 | 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.
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 | 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. |
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