Decontamination

As the name implies, terrorists are interested in causing terror, or widespread fear and panic. Although terrorists may kill to forward their aims, their choice of agent may be more directed toward those that cause panic and terror rather than agents that kill rapidly. Large numbers of victims may only serve to provoke those they wish to terrorize. The events of September 11, 2001, and the Tokyo Sarin Subway attack opened many eyes to the extremes that terrorists will go to force their agenda. The ability to decontaminate victims completely may be impossible given the resources available when presented with several thousand potentially exposed patients. Critical care physicians will ultimately take care of the sickest of these patients, specifically those who were the most contaminated. The truly contaminated patient may require further pulmonary, GI, or wound decontamination if they are admitted to the intensive care unit. A concrete understanding of decontamination procedures and protocols is crucial. An understanding of decontamination will steer your treatment of the contaminated patient, but also will help you to protect your staff from becoming secondarily contaminated. Critical care clinicians should be integrated in disaster preparation and planning for their hospital and community. Decontamination is one of the foundations of disaster preparation and planning. Intensivists are aptly trained for these unique patients not only in their ability to care for them, but their multidisciplinary approach enables them to lessen early preventable mortality and foresee pitfalls in the care of CBR patients [13,79].