Keypoints and Key

A prompt and proper response is one that integrates community, state, and federal policies and procedures.
A review of standard texts and articles associated with bioterrorism is necessary to enhance the material contained within Bio-Terry. Consult the References section at the back of this manual.
With the evolution of bioterrorism management, the present treatment and dosing regimens may change. Contact local and federal authorities for current recommendations.
Familiarization of each antibiotic, antiviral, vaccine, and toxoid (warnings, adverse reactions, contraindications) is mandatory before prescribing (Physicians' Desk Reference, the "Red Book.")
Certain medications that may be contraindicated in specific circumstances (e.g., pediatrics, pregnancy) may be advisable to administer after a bioterrorist attack when the risk of contracting a lethal disease is weighed against the drug effect.
When treatment may deviate from normal standard of care, consultation with regional and federal experts is necessary.
Diagnostic samples may be collected for the following tests: Gram stain/culture, Ag-ELISA, Wright-Giesma stain, IFA, Agglutination, PCR, Ab-ELISA, RT-PCR.
The most destructive attack is an aerosol assault. Signs and symptoms are emphasized from that perspective.
Specific pediatric considerations include:
  • greater exposure to aerosolized agents due to increased respirations/minutes;
  • increased exposure to transdermal toxins due to greater surface to mass ration;
  • greater permeability of intact skin resulting in easier absorption;
  • increased likelihood of heat loss with showering due to an increased total body surface area;
  • greater risk of dehydration due to vomiting and diarrhea.
The removal of clothing as a decon procedure has the additional advantage of detecting a secondary device concealed on a victim.
Specific bio-syndromes associated with each agent is located on every Bio-Terry page.
A legend on each Bio-Terry page indicates early, delayed, and classical signs and symptoms.
A Bio-Terry table is included at the end of this manual to cross-reference signs and symptoms with a specific agent.

Copyright 5/2000
Paul Rega, M.D.
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