5. Timeline For Medical Intervention of Terrorist / Warfare Agents 10 min 20 min 40 min 1 hr 2 hr 4 hr 8 hr 1 day 2 days 4 days 8 days 16 days Saxitoxin Tetrodotoxin Conotoxin Batrachotoxin Tricothecene Aflatoxin Ricin Perfringens Verotoxin Botulism SEB Toxins Elapsed Time From: Greenwood, D. P., A Relative Assessment of Putative Biological-Warfare Agents: Technical Report 1040 , (Lexington, Massachusetts: Lincoln Laboratory, Massachusetts Institute of Technology, 17 July 1997). Chemical Agents T=0 threat first reaches victims Overt Encephalitis (various) Hantaan Congo-Crimean Chikungunya Rift Valley Dengue Yellow Ebola/Marburg Lassa Smallpox Viruses Cryptococcosis Coccidioidomycosis Histoplasmosis Fungi Anthrax Plague Shigellosis Cholera Salmonella Tularemia Legionnaire’s Glanders Melioidosis Brucellosis Typhoid Nocardiosis Bacteria RMSF Typhus Psittacosis Q fever Rickettsiae, Chlamydiae Covert 1 st Responders Arrive (1) 2 nd Responders Arrive (1) Civil Support Teams Arrive (1) Follow-up Federal Resources & Supplies Arrive (1) (1) After Notification
6. Summary Comparison SUMMARY CHARACTERISTICS Low Local to Global CHEM RAD BIO AGENTS Days to Weeks City Blocks City to Region Potential Impact High Medium Availability Seconds to Hours Minutes to Hours Time To Effects
7. Chem-Agent Dose Note: A barrel holds 44 gallons; tanker trucks carry 1,000 to 12,000 gallons; rail cars carry in excess of 20,000 gallons. Lethal doses vary among different Chem-agents 100% Lethal Air Dose Quantity 5.3 Quarts 21 Gallons 1820 Gallons Riot-Control 1.5 Quarts 6 Gallons 520 Gallons Blood 2.3 Quarts 9 Gallons 780 Gallons Choking 1 Quart 4 Gallons 338 Gallons Blister 1.3 ounces 2 ½ Cups 13 Gallons Nerve Boeing 747-400 Movie Theater Domed Stadium Chemical Agent
24. The process of removing or neutralizing surface contaminants that have accumulated on personnel and equipment. What is Decontamination?
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30. Urgency for decontamination Triage High risk for secondary contamination Mild or no illness Decontamination before treatment Low risk for secondary contamination Mild or no illness Decontamination not needed High risk for secondary contamination Critically ill Simultaneous decontamination and treatment Low risk for secondary contamination Critically ill Focus on Treatment Urgency for Medical Care
94. Medical Management Medical Treatment Protocol available from US Dept. of Health and Human Services Agency for Toxic Substances and Disease Registry http://www.atsdr.cdc.gov/mmg.html