarin (GB) and Soman (GD)
• 1960s- more focus on creating their potency and environmental persistence
• creation of the v-agents
• VX more potent than Sarin

Question 17

physiological effects chemical warfare (CW)

Answer 17

• acts on the central nervous system
• seizures
• respiratory arrest
• cardiac arrest

Question 18

signs and symptoms of nerve agents

Answer 18

• pinpoint pupils
• runny nose
• difficulty breathing
• loss of consciousness
• convulsions/seizures
• sweating
• nausea/vomiting

Question 19

routes of exposure for nerve agents

Answer 19

• inhalation
• skin absorption
• ingestion
• injection

Question 20

SLUDGEM

Answer 20

• salivation
• lacrimation (secretion of tears)
• urination
• defecation
• gastroenteritis (GI irritation)
• emesis
• miosis (pupil constriction)
• everything comes out at once

Question 21

pathophysiology of nerve agents

Answer 21

• the NA binds with acetylcholinesterase

- allowing acetylcholine to overstimulate the nerve pathway located in the nervous system

Question 22

Tabun (GA)

Answer 22

• persistent

- evaporates in 1-2 days

Question 23

Soman (GD)

Answer 23

• non persistent

- evaporates rapidly

Question 24

Sarin (GB)

Answer 24

• non persistent

- evaporates rapidly

Question 25

V agent (VX)

Answer 25

• persistent

- remains for weeks or longer

Question 26

Tokyo Subway attack

Answer 26

• march 20, 1995
• morning rush hour
• container of Sarin nerve gas
• 5 cars in 3 underground lines
• 3 cult members
• delivery- plastic bags punctured with sharpened umbrellas
• dispersion- liquid which turned into gas, concentration

Question 27

riot-control agents

Answer 27

• tear gas (CS)
• mace (CN)
• pepper spray (OC)

Question 28

herbicide agents

Answer 28

• main purpose is to disrupt agriculture food production and/or to destroy plants which provides cover or concealment to the enemy
• vietnam war- agent orange
• not banned by the CWC unless they are used as a method of warefare
• the used of agent orange still a lingering issue in the US vietnam relations
• in 2003, survivors sued the US corporation for damages