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

No abstract available.
Carcinoma, Squamous Cell* ; Humans ; Nuclear Weapons* ; Survivors*

The Philippine Journal of Otolaryngology Head and Neck Surgerypreviously co published two guest editorials, on “Reducing the Risks of Nuclear War— the Role of Health Professionals”¹and “Time to Treat the Climate and Nature Crisis as One Indivisible Global Health Emergency”²that addressed dual potentially catastrophic concerns that both place us “on the brink.”³

By co-publishing these guest editorials, the Philippine Journal of Otolaryngology Head and Neck Surgery joined the call for “health professional associations to inform their members worldwide about the threat to human survival and to join with the International Physicians for the Prevention of Nuclear War (IPPNW) to support efforts to reduce the near-term risks of nuclear war.”¹As enumerated in the editorial,¹we urged three immediate steps that should be taken by nuclear-armed states and their allies: 1) adopt a no first use policy;⁴2) take their nuclear weapons off hair-trigger alert; and 3) urge all states involved in current conflicts to pledge publicly and unequivocally that they will not use nuclear weapons in these conflicts.It is alarming that noprogress has been made on these measures.

Thus, on our 44th Anniversary, we join over 150 scholarly scientific journals worldwide in co-publishing another Guest Editorial on “Ending Nuclear Weapons, Before They End Us.”⁵We call on the World Health Assembly (WHA) to vote this May on re establishing a mandate for the World Health Organization (WHO) to address the consequences of nuclear weapons and war,6and urge health professionals and their associations (including otolaryngologists – head and neck surgeons, all surgeons and physicians, and the Philippine Society of Otolaryngology – Head and Neck Surgery, Philippine College of Surgeons, Philippine College of Physicians,
Philippine Academy of Family Physicians, Philippine Pediatric Society, Philippine Obstetrical and Gynecologic Society, Philippine Society of Anesthesiology, Philippine College of Radiology, Philippine Society of Pathologists, other specialty and subspecialty societies, and the Philippine Medical Association) to urge the Philippine Government to support such a mandate and support the new United Nations (UN) comprehensive study on the effects of nuclear war.⁷

war ; armed conflicts ; Nuclear Energy ; Atomic Energy ; Radiation ; Nuclear Weapons

war ; Armed Conflicts ; Nuclear Energy ; Atomic Energy ; Radiation ; Nuclear Weapons

Taser guns are considered less lethal weapon than pistols. However, several cases and animal experiments reported injuries associated with Taser guns. This report describes the case of a patient who suffered a penetrating eye injury after being shot by a Taser gun. It is important for the emergency physician to understand potential injuries that can be caused by Taser guns.
Animal Experimentation ; Emergencies ; Eye Injuries, Penetrating ; Firearms ; Humans ; Weapons

It is important to have adequate knowledge of the circumstances surround ing the death before the start of an autopsy, as identical autopsy findings may be interpreted quite differently under different circumstances. Clothes worn by homicide victims, especially those whose deaths involed blunt force. sharp instruments or firearms, should be carefully examined to detect traces of the murder weapon. The body surface should also be carefully examined to determine the exact nature of the wounds. Certain patterns of injury in cases of suicide versus homicide are outlined. Clues in establishing causal relationship in cases of compensation medicine are investigation is emphasized.
Autopsy ; Compensation and Redress ; Firearms ; Homicide ; Suicide ; Thoracic Injuries* ; Thorax* ; Weapons ; Wounds and Injuries

Shotguns were developed as an alternative to single-missile rifle or handgun in order to enable gunner to spray a wide area with shot and thus kill birds and small animals too difficult to hit with single-missile weapons. As the popularity of shotguns grew, ammunition was developed for large game. The use of shotguns on humans has been markedly increasing in various manner of death. In forensic aspect, the shotgun wounds have characteristic findings due to their own characteristics and medical examiners may determine the range, distance, direction and kinds of gun. When the muzzle of the shotgun is placed tightly against the surface of the abdomen or thorax, the consequent wound of entrance will be single in number and circular in shape, and will have a diameter approximately equal to that of the bore of the weapon. However, when the wound is made over a site with underlying bone, especially in the scalp, the wound may have a different appearance, showing star shaped entrance due to tears from the sides of the wound and accompanying soot and burn effect. When the muzzle is held short to mid-range, considerable variation occurs in the appearance of the wound. We report two cases of shotgun wounds which showed typical findings of contact shots and distant shots.
Abdomen ; Animals ; Birds ; Burns ; Coroners and Medical Examiners ; Firearms ; Humans ; Scalp ; Soot ; Thorax ; Weapons ; Wounds and Injuries*

Shotguns were developed as an alternative to single-missile rifle or handgun in order to enable gunner to spray a wide area with shot and thus kill birds and small animals too difficult to hit with single-missile weapons. As the popularity of shotguns grew, ammunition was developed for large game. The use of shotguns on humans has been markedly increasing in various manner of death. In forensic aspect, the shotgun wounds have characteristic findings due to their own characteristics and medical examiners may determine the range, distance, direction and kinds of gun. When the muzzle of the shotgun is placed tightly against the surface of the abdomen or thorax, the consequent wound of entrance will be single in number and circular in shape, and will have a diameter approximately equal to that of the bore of the weapon. However, when the wound is made over a site with underlying bone, especially in the scalp, the wound may have a different appearance, showing star shaped entrance due to tears from the sides of the wound and accompanying soot and burn effect. When the muzzle is held short to mid-range, considerable variation occurs in the appearance of the wound. We report two cases of shotgun wounds which showed typical findings of contact shots and distant shots.
Abdomen ; Animals ; Birds ; Burns ; Coroners and Medical Examiners ; Firearms ; Humans ; Scalp ; Soot ; Thorax ; Weapons ; Wounds and Injuries*

Public health emergencies caused by infectious diseases are the greatest threat to mankind in the 21st century, and pose an even more significant threat than nuclear weapons. The first step in preparing for and responding to such public health emergencies is to conduct thorough surveillance and rapid epidemiological investigations. Especially in the case of public health emergencies, most information is not smoothly transmitted. Therefore, it is necessary to evaluate the emergency and to collect data quickly and efficiently by defining the minimum necessary data and information. In addition, these data should be analyzed and interpreted promptly, and countermeasures and strategies should be developed and utilized in preparedness and response activities. Epidemiological investigations should also be carried out promptly in accordance with the emergency situation, and in particular, if the infection source is not known, maximal measures should be taken to prevent epidemiologists from becoming infected. In order to carry out surveillance and epidemiological investigations effectively in the future in the event of a public health emergency, continuous efforts should be made to nurture professional manpower, international cooperation, and use of the latest information technology.
Communicable Diseases* ; Disease Outbreaks ; Emergencies* ; Epidemiology ; International Cooperation ; Nuclear Weapons ; Public Health*