Medical Aspects of Chemical Warfare (2008) - The Black Vault

Medical Aspects of Chemical Warfarecal casualty management in pediatrics.The Regional Emergency Medical Advisory Committeeof New York City, the City of New York FireDepartment, and the City of New York Bureau ofEmergency Medical Services, in collaboration with theCenter for Pediatric Emergency Medicine of the NewYork University School of Medicine and the BellevueHospital Center, have developed and published a pediatricnerve agent antidote dosing schedule. 121 Dosingcards for the treatment of children exposed to weaponsof mass destruction have been developed by US PublicHealth Service pharmacist officers. 122SummaryMuch progress has been made in understandinghow to manage pediatric patients affected by chemicalagents. Several pediatric organizations, such asthe American Academy of Pediatrics, have offeredguidance on handling these situations. Gatheringinformation about pediatric chemical casualties ischallenging because experience is limited; further researchand resources are needed to fully understandall the physical and psychological impacts a terrorattack has on children. In a chemical attack, priorpreparation and planning will make a difference inwhether lives are saved or lost. Efforts must be madeto learn how to best manage chemical attacks and howto best prepare to protect the pediatric population.AcknowledgmentThe authors wish to thank Keyvan Rafei, MD (University of Maryland Medical Center, Baltimore, Maryland)and Major Scott Willens, DVM (USAMRICD) for providing insightful suggestions and commentsthroughout the preparation of this chapter.684References1. United Nations Security Council. Report of the Specialists Appointed by the Secretary-General to Investigate Allegations bythe Islamic Republic of Iran Concerning the Use of Chemical Weapons. UN Security Council: New York, NY; 1984. ReportS/16433.2. United Nations Security Council. Report of the Mission Dispatched by the Secretary-General to Investigate Allegations of theUse of Chemical Weapons in the Conflict Between the Islamic Republic of Iran and Iraq. UN Security Council: New York, NY;1986. Report S/17911.3. Hu H, Cook-Deegan R, Shukri A. The use of chemical weapons: conducting an investigation using survey epidemiology.JAMA. 1989;262(5):640–643.4. Hay A, Roberts G. The use of poison gas against the Iraqi Kurds: analysis of bomb fragments, soil, and wool samples.JAMA. 1990;263(8):1065–1066.5. Kelly L, Dewar D, Curry B. Experiencing chemical warfare: two physicians tell their story of Halabja in Northern Iraq.Can J Rural Med. 2004;9(3):178–181.6. Goldberg J. The great terror. New Yorker. March 25, 2002: 52–75.7. O’Leary CA. The Kurds of Iraq: recent history, future prospects. Middle East Rev Int Affairs J. 2002;6(4):17–29.8. Mohamed-Ali H. Late lesions due to poison gas in survivors of the Iraqi poison warfare against the Kurdish people.Wien Med Wochenschr. 1992;142(1):8–15.9. Gosden C, Amitay M, Gardener D, Amin B. Examining long-term severe health consequences of CBW use againstcivilian populations. Bull UN Institute Disarm Res (UNIDIR). 1999;Disarmament Forum Three.10. Dompeling E, Jobsis Q, Vandevijver NMA, et al. Chronic bronchiolitis in a 5-yr-old child after exposure to sulfurmustard gas. Eur Respir J. 2004;23:343–346.