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 hospitalized herself.

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.