Ciottone's Disaster Medicine

Front Matter
	Ciottone’s
	Third Edition
	Copyright
	Dedication
	Associate Editor Dedications
	FOREWORD
	Preface
	Contents
Chapter (1)
	1 - Introduction to Disaster Medicine
		THE DISASTER CYCLE
		NATURAL AND HUMAN-MADE DISASTERS
		DEFINING DISASTER
		DISASTER MEDICINE
		REFERENCES
Chapter (2)
	2 - Public Health and Disasters
		INTRODUCTION TO PUBLIC HEALTH
			Definition, History, and Achievements of Public Health
			The Public Health System
			Public Health Essential Services
		PUBLIC HEALTH CONSEQUENCES OF DISASTERS
			Direct Effect on the Population’s Health
			Direct Effect on the Health System
			Indirect Effect on the Population’s Health
			Indirect Effect on the Health System
		PUBLIC HEALTH AND THE DISASTER MANAGEMENT CYCLE
			Prevention and Mitigation
			Preparedness
			Response
			Recovery
		THE ROLE OF PUBLIC HEALTH IN DISASTER MANAGEMENT: THE CASE OF COVID-19
		PUBLIC HEALTH IN NATIONAL DISASTER FRAMEWORKS: THE CASE OF THE UNITED STATES
		CONCLUSION
		ACKNOWLEDGMENT
		REFERENCES
Chapter (3)
	3 - Role of Emergency Medical Services in Disaster Management and Preparedness
		HISTORICAL PERSPECTIVE
		EMS INTERNATIONALLY
		CURRENT PRACTICE
		 PITFALLS
			Preparedness
			Disasters Are Not Just Large MCIs
			Mental Health
			Manpower and Community Empowerment
		ACKNOWLEDGMENT
		REFERENCES
Chapter (4)
	  4 - Role of Emergency Medicine in Disaster Management
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Role of Emergency Medicine Specialists
			Role of the ED in a Disaster
		ORGANIZATION OF THE EMERGENCY DEPARTMENT DURING A DISASTER
			Initiate Procedures for Clearing ED Care Space for Incoming Patients
				Setting Up a Decontamination Area
				Establishing Zones and Health Care Teams
				Assessing Functionality of ED Tracking Systems for the Impending Disaster
				Alerting and Organizing Registration for the Incoming Victims
				Organizing Specialty Services in the ED
				Managing Volunteer Health Providers
		WHEN THE NUMBER OF VICTIMS BEGINS TO WIND DOWN
			Emergency Medicine Preparedness and Training for Disasters
		CONCLUSION
		 PITFALLS
		REFERENCES
Chapter (5)
	5 - Role of Hospitals in a Disaster
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Public Expectation of Hospital Function
				Administrative and Organizational Elements
		ELEMENTS OF COMPREHENSIVE HOSPITAL PREPAREDNESS FOR DISASTERS
			Hospital Vulnerability
			Structural Elements
			Nonstructural Elements
			Hazard Vulnerability Analysis (for More Details Please See Chapter 25)
			Resource Analysis
			Hospital Incident Command System (for More Details Please See Chapter 41)
			Surge Capacity (for More Details Please See Chapter 38)
			Hospital Evacuation
			Shelter-in-Place
			Reverse Triage
			Patient Tracking
		EDUCATION AND TRAINING
		ATTACKS ON HEALTH CARE FACILITIES
			Assessment of Hospital Preparedness for Disasters
		 PITFALLS
		SUMMARY
		ACKNOWLEDGMENT
		REFERENCES
Chapter (6)
	6 - Pandemic Preparedness and Response
		HISTORICAL PERSPECTIVE
			Black Death 1347
			Influenza 1918
			SARS CoV 2002
			Ebola Virus Disease 2013
			SARS CoV-2 2019
		EPIDEMIOLOGICAL LIFE CYCLE OF A PANDEMIC
			Preemergence
			Localized Emergence
			Full Pandemic Emergence
		CURRENT PRACTICE
		PEARLS AND PITFALLS
			Early Outbreak Control
			Testing Limitations
			Experimental Therapeutics
			Surge Capacity and Resource Allocation
			Crisis Communication
			Societal Effects
			Vaccine Production and Distribution
		References
Chapter (7)
	 7 - Health in Complex Emergencies
		INTRODUCTION OF TOPIC
			Displacement and Migration
			Other Effects of War on Human Security
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Humanitarian Response
		Civilian Medical Needs in Complex Emergencies
			Public Health Priorities and Indicators
			Communicable Diseases
				Diarrhea
				Measles
				Malaria
				Respiratory Illnesses
				Meningitis
			Noncommunicable Health Issues
				Mental Health
				Sexual and Reproductive Health
				Noncommunicable Diseases
			Sector-Specific Responses
				Nutrition
				Shelter
				Water and Sanitation
		PITFALLS
		SUMMARY
		ACKNOWLEDGMENT
		REFERENCES
Chapter (8)
	 8 - Disaster Medicine in a Changing Climate
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
		DIRECT EFFECTS OF CLIMATE CHANGE
			Heat Waves
			Sea-Level Rise
			Tropical Cyclones
			Extreme local weather events
			Flooding
			Wildfires
		INDIRECT EFFECTS OF CLIMATE CHANGE
			Epidemics, Pandemics, and Vector-Borne Disease
			Mobility, Migration, and Complex Humanitarian Emergencies
			Interpersonal Violence and Armed Conflict
			Disasters Related to Energy Production
		 PITFALLS
		CONCLUSION
		ACKNOWLEDGMENT
		References
Chapter (9)
	9 - Children and Disaster
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
		COMPLEX HUMANITARIAN EMERGENCIES
			Water, Sanitation, and Hygiene
			Food Security and Nutrition
			Shelter, Settlement, and Nonfood Items
			Health Action
		MASS CASUALTY INCIDENTS (MCIs)
			Pediatric Mass Casualty Triage
			Pediatric Disaster Surge Capacity
			Readiness for Pediatric MCIs
			Readiness for Pediatric Bioevents
		PSYCHOLOGICAL SUPPORT
		 PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (10)
	10 - Psychological Effects of Disaster on Displaced Populations and Refugees of Multiple Traumas
		POSTMIGRATION AND ADJUSTMENT OF TRAUMATIZED REFUGEES IN HOST NATIONS
		LEVEL OF EXPOSURE TO VIOLENCE AND HUMAN DISASTER VERSUS VULNERABILITIES OF DISPLACEMENT
		DISASTER AND MENTAL HEALTH TRIAGE OF REFUGEES AND SUGGESTED THERAPEUTIC APPROACHES
		UNACCOMPANIED CHILDREN, WOMEN, AND DISPLACED REFUGEE FAMILIES
		NATIONAL AND INTERNATIONAL POLICIES ON ASYLUM SEEKERS, DISPLACED POPULATIONS, AND REFUGEES OF MULTIPLE TRAUMAS
		CONCLUDING REMARKS ON A REFUGEE BEING IN AN UNFAMILIAR, UNKNOWN HOST SURROUNDING
		ACKNOWLEDGMENT
		REFERENCES
Chapter (11)
	11 - Ethical Issues in Disaster Medicine
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
		SECTION 1: PREVENTION, MITIGATION, AND PLANNING
		SECTION 2: ALTERED STANDARDS OF CARE
		SECTION 3: INFORMED CONSENT
		SECTION 4: TRIAGE AND RESOURCE ALLOCATION IN GENERAL
			Triage Methods
			Fundamental Goals of Triage
			Disability Weights, Age Weights, and Discrimination
			Response Worker Prioritization
			Nondisaster Needs
			Repeat Triage
		SECTION 5: DISPARITIES
		SECTION 6: QUARANTINE
		SECTION 7: SURVEILLANCE
		SECTION 8: RESEARCH
		SECTION 9: RESCUERS’ RIGHTS
		SECTION 10: TRANSPARENCY AND COMMUNICATION
		SECTION 11: POLITICAL INVOLVEMENT
		SECTION 12: RECOVERY
		CONCLUSION
		 PITFALLS
		ACKNOWLEDGMENT
		References
Chapter (12)
	12 - Issues of Liability in Emergency Response
		HISTORICAL PERSPECTIVE
			History of Emergency Response Management
			Basic Concepts of Law
		CURRENT PRACTICE
			Basis of Law
			The Judicial System
				Courts
				Venue
				Case Law
				Standard of Care
				The Role of the Jury
				The Role of the Trial Judge
				The Attachment of Liability
				Immunities
				Good Samaritan Laws
				Federal Tort Claims Act
				Volunteer Protection Act
				The Emergency Management Assistance Compact
				The Uniform Emergency Volunteer Health Practitioners Act
				The Model State Emergency Health Powers Act
		PATIENT RIGHTS
		NONDISCRIMINATORY RESPONSE
		REGULATORY VIOLATIONS
		SUMMARY
		 PITFALLS
		REFERENCES
Chapter (13)
	13 - Disaster Response in the United States
		HISTORICAL PERSPECTIVE
			The Early History: 1776 to 1945
			Civil Defense Era: 1946 to 1974
			Coordinating State and Federal Response: 1975 to 1990
			Turn of the Century: 1990s to the Present
		CURRENT CONCEPTS OF DISASTER RESPONSE
		LOCAL-LEVEL EMERGENCY MANAGEMENT
		STATE-LEVEL EMERGENCY MANAGEMENT
		FEDERAL-LEVEL EMERGENCY MANAGEMENT
		SUMMARY
		ACKNOWLEDGMENT
		References
Chapter (14)
	14 - Disaster Response in Europe
		HISTORICAL PERSPECTIVE
			From Ancient Times to the Middle Ages
			Modern Era
		CONTEMPORARY ERA AND CURRENT PRACTICE
			Local Level Emergency Management
			Regional Level Emergency Management
			National Level Emergency Management
			International Level Emergency Management (European Union)
		REFERENCES
Chapter (15)
	15 - Disaster Response in Asia
		OVERVIEW
		DISASTER COORDINATION IN ASIA
		DISASTER MECHANISM IN ASIA AND ASEAN
		DISASTER RESPONSE IN ASIA
		DISASTER RESPONSE IN CHINA
		DISASTER RESPONSE IN JAPAN
		DISASTER RESPONSE IN THE PHILIPPINES
		DISASTER RESPONSE IN NEPAL
		DISASTER RESPONSE IN THAILAND
		ACKNOWLEDGMENT
		REFERENCES
Chapter (16)
	16 - Building Local Capacity and Disaster Resiliency
		HISTORICAL PERSPECTIVE
		OPERATIONAL FAMILIARITY
		BRINGING TOGETHER TRAINING, OPERATIONS, AND RESEARCH—THE CONCEPT OF A CENTER OF EXCELLENCE IN DISASTER MEDICINE
		SUMMARY
		References
Chapter (17)
	17 - Local Disaster Response in the United States
		CURRENT PRACTICE
			National Response Framework
		SUPPORTING ORGANIZATIONS AND CAPABILITIES
		LOCAL RESOURCES
		LOCAL RESPONSE CONCEPTS OF OPERATIONS
			Community Warning
			Response Scene Operations
			Receiving Facility Considerations
			Public Welfare Issues
		ISSUES IN LOCAL RESPONSE
		ACKNOWLEDGMENT
		REFERENCES
Chapter (18)
	18 - State Disaster Response: Systems and Programs
		STATE AND LOCAL EMERGENCY MANAGEMENT ORGANIZATION
		STATE DEPARTMENTS OF HEALTH AND HEALTH FUNCTIONS
		SPECIFIC PUBLIC HEALTH AND MEDICAL PROGRAMS
		EMERGENCY FUNCTIONS
		SUMMARY
		REFERENCES
Chapter (19)
	19 - Selected U.S. Federal Disaster Response Agencies and Capabilities
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Department of Homeland Security
			Department of Health and Human Services
				National Disaster Medical System
				Strategic National Stockpile
				The Office of the Assistant Secretary for Preparedness and Response
				Agency for Health Care Research and Quality
				Centers for Disease Control and Prevention
				Food and Drug Administration
				Health Resources and Services Administration
				Indian Health Service
				National Institutes of Health
				Substance Abuse and Mental Health Services Administration
				Commissioned Corps of the U.S. Public Health Service
			Department of Veterans Affairs
			Department of Defense
			American Red Cross
		 PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (20)
	20 - Global Disaster Response and Emergency Medical Teams
		INTRODUCTION
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			WHO Standards for Foreign Medical Teams
			Phases of Response
			Data Management and Information Technology
			Emergency Department
			General Surgery
			Orthopedics
			Anesthesia
			Pediatrics
			Obstetrics and Gynecology
			Inpatient Services
			Mental Health Services
			Rehabilitation
			Specialty Services
			Ancillary Services
			Training
			Ethical Issues
		LESSONS LEARNED
		 PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (21)
	21 - Civil-Military Coordination in Disaster Response
		INTRODUCTION
		KEY CONCEPTS
			Humanitarian Action
			Distinction
			Do No Harm and Last Resort
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE AND FUTURE TRENDS
			Increasing Complexity of Civil-Military Engagement
			Nontraditional Civil-Military Actors
			Increasing Civil-Military Interoperability Outside the Acute Disaster Space
		SUMMARY
		REFERENCES
Chapter (22)
	 22 - Evaluation of Emerging Data to Inform Disaster Response
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Mobile Health
			Geographical Information System Mapping
			Satellites and Unmanned Aerial Vehicles
		 PITFALLS
		REFERENCES
Chapter (23)
	 23 - Disaster and Emergency Management Programs
		WHAT IS DISASTER AND EMERGENCY MANAGEMENT?
			The Emergency Management Cycle
			Why Do We Need Disaster and Emergency Management Programs?
		HISTORICAL PERSPECTIVE
			History of Disaster and Emergency Management Programs
		CURRENT PRACTICE
			Federal Programs
				Community Emergency Response Team
				Voluntary Organizations Active in Disaster
				National Preparedness System
				Medical Reserve Corps
				National Disaster Medical System
				Federal Education Programs
			State Emergency Management
			Local Emergency Management
			Nongovernment Organizations
				Community and Faith-Based Organizations
				University Programs
				Private Sector Programs
					Hospitals.
					Businesses
		PITFALLS
			Communication
			Resilience
			Accountability
			Funding
			Lack of Private Sector Ties
		ACKNOWLEDGMENT
		REFERENCES
Chapter (24)
	24 - Emergency Department Design
		HISTORICAL PERSPECTIVE
			Emergency Department Design Recommendations of Project ER One Revisited
				Scalability
				Alternate Care Sites
				Capability
				Threat Mitigation
		CURRENT PRACTICE
		RECOMMENDATIONS FOR COVID RESPONSE11
			Scalability, Surge, and Treatment Capacity
			Security
				Information
			Isolation and Decontamination
		 PITFALLS
		CONCLUSION
		ACKNOWLEDGMENT
		REFERENCES
Chapter (25)
	 25 - Hazard Vulnerability Analysis
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Selecting the Team
			Hazard Identification
			Hazard Profiling (Probability and Consequences)
				Probability Assessment
				Consequences
				Risk
			Vulnerability (Preparedness) Assessment
		SUMMARY
		PITFALLS
		CONCLUSION
		ACKNOWLEDGMENT
		REFERENCES
Chapter (26)
	26 - Public Information Management
		MEDIA HISTORY
		MEDIA AND DISASTERS
		CURRENT PRACTICES
			Medical/Emergency Medical Services (EMS)/Fire Models
			Effect of Media Reports
			Media Communication
			Use of Message Maps
		 PITFALLS OF MANAGING PUBLIC INFORMATION
			Failing to Bring in Experts
			Using Complex Language or Jargon
			Arguing, Fighting, or Losing Your Temper: Beware of “Gotcha Questions”42
			Predicting
			Answering a Question That You Are Not Qualified to Answer
			Failing to Show Empathy
			Lying, Clouding the Truth, or Covering Up
			Not Responding Quickly
			Not Responding at All
			Failing to Practice Emergency Communications
		CONCLUSION
		SUGGESTED READING
		ACKNOWLEDGMENT
		REFERENCES
Chapter (27)
	27 - Informatics and Information Technology in Disaster Medicine
		INFORMATION TECHNOLOGY
			Smartphones
			Notification Applications
			Reference Applications
			Radios
		INFORMATICS
		SUMMARY
		Suggested Additional Resources
		REFERENCES
Chapter (28)
	28 - Medical Simulation in Disaster Preparedness
		HISTORICAL PERSPECTIVE
		TYPES OF SIMULATION
			Skills Training Simulation
			Mannequin-Based Simulation
			Standardized Patient Simulation
			Virtual Simulation
				Virtual Reality
				Augmented Reality
				Serious Game-Based Platform
			Full Scale High-Fidelity Simulation
			Tabletop Drills
			Operations-Based Exercises
		ADVANTAGES OF VIRTUAL SIMULATION
			Cost and Convenience
			A Holistic Approach to Disaster Management
			Customization
			The Freedom to Make Mistakes and to Learn From Them
			Detailed Feedback and Evaluation
			Personalized Schedule
		LIMITATIONS OF VIRTUAL SIMULATION
		CONCLUSION
		ACKNOWLEDGMENT
		REFERENCES
Chapter (29)
	29 - Disaster Mitigation
		HYOGO FRAMEWORK FOR ACTION
		ENGAGING THE WHOLE COMMUNITY
		INTRODUCTION OF MITIGATION IN THE UNITED STATES
		GOALS AND CONCEPTS OF MITIGATION
		RECENT HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
		NEW HAMPSHIRE CRITICAL CARE AND SUPPLEMENTAL OXYGEN PROGRAM (NHCCSOP)
		COMMON PITFALLS
		CONCLUSION
		ACKNOWLEDGMENT
		Suggested Readings
		REFERENCES
Chapter (30)
	30 - Disaster Risk Management
		ETHICAL CONSIDERATIONS
			Ventilator Allocation
			Critical Care Admission Thresholds
			Triage of Pharmaceuticals and Medical Countermeasures
			Elective Procedures and Outpatient Units
		LEGAL CONSIDERATIONS
			Altered Standards of Care
			Triage Protocols
			Modified Scopes of Practice
				Physician Assistants
				Advanced Practice Nurses
				Advanced Prehospital Providers (Paramedics)
				Health Profession Students
			Credentialing of Volunteer Health Care Providers
			Waiver of State and Federal Health Care Laws and Regulations
				Health Insurance Portability and Accountability Act
				Emergency Medical Treatment and Active Labor Act
				Medical Licensing
		OPERATIONAL CONSIDERATIONS
			Reducing Nonessential Hospital Operations
			Closing Outpatient Services
			Cancellation of Elective Procedures
			Surge Capacity and Capability
				Emergency Department Surge Capacity
				Medical/Surgical Beds and Step-Down
			Critical Care Surge Capability
				Transforming Nonpatient Care Areas into Subacute Holding Areas
				Mobile Solutions, Tents, etc.
				Supply Chain Issues
				Medical Equipment and Supplies
				Linen
				Pharmaceuticals and Medical Countermeasures
				Food Services
			Alternative Care Sites
		SUMMARY
		ACKNOWLEDGMENT
		REFERENCES
Chapter (31)
	31 - Vaccines
		HISTORICAL BACKGROUND
		IMMUNITY
		VACCINES
			Vaccine Storage
		CURRENT PRACTICE
			Potential Bioterrorism Agents
				Category A
					Anthrax (Bacillus anthracis).
					Botulism (Clostridium botulinum).
					Smallpox (Variola major).
					Plague (Yersinia pestis).
					Tularemia (Francisella tularensis).
					Hemorrhagic fever viruses.
				Category B
					Food safety threats (e.g., Salmonella species, Chapter 134; Escherichia coli O157:H7, Chapter 137; Shigella, Chapter 133).
					Water safety threats (e.g., Vibrio cholerae, Chapter 132).
					Vaccinations for displaced persons.
					Influenza.
		 PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (32)
	32 - Occupational and Environmental Medicine: An Asset in Time of Crisis
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
		PITFALLS
		REFERENCES
Chapter (33)
	33 - Worker Health and Safety in Disaster Response
		PRE-EVENT: MITIGATION AND PREVENTION, PREPAREDNESS
		DURING THE EVENT: RESPONSE
		RECOVERY
		ISSUES SPECIFIC TO LAW ENFORCEMENT OFFICERS
		ISSUES SPECIFIC TO FIREFIGHTERS
		ISSUES SPECIFIC TO EMERGENCY MEDICAL SERVICES
		ISSUES SPECIFIC TO “FIRST RECEIVERS”
		ACKNOWLEDGMENT
		REFERENCES
Chapter (34)
	34 - Disaster Preparedness
		DEFINITION
			Disaster Terminology
				Disaster Risk Management
				Preparedness
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			The Approach to Disaster Preparedness
			Health Objectives of Disaster Preparedness
			Key Elements of Disaster Preparedness
			A Capability-Based Approach for Disaster Preparedness Programs
			Capability and Capacity
			Process for Development of Disaster Preparedness Programs
			Risk Assessment
			Emergency Operations Plan
				Principles of Effective Emergency Operations Planning
				Operational-Level Planning
				Objective-Based Planning
				Capability-Based Planning
				Consensus-Based Planning
				Compliance With Local, National, and International Strategies
				Plan Elements
				Planning Method
			Gap Analysis
				Implementation of Preparedness Programs
				Managing the Process of Disaster Preparedness
				Monitoring and Evaluation
		DISASTER PREPAREDNESS PITFALLS
			Pitfalls of Disaster Management in General
			Preparedness as a Short-Term Activity Instead of Long-Term Sustainable Programs
			Lack of Valid Assumptions and Knowledge Regarding the Disaster Phenomenon
			Over-Reliance on External Assistance, Mobile Field Hospitals, and Specialized Surgical Teams
			Misuse of Disaster Exercises
			Problems in Disaster Planning
			Overemphasis on Mass Casualty Care in Health Sector Disaster Plans
			Poor Planning for Management of Human Resources
			Quality Management as Applied to Disaster Preparedness
		THE FUTURE OF DISASTER PREPAREDNESS
		SUGGESTED READING
		REFERENCES
Chapter (35)
	35 - Policy Issues in Disaster Preparedness and Response
		THE ETHICAL VIEW FOR THE SCIENTIST
		EVACUATION ORDERS: “YOU MAY WANT TO HEED THIS ADVICE FOR YOUR OWN GOOD”
		AN OUTBREAK AND THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT: PATIENT CARE ENSURED
		SMALLPOX VACCINATIONS: THINK BEFORE REQUIRING
		LEGISLATING PUBLIC HEALTH
			Communication Policy in the Age of Social Media
			Socioeconomic Disparity in Disaster Preparedness
		THE DIRECTION FROM HERE
		REFERENCES
Chapter (36)
	36 - Mutual Aid
		THE MUTUAL AID CONCEPT
			Response, Recovery, and Regional Capacity Building
			Conceptual Planning Concerns
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Local Community Assets
				Local Emergency Planning Committees
				U.S  Citizen Corps
				Other Government Agencies
				Voluntary Organizations and Volunteers
				Local Emergency Management Plans and Mutual Aid
				Hospitals
				Command Structure
			State Assets
				National Guard
				State Emergency Response Commission
				Emergency Management Assistance Compact
				Model Intrastate Mutual Aid Legislation
			Private Sector Resources
			Federal Assets
				The Disaster Declaration Process and Federal Disaster Assistance
		OPERATIONAL PITFALLS
			Too Many Contracts
			Two-Hat Syndrome
			Complicated Wire Diagram—Who Is in Charge?
			Resource Inequity
		SUMMARY
		ACKNOWLEDGMENT
		REFERENCES
Chapter (37)
	37 - Disaster Nursing
		INTRODUCTION
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Leadership
			Education and Principles of Disaster Nursing
			Nursing Within the Disaster Cycle
				Mitigation
				Preparedness
			Response
				Recovery
		NURSING ROLES WITHIN DISASTER RESPONSE
			International Roles for Nurses
			National Roles for Nurses
			Nursing Roles in National Disaster Medical System Responses
			Military Roles for Nurses
				Case Study for Nurses in a Deployed Environment
		CRISIS STANDARDS OF CARE
		PSYCHOLOGICAL CONCERNS
		CONCLUSION
		ACKNOWLEDGMENT
		REFERENCES
Chapter (38)
	38 - Patient Surge
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Surge “Capability” Versus Surge “Capacity”
		DEVELOPING USEFUL INDICATORS AND TRIGGERS
			The Components of Surge
			Staffing Strategies
			Supply Strategies
			Strategies for Expanding Space
			Systems
			Strategies to Manage Demand
		PITFALLS
		CONCLUSION
		REFERENCES
Chapter (39)
	39 - Accidental Versus Intentional Event
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Epidemiological Clues
			Unusual Variations in Disease Outbreaks
			Unusual Characteristics of Disease or Agents
			Other Species Signals
			Radiological and Chemical Agents
		PITFALLS
		REFERENCES
Chapter (40)
	 40 - Crisis Meta-Leadership and the Practice of Disaster Medicine
		DIMENSION ONE: THE PERSON
		DIMENSION TWO: THE SITUATION
		DIMENSION THREE: CONNECTIVITY
		SWARM LEADERSHIP
		CONCLUSION
		ACKNOWLEDGMENT
		REFERENCES
Chapter (41)
	41 - The Incident Command System
		DESCRIPTION OF EVENT
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
		FOUNDATION OF ICS
		ICS COMMAND STAFF
		GENERAL STAFF
			Operations Section
			Planning Section
			Logistics Section
			Finance/Administration Section
		PITFALLS
		SUMMARY
		ACKNOWLEDGMENT
		REFERENCES
Chapter (42)
	42 - Scene Safety and Situational Awareness in Disaster Response
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
		OVERWHELMING GEOGRAPHICAL INVOLVEMENT
		DYNAMIC ENVIRONMENTS AND UNSTABLE TERRAIN
		DELAYED COLLAPSE OF INFRASTRUCTURE AND AIRBORNE DEBRIS
		HAZARDOUS EXPOSURE TO TOXINS AND CHEMICALS
		INCLEMENT WEATHER
		SUBOPTIMAL AND INADEQUATE PERSONAL PROTECTIVE EQUIPMENT
		MENTAL AND PHYSICAL EXHAUSTION
		DELAYED INTENTIONAL OR UNINTENTIONAL EXPLOSIONS
		UNTRAINED VOLUNTEERS
		SCENE SAFETY AT THE DISASTER SITE
			Gather Information
			Analyze Options and Make Decisions
			Take Action
		CREW RESOURCE MANAGEMENT FOR SAFETY
		RESPONSE TO DISASTERS
		SCENE SIZE-UP
		LOOKOUTS, COMMUNICATIONS, ESCAPE ROUTES, AND SAFETY ZONES
		 PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (43)
	 43 - Predisaster and Postdisaster Needs Assessment
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Purpose
			Preparedness
			Planning
			Conducting the Assessment
			Sentinel Surveillance
			Surveys by Specialist Teams (Sampling Methods)
			Detailed Critical Sector Assessments by Specialists
			New Innovations
			Analyzing and Presenting Data
		 PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (44)
	44 - Operations and Logistics
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Operations
			Logistics
		 PITFALLS
			Logistics and COVID-19
		ACKNOWLEDGMENT
		REFERENCES
Chapter (45)
	45 - Disaster Communications
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
		PITFALLS
		Disclaimers
		SUMMARY
		REFERENCES
Chapter (46)
	46 - Mobile Disaster Applications
		FORM FACTORS
		THIN VERSUS THICK CLIENT
		PATIENT IDENTIFICATION
		PATIENT TRACKING
		CELL SERVICE AND INTERNET DISRUPTION
		RESOURCE MANAGEMENT
		PITFALLS
		SUMMARY
		ACKNOWLEDGMENT
		SUGGESTED READINGS
Chapter (47)
	47 - The Role of Social Media in Disasters
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
		THE EFFECT OF SOCIAL MEDIA ON THE COVID-19 PANDEMIC
		SOCIAL TECHNOLOGY AS AN ALTERNATE WAY OF PROVIDING MEDICAL CARE
		FINAL THOUGHTS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (48)
	48 - Volunteers and Donations
		DRUG DONATIONS
			Historical Perspective
			Current Practice
		BLOOD DONATIONS
		DISASTER VOLUNTEERISM
			Historical Perspective
			Current Practice
		REFERENCES
Chapter (49)
	49 - Personal Protective Equipment
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Hazard Vulnerability Analysis
			Regulations and Training
			Route of Exposure
			Inhalation Protection
				Air-Purifying Respirators
				Atmosphere-Supplying Respirators
			Skin Protection
			Eye Protection
			Hearing Protection
			Categories of Proper Precautions
		PITFALLS AND ONGOING CHALLENGES
			Risks to Providers
		REFERENCES
Chapter (50)
	50 - Role of Bystanders in Disasters
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (51)
	51 - Disaster Surveillance Systems
		INTRODUCTION
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Data Collection
			Analysis, Interpretation, and Dissemination
		 PITFALLS
		REFERENCES
Chapter (52)
	52 - Use of Geographical Information Systems in Crises
		INTRODUCTION
		HISTORICAL PERSPECTIVE
			Aerial Photography, Satellite Imaging, and Remote Sensing
				Expanding Agency: Crowd-Sourcing, Participatory Mapping, and Collective Intelligence
				Hazard Modeling, Operations Research, and GIS for Decision Support
		CURRENT PRACTICE
		 PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (53)
	53 - Management of Mass Fatalities
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Established Facts
			Current Approaches to Mass Fatality Management Planning
		 PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (54)
	54 - Disaster Management of Animals
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (55)
	55 - Urban Search and Rescue
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Urban Search and Rescue Task Force Composition and Deployment
			Search and Rescue Operations
			Confined Space Medicine
			Crush Injury and Crush Syndrome
		PITFALLS
		REFERENCES
Chapter (56)
	56 - Triage
		INTRODUCTION
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Out-of-Planning Casualties
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (57)
	57 - Patient Tracking Systems in Disasters
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Manual Systems: Paper Tags, Cards, and Charts
			Current Electronic Systems
				Electronic Systems: Barcodes, RFID, and Wi-Fi Networks
					General considerations.
			The Future
		PITFALLS
		REFERENCES
Chapter (58)
	    58 - Mass Gatherings
		DESCRIPTION OF EVENT
		APPROACHES TO ASSESSING RISK
		PREINCIDENT ACTIONS
			Mass Gatherings Overall
			Security and Crowd Control
			On-Site Medical Care
			Environmental Factors
			Alcohol and Illicit Drug Usage
			Crowd Density and Demographics
			Event Type
			Command Structure and Communication
			Religious Mass Gatherings
			Concerts and Sports Gatherings
			Marathons
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (59)
	59 - Infectious Disease in a Disaster Zone
		HISTORICAL PERSPECTIVE
			Waterborne Diseases
			Diseases Associated With Overcrowding
			Vector-Borne Diseases
			Infections from Traumatic Injuries
		CURRENT PRACTICE
		PITFALLS
		REFERENCES
Chapter (60)
	 60 - Pharmaceuticals and Medical Equipment in Disasters
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Terrorism
			Natural Disasters
				World Health Organization Medical Kits
			Management of Pharmaceutical Donations
		PITFALLS
		SUMMARY
		SUGGESTED READINGS
		REFERENCES
Chapter (61)
	61 - Displaced Populations
		VULNERABILITIES: AGE AND GENDER MATTERS
			Refugees
			Internally Displaced Persons
		PRIORITIES FOR A DISPLACED POPULATION
			Initial Evaluation
			Measles and Tuberculosis
			Water
			Sanitation and Hygiene
			Food and Nutrition
			Shelter
			Medical Care
		REFERENCES
Chapter (62)
	62 - Palliative Care in Disasters
		DEFINITION OF PALLIATIVE CARE AND HUMANITARIANISM
			Palliative Care
			Principles of Palliative Care in a Humanitarian Emergency
		HOW PALLIATIVE CARE CAN HELP IN VARIOUS HUMANITARIAN EMERGENCIES AND CRISES
		MEDICATIONS AND EQUIPMENT ESSENTIAL FOR PALLIATIVE CARE
		ETHICS OF PALLIATIVE CARE IN HUMANITARIAN EMERGENCIES AND CRISES
		CHALLENGES TO PALLIATIVE CARE IN HUMANITARIAN CRISIS
		RESOURCES TO HELP IMPLEMENT PALLIATIVE CARE
		PALLIATIVE CARE TRAINING
		REFERENCES
Chapter (63)
	63 - Rehabilitation and Reconstruction
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (64)
	64 - Disaster Education and Research
		HISTORICAL PERSPECTIVE
		DEFINITIONS
		CURRENT PRACTICE
			Research
				Epidemiology
				After-Action Reports
				Technique Discussion
				Trials of Techniques or Equipment
				Organizational and Analytical Schemes
				Comparative Trials
			Education
			Simulation in Disaster Research and Education
				Future Directions in Simulation
		PITFALLS
			Inaccurate Information
			Reliance on Technology
				The Unexpected
			Bias and Error in Research
		ACKNOWLEDGMENT
		REFERENCES
Chapter (65)
	65 - Practical Applications of Disaster Epidemiology
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Vulnerability Analyses
			Baseline Population Data and Rapid Needs Assessments
			Surveys
			Qualitative Assessments
		PITFALLS
		REFERENCES
Chapter (66)
	66 - Measures of Effectiveness in Disaster Management
		INTRODUCTION OF TOPIC
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
		PITFALLS
		REFERENCES
Chapter (67)
	67 - Counter-Terrorism Medicine
		HISTORICAL PERSPECTIVE
			9/11  and the Israeli Experience
			What’s in a Word?
		CURRENT PRACTICE
			New Modalities, Old Threats, and Keeping Pace With New Asymmetrical Threats
			Health Care Under Threat
		COUNTERTERRORISM MEDICINE
			Redefining Terrorism from a Health Care Perspective
			Counterterrorism Medicine as a Subspeciality of Disaster Medicine
			A Health Care Seat at the Counterterrorism Table
		PITFALLS
		SUMMARY
		REFERENCES
Chapter (68)
	68 - The Psychology of Terrorism
		HISTORICAL PERSPECTIVE
		DEVELOPMENTAL PERSPECTIVES
		PITFALLS
		COMMUNITY PERSPECTIVES
		LEARNING THEORY PERSPECTIVES
		CONCLUSION
		SUGGESTED READINGS
		REFERENCES
Chapter (69)
	69 - Thinking Outside the Box: Health Service Support Considerations in the Era of Asymmetrical Threats
		WHAT’S OUTSIDE THE BOX?
		BE PRACTICAL
		BE PROACTIVE
		AVOID DUPLICATING EFFORTS
		DISPERSE RESOURCES
		EXPAND THE MEDICAL INFRASTRUCTURE
		BE DIVERSE AND COLLABORATE
		PROVIDE EMERGENCY MANAGEMENT TRAINING
		NO BYSTANDERS, EDUCATE THE PEOPLE
		BE PREPARED
		POST-INCIDENT REQUIRED ACTIONS
		CONCLUSION AND DISCUSSIONS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (70)
	70 - Integrated Response to Terrorist Attacks
		HISTORICAL PERSPECTIVE
			Federal
		FIRE SERVICE
			Development and History of Response
			Paradigm Change
		EMERGENCY MEDICAL SERVICES
			Development and History of Response
			Paradigm Change
		LAW ENFORCEMENT
			Development and History
			Paradigm Change
		CURRENT AND FUTURE BEST PRACTICE: INTEGRATED OPERATIONS
		CHALLENGES TO IMPLEMENTING THE NEW RESPONSE PARADIGM
		THE MODEL HIGH-THREAT OPERATIONAL PROGRAM
			Intelligence and Training
			Public Engagement
			Patrol Officer Tactical Emergency Casualty Care Training
			Fire-EMS Tactical Emergency Casualty Care and Indirect Threat/Warm Zone Integrated Medical Rescue Operations
			Escorted Warm Zone Care
			Indirect Threat and Warm “Island” Care
			The “Warm Corridor”
			Fire as a Weapon
			Response to Mass Casualty Events Involving Explosives
		CONCLUSION
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (71)
	71 - Coordinated Attack
		INTRODUCTION
		DEFINITION
		HISTORICAL PERSPECTIVE
			Conventional Tactics
			Unconventional Tactics
			Categorization of Coordinated Attacks
			Municipal Preparedness
			Public Preparedness
		CURRENT PRACTICE
			Response Strategies
			Medical Management of Mass Casualty Incidents
			Threat Assessment
		PITFALLS
		CONCLUSION
		REFERENCES
Chapter (72)
	72 - Active-Shooter Response
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Preincident Actions
				Mitigation
				Profiling the Active Shooter
				Target Hardening
				Hazard Vulnerability Analysis
				Public Education Drills
				Law Enforcement and Emergency Medical Services Preparation
				Hospital Preparedness
			Postincident Actions
				Prehospital
				Hospital
		CONCLUSION
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (73)
	73 - Hostage Taking
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
			Individuals
			Organizations
			Responding Agencies
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (74)
	74 - Civil Unrest and Rioting
		INTRODUCTION
		CAUSES OF CIVIL UNREST
		CURRENT PRACTICE
			Preincident Actions
			Midincident Actions
			Postincident Actions
		INJURIES IN CIVIL UNREST
			Kinetic Impact Projectiles
			Blunt Trauma
			Riot Control Agents
			Miscellaneous Weapons
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (75)
	75 - Introduction to Explosions and Blasts
		DESCRIPTION OF EVENT
			Physics of Blast Injury
			Physiology of Blast Injury
		HISTORICAL CONTEXT
			Increasing Prevalence and Lethality of Explosive Devices
			Prognostic Factors and Critical Mortality Rates
			Triage Efficacy
			Building Collapse
			Open Air Versus Confined Space
		MEDICAL TREATMENT OF CASUALTIES
			Primary Stabilization
			Thoracic Injury
			Cardiovascular Injury
			Abdominal Injury
			Musculoskeletal/Extremity Injury
			Central Nervous System Injury
			Auditory Injury
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (76)
	76 - Suicide Bomber
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
			Prehospital Care
			Emergency Department Care
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (77)
	77 - Improvised Explosive Devices
		ANATOMY OF AN IMPROVISED EXPLOSIVE DEVICE
			Power Source
			Switch/Trigger
			Initiator
			Explosive Material
			Containment
		TYPES OF IMPROVISED EXPLOSIVE DEVICES
		BLAST INJURIES
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Global War on Terror
		CONCLUSION
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
			SUGGESTED READINGS
Chapter (78)
	78 - Conventional Explosions at Mass Gatherings
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (79)
	79 - Nuclear and Radiation Disaster Management
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Basic Principles
				Radiation Physics
				Radiation Biology
				Radiation Dose and Units
			Nuclear Disaster Scenarios
				Detonation of Nuclear Weapons
					Strategic nuclear weapons
					Tactical nuclear weapons
					Improvised Nuclear Device (IND)
				Effects of Nuclear Weapons
				Attacks on Nuclear Reactors
				Detonation of a Radiological Dispersal Device
				Simple Dispersal Device
				Radiation Accidents
			Principles of Medical Management
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (80)
	     80 - Dirty Bomb (Radiological Dispersal Device)
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (81)
	81 - General Approach to Chemical Attack
		HISTORICAL PERSPECTIVE
			Brief History
			The Chemical Weapons Convention
			Chemical Agents
		CURRENT PRACTICE
		DOCTRINE AND POLICY
			National Incident Management System
			Emergency Management Programs
		CURRENT STANDARDS AND GUIDELINES
			Research, Development, and Support
			Other Departments and Agencies
		THE RESPONSE
		INITIAL ACTIONS
			Recognizing an Attack
			Establishing Scene Safety
		RESPONSE CAPABILITIES
			Command and Control
			Reconnaissance/Hazard Detection and Identification
			Casualty Extraction
			Medical Triage, Treatment, and Transport
			Decontamination
			Scene Security/Explosives Ordnance Disposal
			Supplies and Logistics
		PITFALLS
			Emerging Threats
		ACKNOWLEDGMENT
		REFERENCES
Chapter (82)
	82 - Biological Attack
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Threat Assessment
		BIOTERRORISM RECOGNITION
		THREAT AGENTS
			Anthrax
				Cutaneous Anthrax
				Inhalational Anthrax
			Smallpox
			Botulism
			Plague
			Tularemia
			Viral Hemorrhagic Fevers
		MANAGEMENT OF SPECIAL PATIENT POPULATIONS
		PSYCHOSOCIAL MORBIDITY
		PITFALLS
		REFERENCES
Chapter (83)
	83 - Future Biological and Chemical Weapons
		HISTORICAL PERSPECTIVE
		FUTURE BIOLOGICAL WEAPONS
			Existing Agents and Their Potential for Future Use
			Selected Emerging and Reemerging Infections with Weaponization Potential
				Avian Influenza
				Human Influenza
				Severe Acute Respiratory Syndrome, Coronavirus Disease 2019, and SARS-Associated Coronaviruses
				Middle East Respiratory Syndrome
				Nipah and Hendra Viruses
				Smallpox
				Biological Response Modifiers
				Synthetic Biology and Bioengineered Pathogens
				CRISPR
		POTENTIAL FUTURE CHEMICAL WEAPONS
			Nature of the Problem
			Existing Agents and Their Potential for Future Use
			Selected Emerging Chemical Threats With Weaponization Potential
				Novichok and Carbamates
				Incapacitating Agents
				Toxic Industrial Chemicals
				Other Classes of Potential Chemical Weapons
					Bicyclic Phosphates
					Bioregulators
			Technological Modifications of Battlefield Chemical Agents and Delivery Systems
				Agent Thickening
				Binary Weapons
				Dusty Agents
				Developments in Delivery Systems
				“Designer” Chemicals
		CONCLUSIONS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (84)
	84 - Directed-Energy Weapons
		HISTORICAL PERSPECTIVE
			Lasers
			Microwave-Radiation Emitters and MASERs
			Sonic Weapons
			Particle Beam Generators
		CURRENT PRACTICE
		KEY MANAGEMENT ISSUES
			Laser Eye Injury
				Retinal Damage
				Cornea and Lens
			Laser Skin Burns
			Electromagnetic Beam Weapon Clinical Effects
		PITFALLS
		REFERENCES
Chapter (85)
	85 - Chemical, Biological, Radiological, and Nuclear Quarantine
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Authority for Quarantine
				Federal Law
				State, Local, and Tribal Law
			Who Is in Charge?
				Federal Enforcement
				State and Local Enforcement
				First Responders
			Training and Response of First Responders: Quarantine
			Types of Quarantine
				Biological
				Chemical
				Radiological and Nuclear
			Execution of Quarantine
				Control of Individual, Animal, and Environmental Movements
				Management and Protection of Community Assets
				Health Care Assets
				Schools
				Travel
				Business and Agriculture
		PITFALLS
		CONCLUSION
		ACKNOWLEDGMENT
		REFERENCES
Chapter (86)
	86 - Decontamination: Chemical and Radiation
		HISTORICAL PERSPECTIVE
			Chemical Exposure
			Radiation Exposure
		CURRENT PRACTICE
			Field Decontamination
			Personal Decontamination
			Casualty Decontamination
				Step 1: Set Up the Decontamination and Support Areas
				Step 2: Conduct Decontamination Triage
					Chemical Detection
					Radiation Survey
				Step 3: Decontaminate the Victims
				Step 4: Segregate Victims for Observation or Treatment
				Step 5: Release the Victims
			Hospital Decontamination
			Personnel Decontamination
			Mechanical Decontamination
				Decontamination Solutions
			Internal Decontamination
				Reduction of Gastrointestinal Absorption
				Block Uptake in the Target Organ
				Diluting Agents
				Chelating Agents
				Wound Excision
		SPECIAL POPULATIONS
			Infants, Children, and Adolescents (Pediatric): Considerations
			The Elderly, People With Chronic Medical Conditions, and Pregnant Women: Considerations
		CERTIFICATION OF DECONTAMINATION
			Radiation
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (87)
	87 - Military Lessons Learned for Disaster Response
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
			Domestic Response Systems
			Clinical Care Advances
			Humanitarian Assistance
			Operations Management and System Design
			Innovation and Technology
		CONCLUSIONS
		PITFALLS
		Disclosure
		REFERENCES
Chapter (88)
	88 - Integration of Law Enforcement and Military Resources With the Emergency Response to a Terrorist Incident
		HISTORICAL PERSPECTIVE
			Law Enforcement
			Military
		CURRENT PRACTICE
			Law Enforcement
			Military
		PITFALLS
			Law Enforcement
				Failure to Ascribe to the Incident Command System
				Jurisdictional Confusion
				Patient Care versus Evidence Preservation
			Military
				Presuming the Role of Lead Agency
				Inappropriate Immediate Response Authority
				Violation of the Posse Comitatus Act
		CONCLUSION
		ACKNOWLEDGMENT
		REFERENCES
Chapter (89)
	89 - Tactical Emergency Medical Support
		THE HISTORY OF TEMS
		CURRENT PRACTICE
			Before a mission
			During a mission
			After the mission
		THE BIRTH OF TACTICAL COMBAT CASUALTY CARE (TCCC) AND TACTICAL EMERGENCY CASUALTY CARE (TECC)
		THE PHASES OF TECC22
			Direct Threat Care/Hot Zone Care
			Indirect Threat Care/ Warm Zone Care
			Evacuation/Cold Zone Care
		INTERNATIONAL PERSPECTIVES ON DELIVERY MODELS
		THE PHYSICIAN’S ROLE IN TEMS
		SUMMARY
		ACKNOWLEDGMENT
		REFERENCES
Chapter (90)
	90 - Operational Rescue
		HISTORICAL PERSPECTIVE
			Recreational rescue
				Situational Rescue
				Operational Rescue
		CURRENT PRACTICES
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (91)
	91 - Operations Security, Site Security, and Incident Response
		INCIDENT MANAGEMENT/UNIFIED COMMAND AS THE FOUNDATION
		HISTORICAL PERSPECTIVE
		CURRENT MEDICINE
			Operations Security and Site Security: Challenges of a General Nature
				Victim Rescue
				Personnel Needs
		INTEGRATION
		THE PRESS AND DIGNITARIES
		OPSEC AND SITE-SECURITY DEMANDS FOR OFFSITE OPERATIONS
		OPSEC AND SITE SECURITY FOR A TERRORIST INCIDENT
		ESTABLISHING A PERIMETER
		EVIDENCE PROTECTION
		INFORMATION SECURITY AND TRAFFIC AND CROWD CONTROL
		SECONDARY DEVICES OR THREATS
		CONCLUSION
		ACKNOWLEDGMENT
		REFERENCES
Chapter (92)
	92 - Medical Intelligence
		BACKGROUND
		HISTORICAL PERSPECTIVE
			The Importance of Medical Intelligence
		CURRENT PRACTICE
			Civilian Medical Intelligence
			Sources of Medical Intelligence
			The Origin of Modern Civilian Medical Intelligence in the United States
			Key Components of Civilian Medical Intelligence
			Integration of Medical Intelligence Into National-Level Knowledge Management Systems
				Fusion Centers
			Medical Intelligence and Risk Management
		PITFALLS
			Incomplete Integration of Veterinary Medicine Into Medical Intelligence Systems
			Inherent Difficulties in the Natural Course of Bioterrorism-Related Illness
				Lack of Clinical Training among Medical Personnel
			Inherent Difficulties of Syndromic Surveillance
			Challenges Integrating Public Health and National-Level Knowledge Management Systems
			Violation of Civil Liberties and Right to Privacy
		ACKNOWLEDGMENT
		REFERENCES
Chapter (93)
	93 - Dignitary Protective Medicine
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (94)
	94 - Introduction to Natural Disasters
		INTRODUCTION
		HISTORICAL PERSPECTIVE
		TYPES OF NATURAL DISASTERS
		GLOBAL INITIATIVES
		DISASTER MANAGEMENT AND THE ROLE OF HEALTH SYSTEMS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (95)
	95 - Hurricanes, Cyclones, and Typhoons
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		DURING THE STORM
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (96)
	96 - Earthquakes
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (97)
	97 - Tornadoes
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
			Communication
				Command and Control
				Warning Systems
			Injury Prevention
				Focused Education
				Sheltering Guidelines
				Health Care Provider Training
			Emergency Medical Response
				Traffic Control at Hospitals
		POSTINCIDENT ACTIONS
			Search and Rescue
			Emergency Medical Service Triage
			Hospital Triage
			Secondary Response
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (98)
	98 - Floods
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (99)
	99 - Tsunamis
		DESCRIPTION OF THE EVENT
		PREINCIDENT ACTIONS
			Disaster Risk Reduction (DRR)
		POSTINCIDENT ACTIONS
			Mental Health
			Logistic and Stockpiles
			Postmortem Management
		RECOVERY
		UNIQUE CONSIDERATIONS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (100)
	100 - Heat Wave
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		REFERENCES
Chapter (101)
	101 - Winter Storm
		DESCRIPTION OF EVENT
		PREINCIDENT ACTION
		POSTINCIDENT ACTION
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (102)
	102 - Volcanic Eruption
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCE
Chapter (103)
	103 - Famine
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (104)
	104 - Landslides
		DESCRIPTION OF EVENT
			What Is a Landslide?
			Types of Landslides
			Historical Scope
			Health Impacts
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS AND PITFALLS
		REFERENCES
Chapter (105)
	105 - Avalanche
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		CONCLUSIONS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (106)
	106 - Introduction to Nuclear and Radiological Disasters
		RADIATION PHYSICS
			Biological Effects
			Nuclear or Radiological Scenarios
		HISTORICAL PERSPECTIVE
		CURRENT PRACTICE
		PITFALLS
		REFERENCES
Chapter (107)
	107 - Nuclear Detonation
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
			Blast Injury
			Burn Injury
			Acute Radiation Injury
			Acute Radiation Syndrome
			Delayed Radiation Effects (2 to 4 Weeks after Event)
			Risk of Malignancy
			Psychological Injury
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (108)
	108 - Radiation Accident—Isolated and Dispersed Exposure
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
			Decontamination of Patients
		MEDICAL TREATMENT OF CAUSALITIES
			Acute Radiation Syndromes
			Cutaneous Radiation Injury
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (109)
	109 - Nuclear Power Plant Meltdown
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		SUGGESTED READINGS
		REFERENCES
Chapter (110)
	110 - Introduction to Chemical Disasters
		HISTORICAL PERSPECTIVE
			Industrial and Environmental Chemical Disasters
			Chemicals as Weapons
		Current Practice
			Event Triage
			Clinical Manifestations of Chemical Agents
		FURTHER CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (111)
	111 - Industrial-Chemical Disasters
		DESCRIPTION OF EVENT
			Definitions
				Industrial-Chemical Disasters
				Hybrid Disasters
				Scope of the Problem
				Nonpetroleum Releases
				Petroleum-Based Releases
			Situational Factors
			Socioeconomic Factors
		PREINCIDENT ACTIONS
			Risk Management Strategies
			Emergency Preparedness
			Emergency Planning
				Information Databases and Resource Management Systems
			Specialized Communication Systems
			Resource Stocks
				Training and Education
			Warning Systems
			Exercises
		POSTINCIDENT ACTIONS
			Detection and Management of the Consequences of Industrial-Chemical Disasters
			Risk Communication
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
			Lack of Familiarity
			Lack of Community Preparedness
			High Occupational Health Risk Posed to Responders
		ACKNOWLEDGMENT
		REFERENCES
Chapter (112)
	112 - Nerve-Agent Mass Casualty Incidents
		DESCRIPTION OF EVENT
		PREINCIDENT CONSIDERATIONS
			Prevention
			Communication and Multiagency Cooperation
			Mitigation and Preparedness
		POSTINCIDENT CONSIDERATIONS
			Recognition
			Scene Safety, Staging, Evacuation, and Personal Protective Equipment (PPE)
			Disrobing and Decontamination
			Triage
			In the Hospital
		MEDICAL MANAGEMENT OF CASUALTIES
			Decontamination
			Supportive Care
			Antidotal Therapy
				Anticholinergic Therapy
				Oxime Therapy
			Anticonvulsant Therapy
			Other Therapies
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (113)
	113 - Vesicant Agent Attack
		DESCRIPTION OF EVENT
			Mustard Agents
				Eye
				Respiratory
				Dermal
				Bone Marrow Suppression
				Systemic Effects
			Lewisite and Other Arsenicals
			Phosgene Oxime (CX)
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
			Protection
			Decontamination
			Mucous Membranes
			Skin
		MEDICAL TREATMENT OF CASUALTIES
			Eye
			Respiratory
			Skin
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (114)
	114 - Respiratory-Agent Mass Casualty Incident (Toxic Inhalational Injury)
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
			Airway
			Breathing
			Circulation
			Phosgenes
			Chlorine Gas
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (115)
	115 - Asphyxiant (Cyanide) Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
			Prehospital Response
			Hospital Response
		MEDICAL TREATMENT OF CASUALTIES
			Mechanisms of Toxicity
			Signs and Symptoms
			Decontamination
			Triage of Cyanide Mass Casualties
			Therapies
				Antidotes
				Cyanide Antidote Kits (CAK)
				Hydroxocobalamin
				Dicobalt Edetate
				Sodium Tetrathionate
				Hexachloroplatinate
				Sulfanegen (3-mercaptopyruvate)
				Anticonvulsants
				Other Therapies
				Supportive Care
		UNIQUE CONSIDERATIONS
		PITFALLS
			Pitfalls in Diagnosis
			Pitfalls in Treatment
			Pitfalls in Antidote Availability
		ACKNOWLEDGMENT
		REFERENCES
Chapter (116)
	116 - Antimuscarinic Agent Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (117)
	117 - Mass Casualty Incidentsfrom HallucinogenicAgents: LSD, Other Indoles,and Phenylethylamine Derivatives
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (118)
	118 - Opioid Agent Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENTS
		REFERENCES
Chapter (119)
	119 - Caustic Agent Mass Casualty Incident, With Special Emphasis on Hydrogen Fluoride (HF)
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		Unique considerations
		PITFALLS
		REFERENCES
Chapter (120)
	120 - Mass Casualties From Crowd-Control Agents
		DESCRIPTION OF EVENT
		EFFECTS OF CROWD-CONTROL AGENTS
			Eyes
			Nose
			Lungs
			Skin
			Gastrointestinal System
			Cellular Respiration
			Pregnancy
		PREINCIDENT ACTION
		POSTINCIDENT ACTION
		MEDICAL TREATMENT OF CASUALTIES
			Eyes
			Airway
			Lungs
			Skin
			Gastrointestinal System
		DIAGNOSTIC TESTING
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (121)
	121 - Cholinergic Agent Attack (Nicotine, Epibatidine, and Anatoxin-a)
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (122)
	122 - Anesthetic-Agent Mass Casualty Incident
		DESCRIPTION OF EVENT
		CHARACTERISTIC PROPERTIES OF POTENTIAL TERROR AGENTS
			Diethyl Ether
			Nitrous Oxide
			Chloroform
			Cyclopropane
			Halothane
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		PITFALLS
		REFERENCES
Chapter (123)
	123 - Introduction to Biological Agents
		INTRODUCTION
		PANDEMICS
		QUARANTINE
		BIOTERRORISM
		INFECTION DYNAMICS
		EMERGING INFECTIOUS DISEASES
		PANDEMIC PREPAREDNESS STEPS
		SUMMARY
		ACKNOWLEDGMENT
		REFERENCES
Chapter (124)
	124 - Bacillus anthracis (Anthrax) Attack
		DESCRIPTION OF EVENT
			Transmission
			Virulence
			Inhaled Anthrax
			Cutaneous Anthrax
			Gastrointestinal Anthrax
			Injectional Anthrax
			Specimen Collection and Organism Identification
			Isolation
		MEDICAL TREATMENT OF ANTHRAX
			Vaccination
			Antitoxin
				Antitoxin Use for PEP
			Treatment of Exposed Individuals
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		ANTHRAX PREVENTION
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (125)
	125 - Yersinia pestis (Plague) Bioterrorism Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (126)
	126 - Francisella tularensis (Tularemia) Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (127)
	127 - Brucella Species (Brucellosis) Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		SUGGESTED READING
		REFERENCES
Chapter (128)
	128 - Coxiella burnetii (Q Fever) Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (129)
	129 - Rickettsia prowazekii Attack (Typhus Fever)
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (130)
	130 - Orientia tsutsugamushi (Scrub Typhus) Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (131)
	131 - Rickettsia rickettsii (Rocky Mountain Spotted Fever) Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (132)
	132 - Vibrio cholerae (Cholera) Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (133)
	133 - Shigella dysenteriae (Shigellosis) Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (134)
	134 - Salmonella (Salmonellosis and Typhoid Fever) Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (135)
	135 - Burkholderia (Glanders and Melioidosis) Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (136)
	136 - Chlamydophila psittaci (Psittacosis) Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (137)
	137 - Escherichia coli O157:H7 (Enterohemorrhagic E. coli)
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (138)
	138 - Viral Encephalitis Caused by Alphaviruses
		Description of event
			Eastern Equine Encephalitis
			Western Equine Encephalitis
			Venezuelan Equine Encephalitis
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (139)
	139 - Tick-Borne Encephalitis Virus Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (140)
	140 - Viral Hemorrhagic Fever Attack
		DESCRIPTION OF EVENT
			Arenaviruses
			Lassa Fever
			Machupo Virus
			Emerging Arenaviruses and the Risk of Bioterrorism
			Filoviruses
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
			Arenavirus
			Filovirus
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (141)
	141 - Variola Major Virus (Smallpox) Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (142)
	142 - Influenza Virus Attack
		DESCRIPTION OF EVENT
			Potential as a Bioterrorism Weapon
			Clinical Presentation
		PREINCIDENT ACTIONS
			Vaccination Issues for Travelers
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
			“Avian” Influenza
			The “Swine” Influenza (H1N1) Pandemic of 2009
			SARS CoV-2 (COVID-19) Pandemic and Influenza
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		SUGGESTED READINGS
		REFERENCES
Chapter (143)
	143 - Monkeypox Attack
		DESCRIPTION OF EVENTS
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (144)
	144 - Hantavirus Pulmonary Syndrome Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (145)
	145 - Henipavirus Attack: Hendra and Nipah Viruses
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		Pitfalls
		ACKNOWLEDGMENT
		REFERENCES
Chapter (146)
	146 - SARS-CoV (COVID-19 and SARS)
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (147)
	147 - Staphylococcal Enterotoxin B Attack
		HISTORY
		ETIOLOGY AND PATHOPHYSIOLOGY
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		SYMPTOMS
		DIAGNOSIS
		MANAGEMENT
		UNIQUE CONSIDERATIONS
		 PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (148)
	148 - Clostridium botulinum Toxin (Botulism) Attack
		 DESCRIPTION OF EVENT
		 PREINCIDENT ACTIONS
		 POSTINCIDENT ACTIONS
		 MEDwICAL TREATMENT OF CASUALTIES
		 UNIQUE CONSIDERATIONS
		 PITFALLS
		REFERENCES
Chapter (149)
	149 - Clostridium perfringens Toxin (Epsilon Toxin) Attack
		 DESCRIPTION OF EVENT
		 PREINCIDENT ACTIONS
		 POSTINCIDENT ACTIONS
		 MEDICAL TREATMENT OF CASUALTIES
		 UNIQUE CONSIDERATIONS
		 PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (150)
	150 - Marine Toxin Attack
		 DESCRIPTION OF EVENT
		 PREINCIDENT ACTIONS
		 POSTINCIDENT ACTIONS
		 MEDICAL TREATMENTS OF CASUALTIES
			Saxitoxin
				Clinical Features
					General
					Cardiovascular
					Respiratory
					Gastrointestinal
					Identification
			Conotoxin
				Clinical Features
					General
					Cardiovascular
					Respiratory
					Gastrointestinal
					Identification
			Tetrodotoxin
				Clinical Features
					General
					Neurological
					Cardiovascular
					Respiratory
					Gastrointestinal
					Other
			Palytoxin
				Clinical Features
					General
					Cardiovascular
					Respiratory
					Gastrointestinal
					Other
		 UNIQUE CONSIDERATION
		 PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (151)
	151 - T-2 Toxin (Trichothecene Mycotoxins) Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (152)
	152 - Ricin Toxin from Ricinus communis (Castor Bean) Attack
		DESCRIPTION OF EVENT
			Ingestion
			Inhalation
			Parenteral
			Dermal
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
			Treating Ingestion Exposure
			Treating Inhalation Exposure
			Treating Parenteral Exposure
			Treating Dermal Exposure
			Asymptomatic Patients
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (153)
	153 - Aflatoxin (Aspergillus Species) Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (154)
	154 - Coccidioides immitis (Coccidioidomycosis) Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (155)
	155 - Histoplasma capsulatum (Histoplasmosis) Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (156)
	156 - Cryptosporidium parvum (Cryptosporidiosis) Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (157)
	157 - Explosions: Fireworks
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		SUGGESTED READING
		REFERENCES
Chapter (158)
	158 - Rocket-Propelled Grenade Attack
		DESCRIPTION OF EVENTS
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (159)
	159 - Conventional Explosion at a Hospital
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (160)
	160 - Conventional Explosion in a High-Rise Building
		DESCRIPTION OF EVENT
			Intentional Explosions
			Health Impacts
				Blast Injuries
				Crush Injuries
				Burn Injuries
		PREINCIDENT ACTIONS
			Prevention
			Mitigation
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (161)
	161 - Conventional Explosion at a Nuclear Power Plant
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		SUGGESTED READING
		REFERENCES
Chapter (162)
	162 - Tunnel Explosion
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENTS
		REFERENCES
Chapter (163)
	163 - Liquefied Natural Gas Explosion
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (164)
	164 - Liquefied Natural Gas Tanker Truck Explosion
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (165)
	165 - Petroleum Distillation and Processing Facility Explosion
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (166)
	166 - Introduction to Fires and Burns
		INTRODUCTION
		PREPARATION
		PREHOSPITAL MANAGEMENT
			Initial Actions and Primary Survey
			Prehospital Treatment
		EMERGENCY DEPARTMENT MANAGEMENT
		 UNIQUE CONSIDERATIONS
			Direct Inhalation Injury
			Cyanide and Carbon Monoxide (CO)
			Fluid Resuscitation in the Burned Patient
		 PITFALLS
			Estimating Burn Depth and Size
			Incident Management
		ACKNOWLEDGMENT
		REFERENCES
Chapter (167)
	167 - Structure Fires
		DESCRIPTION OF EVENT
		HISTORIC FIRES
		PREINCIDENT CONSIDERATIONS
			Mitigation
			Medical Treatment of Casualties
		POSTINCIDENT ACTIONS
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (168)
	168 - Wildland Fires and the Wildland-Urban Interface
		 DESCRIPTION OF EVENT
		 PREINCIDENT ACTIONS
		 POSTINCIDENT ACTIONS
		 MEDICAL TREATMENT OF CASUALTIES
		 UNIQUE CONSIDERATIONS
		 PITFALLS
		ACKNOWLEDGMENT
		Suggested Readings
		REFERENCES
Chapter (169)
	169 - Tunnel Fire
		 DESCRIPTION OF EVENT
		 PREINCIDENT ACTIONS
		 POSTINCIDENT ACTIONS
		 MEDICAL TREATMENT OF CASUALTIES
		 UNIQUE CONSIDERATIONS
		 PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (170)
	170 - Gunshot Attack: Mass Casualties
		 DESCRIPTION OF EVENT
		 PREINCIDENT ACTIONS
		 POSTINCIDENT ACTIONS
		CLINICAL PRESENTATION
		 MEDICAL TREATMENT OF CASUALTIES
		 UNIQUE CONSIDERATIONS
		 PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (171)
	171 - Sniper Attack
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		CLINICAL PRESENTATION
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (172)
	172 - Introduction to Structural Collapse (Crush Injury and Crush Syndrome)
		DESCRIPTION OF EVENT
		PREINCIDENT ACTION
		POSTINCIDENT ACTION
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (173)
	173 - Train Derailment
		DESCRIPTION OF EVENTS
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTION
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (174)
	174 - Subway Derailment
		INTRODUCTION
		PREINCIDENT CONSIDERATIONS
		POSTINCIDENT CONSIDERATIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		Suggested ReadingS
		REFERENCES
Chapter (175)
	175 - Bus Accidents
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (176)
	176 - Aircraft Crash Preparedness and Response
		DESCRIPTION OF EVENT
		PREINCIDENT CONSIDERATIONS
		POSTINCIDENT CONSIDERATIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (177)
	177 - Air Show Disaster
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (178)
	178 - Asteroid Impacts, Orbital Debris, and Spacecraft Reentry Disasters
		DESCRIPTION OF EVENT: ORBITAL DEBRIS
		PREINCIDENT ACTIONS: ORBITAL DEBRIS RISK MITIGATION
		POSTINCIDENT ACTIONS: ORBITAL DEBRIS DISASTER MANAGEMENT
		DESCRIPTION OF EVENT: ASTEROIDS AND METEOROIDS
		PREINCIDENT ACTIONS: MONITORING AND MITIGATION OF NEOS
		POSTINCIDENT ACTIONS: IMPACTOR DAMAGE
			Objects Less Than 300 m in Diameter
			Objects Approximately 1 km to 2 km in Diameter
			Objects More Than 10 km in Diameter
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (179)
	179 - Building Collapse
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (180)
	180 - Bridge Collapse
		 DESCRIPTION OF EVENTS
		 PREINCIDENT ACTIONS
		 POSTINCIDENT ACTIONS
		 MEDICAL TREATMENT OF CASUALTIES
		 UNIQUE CONSIDERATIONS
		 PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (181)
	181 - Human Stampede
		 DESCRIPTION OF EVENT
		 PREINCIDENT ACTIONS
			Human Stampede Preventive and Mitigation Steps
				Engagement of Leadership and Officials
				Venue Preparation
				Crowd Capacity and Crowd Density Control
				Human Stampede Public Awareness
			Human Stampede Preparedness Steps
				Formulating a Mass Gathering Committee
				Conducting Human Stampede Risk Management
				Writing a Human Stampede Incident-Specific Emergency Response Plan
				Establishing Command and Control Center
				Constructing Human Stampede Incident–Specific Training
		 POSTINCIDENT ACTIONS
		 MEDICAL TREATMENT OF CASUALTIES
		 UNIQUE CONSIDERATIONS
		 PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (182)
	182 - Mining Accident
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (183)
	183 - Submarine or Surface Vessel Accident
		Preincident Actions
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (184)
	184 - Aircraft Hijacking
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (185)
	185 - Aircraft Crash Into a High-Rise Building
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
			Blunt Trauma
			Asthma Exacerbation
			Inhalation Injuries
			Thermal Burns
			Ocular Injuries
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (186)
	186 - Maritime Disasters
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (187)
	187 - Cruise Ship Infectious Disease Outbreak
		DESCRIPTION OF EVENT
			Gastrointestinal Illness
			Respiratory Illness
			Other Diseases
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (188)
	188 - Massive Power System Failures
		DESCRIPTION OF EVENT
			Natural Hazards
			Terrorism and Military Actions
			Electromagnetic pulse
		PREINCIDENT ACTIONS
			Preparation for an Unscheduled Power Outage
			Protective Measures Against an Electromagnetic Pulse Device or Carrington Event
			Continuity of Critical Services
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
			Risks to Worker Safety and Health
			Risks to Hospital Patients
		UNIQUE CONSIDERATIONS
		PITFALLS
		Suggested Reading
		REFERENCES
Chapter (189)
	189 - Hospital Power Outages
		 DESCRIPTION OF EVENT
		 PREINCIDENT ACTIONS
		 POSTINCIDENT ACTIONS
		 MEDICAL TREATMENT OF CASUALTIES
		 UNIQUE CONSIDERATIONS
		 PITFALLS
		REFERENCES
Chapter (190)
	190 - Intentional Contamination of Water Supplies
		 DESCRIPTION OF EVENT
			Spectrum of Disease Resulting from Intentional Water Contamination
		 PREINCIDENT ACTIONS
		 POSTINCIDENT ACTIONS
		 MEDICAL TREATMENT OF CASUALTIES
		 UNIQUE CONSIDERATIONS
		 PITFALLS
		ACKNOWLEDGMENT
		REFERENCES
Chapter (191)
	191 - Food Supply Contamination
		DESCRIPTION OF EVENT
			Typical Food Poisoning
			Intentional Attack on the Food Supply
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (192)
	192 - Ecological Terrorism*
		DESCRIPTION OF EVENT
		PREINCIDENT ACTIONS
		POSTINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		SUMMARY
		REFERENCES
Chapter (193)
	193 - Computer and Electronic Terrorism and Emergency Medical Services
		DESCRIPTION OF EVENT
			Viruses/Worms
			Examples of Destructive Viruses/Worms
		METHODS OF ATTACK
			Confidentiality
			Integrity
			Access
				Ransomware
				Denial-of-Service (DoS) Attack
				How Can Antivirus Software Help Against a DoS Attack?
		PREINCIDENT ACTIONS
		PREINCIDENT ACTIONS
		MEDICAL TREATMENT OF CASUALTIES
		UNIQUE CONSIDERATIONS
		PITFALLS
		REFERENCES
Chapter (194)
	194 - Disasters in Space Travel: From Earth to Orbit, and Beyond
		DISASTER POTENTIAL AS A FUNCTION OF LOCATION AND ENERGETICS
		PREFLIGHT TRAINING AND VEHICLE GROUND PROCESSING
		LAUNCH (FROM EARTH OR ANOTHER PLANETARY BODY)
		ON ORBIT/MICROGRAVITY
		BEYOND EARTH ORBIT/PLANETARY EXPLORATION
		ATMOSPHERIC REENTRY
		HIGH-RISK SPACE DISASTERS: POTENTIAL CONSEQUENCES AND MITIGATIONS
		CONSIDERATIONS IN RESPONSE TO A SPACE DISASTER
		CONCLUSION
		ACKNOWLEDGEMENTS
		REFERENCES
Index
	Index