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Chemical and Biological Terrorism Incidents and Intensive Care

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Critical Care Toxicology

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Abstract

The events of 2001, including the terrorist bombing of the World Trade Centers and the deliberate introduction of anthrax spores into the US postal system, marked a watershed in the medical planning for and response to an incident using a chemical or biologic weapon. Although much planning has focused on the prehospital and emergency department phases of these disasters, toxicology and intensive care are among the key resources in the management of the actual uses of these weapons.

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References

  1. Committee on R&D needs for improving civilian medical response to chemical and biological terrorism incidents: chemical and biological terrorism – research and development to improve civilian medical response. Washington, DC: National Academy Press; 1999.

    Google Scholar 

  2. Care of the critically Ill and injured during pandemics and disasters: CHEST consensus statement – introduction and executive summary. 2014;146(4-Suppl):8S–34S.

    Google Scholar 

  3. FBI – terrorism definition. Available at http://www.fbi.gov/about-us/investigate/terrorism/terrorism-definition. Accessed 1 May 2015.

  4. Centers for disease control: bioterrorism alleging use of anthrax and interim guidelines for management – United States 1998. MMWR Morb Mortal Wkly Rep. 1999;48:69–74.

    Google Scholar 

  5. Rogers GC, Condurache CT. Antidotes and treatments for chemical warfare/terrorism agents: an evidence-based review. Clin Pharmacol Ther. 2010;88(3):318–27.

    Google Scholar 

  6. Sidell FR. Chapter 5 nerve agents in medical aspects of chemical and biological warfare, Textbook of Military Medicine. Office of the surgeon general. Washington, DC: TMM Publications; 1997.

    Google Scholar 

  7. Advisory panel to assess domestic response capabilities for terrorism involving weapons of mass destruction: first annual report to the president and the congress: I. Assessing the threat. 1–123 1999. Available at: http://biotech.law.lsu.edu/blaw/general/terror.pdf. Accessed 1 May 2015.

  8. Sidell F. Soman and sarin: clinical manifestations and treatment of accidental poisoning by organophosphates. Clin Toxicol. 1974;7:2–6.

    Article  Google Scholar 

  9. Singh S, Batra YK, Singh SM, et al. Is atropine alone sufficient in acute severe organophosphorus poisoning? Experience of a North West Indian Hospital. Int J Clin Pharmacol Ther. 1995;33:628–30.

    CAS  PubMed  Google Scholar 

  10. Dunn MA, Sidell FR. Progress in medical defense against nerve agents. JAMA. 1989;262:649–52.

    Article  CAS  PubMed  Google Scholar 

  11. Sidell FR, Urbanetti JS, Smith WJ, Hurst CG. Chapter 7 vesicants in medical aspects of chemical and biological warfare, Textbook of Military Medicine. Office of the surgeon general. Washington, DC: TMM Publications; 1997.

    Google Scholar 

  12. Urbanetti JS. Chapter 9 toxic inhalational injury in medical aspects of chemical and biological warfare, Textbook of Military Medicine. Office of the surgeon general. Washington, DC: TMM Publications; 1997.

    Google Scholar 

  13. King AM, Aaron CK. Organophosphate and carbamate poisoning. Emerg Med Clin North Am. 2015;33 (1):133–51.

    Article  PubMed  Google Scholar 

  14. Kaplan DE, Marshall A. The cult at the end of the world: the incredible story of Aum. London: Hutchinson; 1996.

    Google Scholar 

  15. Nebraska biocontainment unit – protocols. Available at http://wwww.nebraskamed.com/biocontainment-unit/ebola. Accessed 1 May 2015.

  16. Meselson M, Guillemin J, Hugh-Jones M, et al. The Sverdlovsk anthrax outbreak of 1979. Science. 1994;266:1202–8.

    Article  CAS  PubMed  Google Scholar 

  17. Inglesby TV, Henderson DA, Bartlett JG, et al. Anthrax as a biological weapon: medical and public health management. Working Group on Civilian Biodefense. JAMA. 1999;281:1735–45.

    Article  CAS  PubMed  Google Scholar 

  18. Adalja AA, Tiner E, Inglesby TV. Clinical management of potential bioterrorism-related conditions. NEJM. 2015;372(10):954–62.

    Article  CAS  PubMed  Google Scholar 

  19. Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJC, Gorbach SL, Hirschmann JV, Kaplan SL, Montoya JG, Wade JC. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59(2):147–59.

    Article  PubMed  Google Scholar 

  20. Friedlander AM, Welkos SL, Pitt MLM, et al. Postexposure prophylaxis against experimental inhalation anthrax. J Infect Dis. 1993;167:1239–43.

    Article  CAS  PubMed  Google Scholar 

  21. Hull HF, Montes JM, Mann JM. Septicemic plague in New Mexico. J Infect Dis. 1987;155:113–8.

    Article  CAS  PubMed  Google Scholar 

  22. Frean JA, Arntzen L, Capper T, et al. In vitro activities of 14 antibiotics against 100 human isolates of Yersinia pestis from a Southern African plague focus. Antimicrob Agents Chemother. 1996;40:2646–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  23. Byrne WR, Welkos SL, Pitt ML, et al. Antibiotic treatment of experimental pneumonic plague in mice. Antimicrob Agents Chemother. 1998;42:675–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Saslaw S, Eigelsbach HT, Wilson HE, et al. Tularemia vaccine study I and II. Arch Intern Med. 1961;107:121–46.

    Article  Google Scholar 

  25. Russell P, Eley SM, Fulop MJ, et al. The efficacy of ciprofloxacin and doxycycline against experimental tularaemia. J Antimicrob Chemother. 1998;41:461–5.

    Article  CAS  PubMed  Google Scholar 

  26. Glatman-Freedman A. Infant botulism. Pediatr Rev. 1996;17:185–6.

    Article  CAS  PubMed  Google Scholar 

  27. Passaro DJ, Werner SB, McGee J, et al. Wound botulism associated with black tar heroin among injecting drug users. JAMA. 1998;279:859–63.

    Article  CAS  PubMed  Google Scholar 

  28. Henderson DA, Inglesby TV, Bartlett JG, et al. Smallpox as a biological weapon: medical and public health management. Working Group on Civilian Biodefense. JAMA. 1999;281:2127–37.

    Article  CAS  PubMed  Google Scholar 

  29. Johnson DW, Sullivan JN, Piquette CA, Hewlett AL, Bailey KL, Smith PW, Kalil AC, Lisco SJ. Lessons learned: critical care management of patients with Ebola in the United States. Crit Care Med. 2015;43:1157–64.

    Article  PubMed  Google Scholar 

  30. McCormick JB, King IJ, Webb PA, et al. Lassa fever: effective therapy with ribavirin. N Engl J Med. 1986;314:20–6.

    Article  CAS  PubMed  Google Scholar 

  31. Huggins JW, Hsiang CM, Cosgriff TM, et al. Prospective, double-blind, concurrent, placebo-controlled clinical trial of intravenous ribavirin therapy of hemorrhagic fever with renal syndrome. J Infect Dis. 1991;164:1119–27.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Pulmonary, Critical Care, and Sleep Medicine, UC Davis Medical Center, Sacramento, CA, USA

    R. Steven Tharratt

  2. Internal Medicine, UC Davis School of Medicine, Davis, CA, USA

    Timothy E. Albertson

Authors
  1. R. Steven Tharratt
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  2. Timothy E. Albertson
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Corresponding authors

Correspondence to R. Steven Tharratt or Timothy E. Albertson .

Editor information

Editors and Affiliations

  1. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Jeffrey Brent

  2. Office of New Drugs Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA

    Keith Burkhart

  3. Clinical Toxicology, St Thomas' Hospital, London, United Kingdom

    Paul Dargan

  4. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Benjamin Hatten

  5. Med & Toxicological Intensive Care Unit, Lariboisière Hospital Paris-Diderot University, Paris, France

    Bruno Megarbane

  6. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Robert Palmer

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

  1. I

    Evidence obtained from at least one properly randomized controlled trial.

  2. II-1

    Evidence obtained from well-designed controlled trials without randomization.

  3. II-2

    Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.

  4. II-3

    Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.

  5. III

    Opinions of respected authorities, based on clinical experience, descriptive studies and case reports, or reports of expert committees.

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© 2016 Springer International Publishing Switzerland

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Tharratt, R.S., Albertson, T.E. (2016). Chemical and Biological Terrorism Incidents and Intensive Care. In: Brent, J., Burkhart, K., Dargan, P., Hatten, B., Megarbane, B., Palmer, R. (eds) Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-20790-2_5-1

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  • DOI: https://doi.org/10.1007/978-3-319-20790-2_5-1

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  • Publisher Name: Springer, Cham

  • Online ISBN: 978-3-319-20790-2

  • eBook Packages: Springer Reference Biomedicine and Life SciencesReference Module Biomedical and Life Sciences

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