Abstract
Children have myriad unique needs compared to adults during all types of disasters. Many of these unique needs emanate from the fundamental differences between adults and children in terms of anatomy and physiology. In the event of a biological or chemical terrorism event, the difficulties which arise from these differences are complicated by a lack of weight-based medication dosing guidelines, a lack of appropriate sized supplies, and a lack of evidence-based practices in children. The risk of biological, chemical, or radiological weapon use has increased as terrorists become more familiar with these agents and their potential for harm. Biological agents are invisible to the eye, odorless, potentially lethal in particulate form; natural organisms are readily available, and can be disguised as natural disasters to spread fear and disease. Chemical agents rapidly attack the body’s critical physiological centers, disabling or killing victims. Potential biochemical agents of terrorism include; Bacillus anthracis (anthrax), Yersinia pestis (plague), tularemia, small pox, botulinum toxin, nerve agents and cyanide. Healthcare providers need to be familiar with clinical presentation and life-saving treatment modalities, as well as the precautions necessary to prevent contamination and transmission to healthcare workers and to proactively plan for the needs of children during a disaster.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Pettineo C, Aitchison R, Leikin SM, Vogel SN, Leikin JB. Biological and chemical weapons of mass destruction: updated clinical therapeutic countermeasures since 2003. Am J Ther. 2009;16(1):35–43.
Stokes E, Gilbert-Palmer D, Young C, Persell D. Chemical agents of terrorism: preparing nurse practitioners. Nurs Pract. 2004;29(5):30–9.
Baker DJ. Critical care requirements after mass toxic agent release. Crit Care Med. 2005;33(1):S66–74.
Pavlin JA. Epidemiology of bioterrorism. Emerg Infect Dis. 1999;5:528–30.
Cieslak TJ, Henreitig FM. Medical consequences of biological warfare: the ten commandments of management. Mil Med. 2001;166(S2):11–2.
Cieslak TJ, Christopher GW, Eitzen EM. Bioterrorism alert for healthcare workers. In: Fong IW, Alibek K, editors. Bioterrorism and infectious agents: a new dilemma for the 21st century. New York: Springer Science & Business Media Inc; 2005. p. 215–34.
Emmad NA, Udeani JC. Biologic toxins. Top Emerg Med. 2002;24(2):72–8.
Bronze MS, Huycke MM, Machado LJ, Voskuhl GW, Greenfield RA. Viral agents as biological weapons and agents of bioterrorism. Am J Med Sci. 2002;323(6):316–25.
Dang C, Kare J, Shneiderman A, Dang ABC. Chemical warfare agents. Top Emerg Med. 2002;24(2):25–39.
American Academy of Pediatrics, Committee on Environmental Health, Committee on Infectious Diseases. Chemical-biological terrorism and its impact on children: a subject review. Pediatrics. 2000;105:662–70.
Greenfield RA, Drevets DA, Machado LJ, Voskuhl GW, Cornea P, Bronze MS. Bacterial pathogens as biological weapons and agents of bioterrorism. Am J Med Sci. 2002;323(6):299–315.
Foltin G, Tunik M, Curran J, Marshall L, Bove J, van Amerongen R, et al. Pediatric nerve agent poisoning: medical and operational considerations for emergency medical services in a large American city. Pediatr Emerg Care. 2006;22(4):239–44.
Gamble MS, Hanners RB, Lackey C, Beaudin CL. Leadership and hospital preparedness: disaster management and emergency services in pediatrics. J Trauma. 2009;67(2):S79–83.
Ciraulo DL, Frykberg ER, Feliciano DV, Knuth TE, Richart CM, Westmoreland CD, Williams KA. A survey assessment of the level of preparedness for domestic terrorism and mass casualty incidents among eastern association for the surgery of trauma members. J Trauma. 2004;56(5):1033–41.
Lynch EL, Thomas TL. Pediatric considerations in chemical exposures: are we prepared? Pediatr Emerg Care. 2004;20(3):198–208.
Kabsai D, Kare J. Prehospital disaster management: implications for weapons of mass destruction. Top Emerg Med. 2002;24(3):37–43.
Karwa M, Currie B, Kvetan V. Bioterrorism: preparing for the impossible or the improbable. Crit Care Med. 2005;33(1):S75–95.
Montello MJ, Tarosky M, Pincock L, Montello N, Hess WA, Velazquez L, et al. Dosing cards for the treatment of children exposed to weapons of mass destruction. Am J Health Syst Pharm. 2006;63(15):944–9.
US Army Medical Research Institute of Chemical Defense. Field management of chemical casualties. 2nd ed. Aberdeen Proving Ground: Chemical Casualty Care Division USAMRICD; 2000. p. 96–135.
US Army Medical Research Institute of Infectious Diseases. Medical management of biological casualties handbook. 6th ed. Fort Detrick, Frederick: US Army Medical Research Institute of, Infectious Diseases; 2005. p. 33–48.
CDC. Use of anthrax vaccine in response to terrorism: supplemental recommendations of the Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep. 2002;51:1024–6.
Nowara WWS, Samet JM, Rosario PA. Early and late pulmonary complications of botulism. Arch Intern Med. 1983;143:451–6.
Disclaimer
The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as necessarily reflecting the views of the U.S. Department of Defense, the U.S. Department of Health and Human Services, or their component services, agencies, and institutions.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer-Verlag London
About this chapter
Cite this chapter
Meyer, M.T., Spinella, P.C., Cieslak, T. (2014). Agents of Biological and Chemical Terrorism. In: Wheeler, D., Wong, H., Shanley, T. (eds) Pediatric Critical Care Medicine. Springer, London. https://doi.org/10.1007/978-1-4471-6362-6_46
Download citation
DOI: https://doi.org/10.1007/978-1-4471-6362-6_46
Published:
Publisher Name: Springer, London
Print ISBN: 978-1-4471-6361-9
Online ISBN: 978-1-4471-6362-6
eBook Packages: MedicineMedicine (R0)