Biomedical Engineering Reference
In-Depth Information
14 Bioterrorism and Implications for
Nurses and Nursing
JACQUELYN M
C
QUAY
The world is a changed place since the events of
September 11, 2001. Nurses, especially those who
do triage in emergency departments are on the
forefront of community disease surveillance. They
must be aware of signs and symptoms that are non-
specific and flu-like in nature, but may actually
be indicative of exposure to biological or chem-
ical agents used as weapons of mass destruction
(WMD). Diagnosis and treatment may be delayed
if the triage nurse does not have the knowledge
to recognize features of a biological or chem-
ical attack and initiate a response. The threat of
WMD is a reality and nurses must have the knowl-
edge, skills, and resources that are integrated into
a community-wide plan and that offer victims the
best hope for survival [1].
Historically, biological and chemical agents
have been used throughout the years as WMD.
They are relatively inexpensive and accessible and
their use is likely to continue into the future. Acts
of terrorism are intended to make a public state-
ment. The mere thought of an exposure to a bioter-
rorist weapon provokes fear in many people. The
psychological impact may far outweigh any phys-
ical effects and even a hoax can achieve the desired
reaction.
The triage process begins with an assessment
of a patient's airway, breathing, circulation and
disability (ABCDs) along with a brief history. An
acuity level is determined based on presenting
signs and symptoms. There is a high likelihood
that the discovery of a bioterrorist incident may
occur in an emergency department so the triage
nurse must be aware that exposure to a biological
or chemical agent may mimic a naturally occurring
disease process.
The use of a biological or chemical agent should
be suspected when clusters of similar presentations
are seen. Triage nurses should be suspicious of a
potential bioterror agent exposure in any of the
following syndromes [2]:
•
infectious gastroenteritis
•
pneumonia and sudden death of a previously
healthy adult
•
an unexplained widened mediastinum in a
febrile patient
•
specific rashes
•
acute neurologic illness and fever
•
generalized weakness with advancing cranial
nerve impairment
•
severe disease manifestations in previously
healthy people
•
large numbers of patients with fever, respira-
tory, and gastrointestinal complaints
•
multiple patients from the same location with
common complaints
•
an endemic disease occurring during an odd
time of the year
•
large number of rapidly fatal cases
•
large number of ill or dead animals
•
large number of patients with sepsis, sepsis with
coagulapathy, fever with rashes, and diploplia
with progressive weakness
Biological agents are used as bioterrorist weapons
because they are easy to manufacture, do not
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