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The ABC’s of Bioterrorism  

5/3/02 
 

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Authors 

Paul Rega, M.D., FACEP 
Kelly Burkholder-Allen
 

Module 4 

The ABC’s of Bioterrorism 

Preparation, Considerations and Precautions for Bioterrorism Patient Care 

DMATs & Bioterrorism

Covert Assault Clues

Flip Side of De-contamination

Standard Precautions

Airborne I.C. Precautions

Droplet I.C. Precautions

Contact I.C. Precautions

Therapeutic Precautions

Specific Pediatric Considerations

Agencies of Assistance

 

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DMATs & Bioterrorism 

Responders

Targets 

DMAT personnel do not have the luxury of believing a biological attack is impossible or improbable.

 

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Covert Assault Clues 

Severe disease manifestations in previously healthy people

Higher than normal number of patients with fever & respiratory/GI complaints

Multiple people with similar complaints from a common location

An endemic disease appearing during an unusual time of year

Unusual number of rapidly fatal cases

Greater number of ill/dead animals

 

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Currently, 17 nations have active bioweapons R & D, including 5 sponsors of international terrorism.

 

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Flip Side of De-contamination 

Removal of clothing in the decon procedure has the additional advantage of detecting weapons or a secondary device on a victim or “pseudo-victim.”

 

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Standard Precautions 

Wash hands

Wear gloves

Wear face shield

Wear cap/gown

Process contaminated equipment and linen

Clean and disinfect environmental surfaces

Adhere to occupational health & blood-borne pathogen requirements to lessen risk of infection with performing risky patient procedures

Place patients at risk for environmental contamination in private or cohort location

 

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Airborne I.C. Precautions 

Place patient in negative pressure room, when possible

Apply high-intensity air filter respiratory protection

Limit patient transport

Place tight sealing mask on patient when transporting

 

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Droplet I.C. Precautions 

Place patient in private or cohort room

Wear masks, eye protection, and face shields within three feet of patient

Limit patient transport

Apply suitable masking of patient when transport is required

 

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Contact I.C. Precautions 

Place patient in private/cohort room

Limit patient transport

Apply suitable mask on patient during transport

Dedicate patient care equipment to one patient.  Otherwise, clean & disinfect between patients

 

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Therapeutic Precautions 

Certain medications that may be contraindicated in specific circumstances (i.g., pediatrics, pregnancy) may be advisable to administer after a bioterrorist attack when the risk of contracting a lethal disease is weighed against the drug effect.

When treatment may deviate from normal standard of care, consultation with regional and Federal authorities is necessary.

 

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Specific Pediatric Considerations 

Greater exposures to aerosolized agents due to increased respirations/minutes

Increased exposure to transdermal toxins due to greater surface/mass ratio.

Greater permeability of intact skin resulting in easier absorption

Increased risk of heat loss with showering due to an increased total body surface area

Greater risk of dehydration/shock due to vomiting and diarrhea

 

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Agencies of Assistance 

CDC Emergency Preparedness & Response Branch:   
1-770-488-7100

DOJ Domestic Preparedness National Response Hotline (agencies only):   
1-800-424-8802

USAMRIID:  1-888-872-7443 (1-888-USA-RIID)

Domestic Preparedness Helpline (M-F), 0900-1800):   
1-800-368-6498