By Tina Hesman
Of The Post-Dispatch
Tim O'Neil Of The Post-Dispatch Contributed To This Report.
* Meanwhile, area hospital officials meet at St. Louis University to better coordinate their response to an attack by terrorists or a natural disaster.

When it comes to handling chemical and biological attacks, planning and practice make for improved, if not perfect, responses.

On Tuesday, while police and firefighters in full protective suits rescued victims of a mock sarin gas attack at the Edward Jones Dome, hospital representatives gathered at St. Louis University to assess their own ability to respond to disasters, including attacks by terrorists.

Sarin was used in a large-scale terrorist attack in Japan in 1995. A simulated chemical attack during a Rams football game gave police and fire units a chance to practice the kind of teamwork that would be needed to save lives and catch the bad guys during a real event, said Sgt. Vince Stehlin, the emergency management coordinator for the St. Louis Police Department.

Twenty-five Police Academy recruits represented a crowd of 60,000 Rams fans. Some of the recruits were smeared with fluorescent dye and glow-in-the-dark hair gel -- stand-ins for deadly chemical weapons.

Emergency workers in moon suits rescued the "victims" from the Dome and sent them through a rigorous decontamination process. First drenched for 15 minutes with spray from two ladder trucks, the dripping recruits then walked between rows of police in hazard suits. The police officers, virtually anonymous behind their gas masks, patted down the recruits, searching for bombs or other weapons.

The search is necessary because terrorists could be hiding among the victims, Stehlin said. After the first stage of decontamination, the police instructed victims to strip off their clothing and place them in tagged evidence bags before heading into a decontamination tent.

The recruit victims wore swim trunks under their dark pants and blue shirts, but real victims would be stripped naked, said Elizabeth Aton, of the Washington University School of Medicine.

Clothing has to come off to avoid further exposure to the chemical agents, Aton said.

Once inside the tent, the victims are scrubbed with soapy water and gently hosed off by safety-suited emergency workers. Paramedics then check blood pressure, pulse and other vital signs to decide which victims need to go to the hospital.

Previous disasters have shown that only 18 percent of victims will travel to hospitals by ambulance, said Phillip Currance, the deputy commander for the U.S. Public Health Service's Disaster Assistance Team, at the SLU conference.

"They walk. They come in taxicabs. They come in pickup trucks," he said.

That could be a problem, because many hospitals say they are unequipped to handle victims of biological or chemical attacks, said Debbie Mays, director of emergency preparedness for BJC HealthCare. Mays surveyed St. Louis area hospitals last October and found that 27 percent said they had no decontamination equipment.

The Missouri Hospital Association is sending new surveys to every hospital in the state this month, Mays said. She expects that more hospitals now have the equipment to deal with attacks by terrorists, she said.

Hospitals have to prepare to lock down their campuses so victims won't contaminate the facilities, she said. Doctors and nurses need to practice treating patients while wearing hot, cumbersome protective equipment.

And resources and personnel could run short in a large-scale attack. But area hospitals realize they can't go it alone after an attack, said Karen Webb, chief medical officer for St. Louis University Hospital. This month, 35 local hospitals will sign a mutual aid agreement, pledging to lend support, supplies and people to each other, Webb said.

One of the first steps of the cooperative agreement is establishing a medical communications center, Webb said. The center will move into donated space at St. Louis University this week, she said.

The conference, sponsored by Tenet St. Louis, brought representatives from Tenet hospitals around the United States and officials from local hospitals together to learn how to improve disaster response, Webb said.

"Everything worked well, although we could pep it up a little bit," Stehlin said. "But we don't want to rush anything when we're dealing with chemicals."

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A sarin primer

* Chemical name: Isopropyl methylphosphonofluoridate.

* Sarin is a colorless and odorless liquid discovered by German chemist Gerhard Schrader in 1938 while he was looking for a better insecticide.

* The Germans developed sarin as a chemical weapon in World War II but never used it on the battlefield. Iraq may have used sarin in its war with Iran and again against the Kurds during an attack on the village of Birjinni.

* The Japanese doomsday cult Aum Shinri Kyo used sarin in two attacks -- one on the Tokyo subway on March 20, 1995 -- killing 19 people and sending more than 5,500 to hospitals.

* Just 0.5 milligram -- a pinprick-size droplet -- can kill a human in minutes by shutting down communication between nerves.

* Symptoms may begin within minutes to hours of exposure. They include headaches, runny nose and congestion, drooling, chest tightness, cramps, diarrhea, loss of bladder and bowel control, constricted pupils, vision problems, coughing, wheezing, muscle twitches, convulsion and respiratory failure.

* Antidotes include atropine and 2-PAM and must be given immediately after exposure to counteract the most severe effects. Full recovery may take months.

Reporter Tina Hesman

E-mail: thesman@post-dispatch.com

Phone: 314-340-8325



Published in the Metro section of the St. Louis Post-Dispatch on Wednesday, October 2, 2002.
Copyright (C)2002, St. Louis Post-Dispatch