The management of nuclear, biological and chemical (NBC) terrorism events is critical to reducing morbidity and mortality in the next decade; however, initial patient care considerations and protective actions for staff are unfamiliar to most front-line clinicians. High explosive events (bomb and blast) remain the most common type of terrorism and are easy to detect. Conversely, some types of terrorist attacks are more likely to be unsuspected or covert. This paper explains the current threat of terrorism and describes clues for detection that an event has occurred. Specific criteria that should lead to a high suspicion for terrorism are illustrated. The manuscript outlines initial actions and clinical priorities for management and treatment of patients exposed to nuclear/radiological, biological, chemical and combined agents (for example an explosion involving a chemical agent). Examples of terrorist events include: a nuclear explosion, an aerosolised release of anthrax (biological), dissemination of sarin in a subway (chemical), and the detonation of a radiologic dispersion device or "dirty bomb" (combined explosive and radiological). Basic principles of decontamination include potential risks to healthcare providers from secondary exposure and contamination. Unique issues may hinder clinical actions. These include coordination with law enforcement for a crime scene, public health entities for surveillance and monitoring, hazardous materials teams for decontamination, and the media for risk communications. Finally, the importance of personal preparedness is discussed.
Biological Warfare Agents ; Chemical Warfare Agents ; Civil Defense ; Nuclear Weapons ; Terrorism

Bombs ; Cesium ; poisoning ; Humans ; Polonium ; poisoning ; Radiation Injuries ; Terrorism

The worst recorded man-made maritime disaster in the country and in Asia was the bombing of Super Ferry 14 last February 27, 2004. The pre-disaster and post disaster events surrounding the bombing incident were reviewed and summarized. The maritime disaster plan of the Philippine Coast Guard and the responding hospitals were reviewed and evaluation of the medical management of the casualties made. Investigation proved the incident to be due to explosive device brought in by a terrorist due to lapses in security. Prompt response of the disaster management team provided immediate rescue of survivors and provision of emergency management to the injured.

terrorism, we overcame these difficulties and were able to achieve our missions successfully. I wish that our special experience in Iraq are will be the guideline to other oral and maxillofacial surgeons, who want to help those individual in unfortunate areas such as Iraq.]]>
Equipment and Supplies ; Humans ; Iraq ; Missions and Missionaries ; Patients' Rooms ; Terrorism

BACKGROUND: Workplace violence (WPV) is becoming an issue that needs immediate attention in the United States, especially during this period as more states are adopting the "stand your ground laws to promote worker protection." This study was conducted to investigate how WPV has contributed to an unsafe environment for nurses and nursing assistants who work in long-term medical care facilities. METHODS: A structure questionnaire was used to collect data for the study. Three facilities were sampled and 80 nurses and certified nursing assistants participated in the study. Ninety-two percent (n = 74) were female and 8% (n = 6) were male. Approximately 62% were black or African American, approximately 33% were Caucasians, and only 2% were from other ethnicities. RESULTS: We found that 65% of the participants had experienced WPV while 41% believed that management shows little or no concern for their safety. Approximately 23% of respondents believed that reporting supervisor's WPV act is an unsafe action. In addition, 22% of those who reported that they have experienced WPV believed that the work environment is not safe to perform their duties. This significant difference in perception of workplace safety between those who had experienced WPV and those who had not was significant (t = 3.95, df = 158, p < 0.0001). CONCLUSION: WPV is an epidemic problem that affects all health-care professionals. The findings of this study could help long-term medical care facilities' management identify the areas to focus on mitigating, controlling, and/or eliminating incidents of WPV.
Bullying ; Female ; Humans ; Jurisprudence ; Male ; Nursing ; Surveys and Questionnaires ; Terrorism ; United States ; Workplace Violence*

The level of terrorist threats using chemical, biological, and radiological agents has been continuously increasing, and it is an undeniable truth that these agents are actually in use today. The fact that most chemical, biological, and radiological agents cause skin-related symptoms, and that the skin symptoms are observed at a relatively early stage of the condition, leads to the conclusion that dermatologists could be the first point of contact for potential victims of these agents. It is highly important that first responders are able to recognize symptoms caused by these agents early and react quickly. Therefore, dermatologists do have a responsibility to take on a role in dealing with chemical, biological, and radiological attacks, and pre-equip themselves with professional knowledge in this field. Among the various types of chemical agents, typical examples of agents causing skin-related symptoms are blistering agents, which lead to bullae and necrosis on the skin. Biological agents are classified from Category A to C according to their respective risk factors. The most dangerous Category A agents include anthrax, smallpox, plague, tularemia, and viral hemorrhagic fever, all of which are known to show characteristic skin-related symptoms. Upon exposure to a certain level of radiation, radiological agents can also lead to erythema on the skin. In this article, we will discuss various characteristics and up-to-date treatment methods of potential chemical, biological, and radiological agents to help dermatologists advance their knowledge in this field.
Anthrax ; Biological Factors ; Blister ; Erythema ; Hemorrhagic Fevers, Viral ; Necrosis ; Plague ; Risk Factors ; Skin ; Smallpox ; Terrorism ; Tularemia ; Weapons

The level of terrorist threats using chemical, biological, and radiological agents has been continuously increasing, and it is an undeniable truth that these agents are actually in use today. The fact that most chemical, biological, and radiological agents cause skin-related symptoms, and that the skin symptoms are observed at a relatively early stage of the condition, leads to the conclusion that dermatologists could be the first point of contact for potential victims of these agents. It is highly important that first responders are able to recognize symptoms caused by these agents early and react quickly. Therefore, dermatologists do have a responsibility to take on a role in dealing with chemical, biological, and radiological attacks, and pre-equip themselves with professional knowledge in this field. Among the various types of chemical agents, typical examples of agents causing skin-related symptoms are blistering agents, which lead to bullae and necrosis on the skin. Biological agents are classified from Category A to C according to their respective risk factors. The most dangerous Category A agents include anthrax, smallpox, plague, tularemia, and viral hemorrhagic fever, all of which are known to show characteristic skin-related symptoms. Upon exposure to a certain level of radiation, radiological agents can also lead to erythema on the skin. In this article, we will discuss various characteristics and up-to-date treatment methods of potential chemical, biological, and radiological agents to help dermatologists advance their knowledge in this field.
Anthrax ; Biological Factors ; Blister ; Erythema ; Hemorrhagic Fevers, Viral ; Necrosis ; Plague ; Risk Factors ; Skin ; Smallpox ; Terrorism ; Tularemia ; Weapons

Deaths caused by grenades hardly occur except for during wartime, and can be seen as a particular incident that can be observed only within the military or by acts of terrorism. However, there has never been any data which tried to analyze the damage patterns through mock grenade explosions. So far, the processes leading to deaths were merely inferred by reconstructing the situation with limited intelligence after the incidents have already occurred. Therefore, the authors believe that having mock grenade explosions in order to compare and study the observances with those of the actual incident will be helpful for a more precise and objective medical jurisprudence, and thus have summarized the damage patterned obtained on 8 butchered pigs, that were 6~8 months old, about 100 cm in length and 70~100 kg in weight by photographing with radioactive rays and running autopsies after detonating grenades on them. In conclusion, if there was extensive loss of body parts, the grenade probably exploded when in contact with the lost body parts. If fractures were found the grenade is likely to have detonated contacting or within 25 cm of distance with the body, and if there were no lacerations or loss of body parts the grenade probably exploded at a distance of at least 50 cm. If soot was prevalent on the deceased's body, the grenade is likely to have exploded within a distance of 25 cm from the body at a free floating state, in which it was not in contact with the ground or the body. Lastly, if no soot was found, the grenade most probably detonated at a distance of 50 cm or more. The posture or the direction of the body cannot give precise clues of the victim's state before theexplosion, and a hasty presupposition could be very dangerous in case of contact explosions especially.
Autopsy ; Bombs ; Explosions ; Hand ; Homicide ; Human Body ; Humans ; Intelligence ; Jurisprudence ; Lacerations ; Military Personnel ; Posture ; Running ; Soot ; Suicide ; Swine ; Terrorism

No abstract available.
Bioterrorism*

No abstract available.
Bioterrorism*