Biomedical Engineering Reference
In-Depth Information
PURPLE
BIOLOGICAL AGENTS
CHEMICAL AGENTS
Anthrax Rx: Ciprofloxacin 150 mg IV q 12 h Blister Agents
Alt: Doxycycline 22 mg IV q 12 h
Rx: BAL 25 mg IM q 6 h, 1
st
2 d
Prophy: Ciprofloxacin 150 mg po q 12 h (if Lewisite or Phosgene)
Botulinum toxin Rx: Trivalent antitoxin (Type A-B-E) Cyanide
Alt: Heptavalent antitoxin, investigational
Rx: Na-nitrite 100 mg IV,
Prophy: Pentavalent toxoid vaccine (Type A-B-C-D-E)
then Na-thiosulfate 500 mg IV
Plague Rx: Streptomycin 100 mg IM q 12 h Nerve Agents
Alt: Gentamicin 15 mg IV q 8 h, or
Rx: Atropine 0.2 mg IV
Prophy: Ciprofloxacin 150 mg po q 12 h (IM if hypoxic), await atrop. effect,
Ricin Rx: None then 2-PAM 500 mg IV / IM
Alt: None
Pulmonary Agents
Prophy: Protective mask to avoid inhalation
Rx: None
Smallpox Rx: None Riot Control Agents
(Vaccinia immune globulin only for certain complications)
Rx: None
Alt: Vaccination / revaccination of exposed persons
Prophy: Vaccination
RADIATION AGENTS
Tularemia Rx: Streptomycin 100 mg IM q 12 h
Alt: Gentamicin 15 mg IV q 8 h
“Dirty” Bomb
Prophy: Ciprofloxacin 150 mg po q 12 h
Rx: Blast / Burn protocol
Viral Hemorrhagic Fevers
Rx: Ribavirin 300 mg IV load Nuclear Reactor
then 160 mg IV q 6 h x 4 d Rx: Potassium iodide 32 mg
then 80 mg IV q 8 h x 6 d
(if I-131 suspected & > 5 cGy)
10 KG 11 KG
Figure 10.2
Pediatric disaster assistance tool. Sample section for treatment of a 10-11 kg. Child, Side A, treatment for specific
agents. Adapted by Carl Baum and Jim Wiley for the Broselow-Luten Coloring Kids System, Vitalsigns
®
(all rights reserved).
is a key element to successful general hospital care
of children.
and carry a high mortality rate with expecta-
tion of major public health disruption. Currently,
the designated category A agents include anthrax,
smallpox, plague, tularemia, the viral hemorrhagic
fevers, and botulinum toxin. Details regarding
pathogenesis, clinical findings, identification and
treatment for these agents are covered in Chapter 4.
10.3 Children and Agent-specific
Vulnerabilities
Limited informationspecific tochildren forweapons
of mass destruction currently exists. This section
addresses specific issues relative to recognition
of pediatric exposure to weapons of mass destruc-
tion and treatment modifications. Recommenda-
tions typically reflect individual cases reported
in the literature or consensus expert opinion.
10.3.2 Anthrax
Dissemination of 2 g of weapons grade anthrax
spores, amounting to 20-200 million infectious
doses, occurred through the United States of
America mail system in the months of September
and October, 2001. Potential exposures and cases
were identified in New York City, Connecticut,
Washington, D.C. and Florida. Despite the large
dose, only 11 cases of inhalational anthrax and
10.3.1 Biological Agents
Category A agents define potential biologic
weapons that are available, easily disseminated
