Toxic Trauma pp 175-190 | Cite as

Preparing for Toxic Trauma

  • David J. Baker


Awareness and preparation by emergency medical responders for possible mass casualties from a toxic chemical release is an essential part of disaster response. Although individual poisoning and small-scale chemical incidents occur on a regular basis, large-scale releases are relatively uncommon and medical experience in managing casualties with toxic trauma is limited. A number of major chemical releases that have taken place over the past 100 years are considered in this chapter. These provide many lessons for those preparing for the management of toxic trauma. In addition, for planning a response, individual training, particularly in protection and application of medical knowledge from common medical conditions that mimic the effects of chemical agents, such as asthma and acute lung injury all contribute to building an effective response to mass chemical casualties, an occurrence, we must hope, will continue to be a rarity.


Personal Protective Equipment Nerve Agent Emergency Medical Team Chemical Weapon Chemical Warfare Agent 
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Further Reading

  1. Dunlop JB (2006) The 2002 Dubrovka and 2004 Beslan hostage crises: a critique of Russian counter—terrorism. Ibidem Verlag, StuttgartGoogle Scholar
  2. Hill BA (2008) History of the medical management of chemical casualties. In: Tuorinsky SD (ed) Medical aspects of chemical warfare office of the surgeon general, US army. Borden Institute, Washington DC, pp 77–114 (Chap.  3)
  3. Lapierre D, Moro J (2002) Five past midnight in Bhopal. Simon and Schuster, LondonGoogle Scholar
  4. Mehta PS, Mehta AS, Mehta SJ, Makhijani AB (1990) Bhopal tragedy’s health effects: a review of methyl isocyanate toxicity. JAMA 264:2781Google Scholar
  5. Moles TM, Baker DJ (1999) Clinical analogies for the management of toxic trauma. Resuscitation 42(2):117–124Google Scholar
  6. Okumura T, Nomura T, Suzuki T et al (2007) The dark morning: the experiences and lessons learned from the Tokyo subway sarin attack. In: Marrs TC, Maynard RL, Sidell FR (eds) Chemical warfare agents: toxicology and treatment, 2nd edn. Wiley, Chichester, pp 277–286 (Chap. 13)Google Scholar
  7. Syria Chemical Attack: What We Know. At Accessed 14 Oct. 2013
  8. United Nations Mission to Investigate Allegations of the Use of Chemical Weapons in the Syrian Arab Republic: Report on the Alleged Use of Chemical Weapons in the Ghouta Area of Damascus on 21 August 2013. At Accessed 14 Oct. 2013
  9. Urbanetti J, Newmark J (2010) Clinical aspects of large scale chemical events. In: Koenig KL, Schultz CH (eds) Disaster medicine: comprehensive principles and practices. Cambridge University Press, New YorkGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  1. 1.Hôpital Necker—Enfants MaladesSAMU de ParisParisFrance

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