Los Angeles City College Triage Algorithms for Mass Casualty Bioterrorism Responses – Description
1. Smallpox is an acute contagious disease caused by the variola virus. It was highly contagious. It was one of the most devastating diseases known to humanity and caused millions of deaths before it was eradicated. Smallpox was identified as Category A, a high priority due to its potential threat to national security. People who had smallpox had a fever and a distinctive, progressive skin rash (Centers for Disease Control and Prevention, 2016). Although there was no exact treatment for smallpox, the vaccine was highly recommended for prevention. Those who survived smallpox have permanent scars over large areas of their body, especially their faces. If someone were exposed to smallpox, personal decontamination could be performed by removing contaminated clothing and washing exposed skin with soap and water. Clean water, saline solution, or commercial ophthalmic solutions are recommended for rinsing eyes. After removal at the decontamination site, clothing should be handled only by the person wearing appropriate personal protective equipment and placed in an impervious bag to prevent further environmental contamination (Occupational Safety and Health Administration, n.d.). A contaminated person is placed on standard, contact, and airborne precautions. The patient should be placed in a negative pressure room. Personnel vaccinated against smallpox or vaccinated personnel within 72 hours of their first exposure to the patient (preferably within 24 hours) should be assisting the infected patient (Centers for Disease Control and Prevention, 2017). The person caring for this patient should wear a gown, gloves, goggles/face shield, and a mask. Patients in isolation may suffer from anxiety, depression, or report feeling stigmatized. They may also feel forgotten, as the need for PPE reduces the frequency of interaction with healthcare staff. All visitors will need to be vaccinated and wear appropriate PPE.
References
Centers for Disease Control and Prevention. (2017, July 24). Protect and Care for Smallpox Patients.https://www.cdc.gov/smallpox/bioterrorism-response-planning/healthcare-facility/protect-care-patients.html#:~:text=Cover%20the%20patient’s%20nose%20and,(preferably%20within%2024%20hours)
Centers for Disease Control and Prevention. (2016, June 7). What Is Smallpox?https://www.cdc.gov/smallpox/about/index.html#:~:text=Before%20smallpox%20was%20eradicated%2C%20it,a%20distinctive%2C%20progressive%20skin%20rash
Lane, J.M. & Summer, L. (2009). Smallpox as a Weapon for Bioterrorism. National Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7120382/
Occupational Safety and Health Administration. (n.d.). Smallpox. United States Department of Labor. https://www.osha.gov/smallpox/control
2. Following the attacks on 9/11 an anthrax bioterrorist attack took place. Following 9/11 letters containing anthrax were mailed to some government workers and government buildings. 22 people were infected and 5 were killed due to pulmonary anthrax (Center for Counterproliferation Research, 2002). Anthrax is a disease caused by the Bacillus anthracis bacteria which can be found in soil and wild animals (CDC, 2022). A person can become infected when a spore makes its way into the body through the air, food, water or a cut (CDC, 2022). The symptoms depend on the route that the anthrax enters your body. If the antrhax is cutaneous then symptoms include blisters and swelling (CDC, 2022). If the anthrax is pulmonary then symptoms include fever, chills, shortness of breath, headache, and chest pain (CDC, 2022). Other types include gastrointestinal causing GI complications like diarrhea and painful swallowing, as well as injection anthrax which causes blisters and abscesses (CDC, 2022). No matter the type, each one has the potential to cause death (CDC, 2022). If exposed the treatment includes antibiotics and antitoxins. Ciprofloxacin is used in combination with other antibiotics is used to treat (CDC, 2022). Treatment may include IV fluids and mechanical ventilation depending on affected area and severity (CDC, 2022). When the possibility of coming into contact with Bacillus Anthracis PPE is needed. This includes an impermeable suit, boot covers, eye and face protection, gloves and an N95 respirator (OSHA, n.d). When treating someone with anthrax it is important to have your entire body covered to avoid coming in direct contact. The decontamination includes the washing of contaminated areas with diluted bleach and clean thoroughly the entire area (Department of Health, 2002).
Link:
https://wmdcenter.ndu.edu/Portals/97/Documents/Publications/Articles/Anthrax-in-America.pdf
References:
Centers for Disease Control and Prevention. (2020, November 20). If you think you have been exposed to anthrax. Centers for Disease Control and Prevention. https://www.cdc.gov/anthrax/exposed/index.html
Department of Health. Decontamination Procedures. (n.d.). https://www.health.ny.gov/professionals/nursing_ho…
Department of Labor Logo United States department of Labor. Anthrax – Hazard Recognition | Occupational Safety and Health Administration. (n.d.). https://www.osha.gov/anthrax/hazards
Working Paper Anthrax in America – National Defense University. (n.d.). https://wmdcenter.ndu.edu/Portals/97/Documents/Pub…
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