RT Expert Provides Basic Advice on Handling Biological, Chemical Attacks
As news has spread about the recent cases of anthrax in Florida, New York, and
Washington, DC, respiratory therapists everywhere are wondering how ready they are to
handle an outbreak of the deadly inhaled version of the disease or some other contaminant
in their communities. According to Tom Johnson, RRT, RT program director at Long
Island University in Brooklyn, NY, who has a long history of involvement with chemical
and biological weapons, they are right to be concerned and should start familiarizing
themselves with some basic precautions.
"First, for most bio-weapons, Standard Precautions are required, since there is no human-
to-human transmission," he says, noting that anthrax falls into that category. "The
exceptions are the pneumonic plague and smallpox -- then we are talking about droplet
nuclei, as we would be with tuberculosis."
Chemical agents would pose additional concerns. "For chemical weapons, neoprene or
butyl rubber gloves must be used in the ED, along with a good fitting respirator, such as
the 9970, and vapor-proof goggles." Treatment of victims must involve gentle
decontamination with rinse water before entering the warm ED environment to reduce the
cutaneous absorption of the chemical and prevent "off-gassing" or "cooking off" the
chemical once inside the hospital. "Hospital security must control access to prevent
victims from contaminating entrances and passageways to the ED. This will be essential,
since victims may arrive on foot or by cab or personal car.
Workers must also be careful to correctly dispose of the rinse water used in early
decontamination, and EDs must have a contingency plan for handling an overload of
patients, ensuring adequate gas exchanges in all areas that victims may be placed in. He
notes that in the Tokyo terrorist attack involving sarin gas, ten percent of the victims
were first responders. Most suffered minor injuries and recovered within the day, but one
nurse who was contaminated while treating overload patients in a chapel had to be
Johnson recently shared his expertise on anthrax and other biological and chemical agents
with the viewers of CNN during several interviews that grew out of an expert list
provided to the network by Long Island University. He has also provided information via
the university public relations department for new reports that have appeared on FOX
News, Inside Edition, Newsweek, the New York Times, the New York Post, and several
local TV and radio stations.