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MDA Response to a Mass Casualty Toxicological Accident
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MDA Response to a Mass Casualty Toxicological Accident

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Chaim RAFALOWSKI …

Chaim RAFALOWSKI

Magen David Adom, Israel

Published in Education , Health & Medicine
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  • 1. Chaim RafalowskiDisaster Management Coordinator Magen David Adom haimr@mda.org.il MDA Mass Toxicological Response
  • 2. •Area 8,522 sq miles•Population: About 7.6 Million.•92% Live In Urban Centers•National Health Insurance Low (1995)•27 General Hospitals , 26 With ED.•6 Level І Trauma Centers 290 Miles•General Hospital Beds :14,500(20,000) MDA Mass Toxicological Response
  • 3. The Israeli National E.M.S SystemPre - hospital careNational Blood ServicesEmergency Medicine trainingNational Red Cross SocietyCivil Auxiliary Service to the I.D.F (Israel Defense Forces ) MDA Mass Toxicological Response
  • 4.  1,545 Paid staff 11,450 Volunteers 1 National Operations and Medical Control Center 11 Regional Dispatch Centers 127 Dispatch posts 76 A.L.S. Ambulances (199) 125 B.L.S / I.L.S Ambulances (492) 167 B.L.S / I.L.S Ambulances in remote locations 121 First Responders motorcycles 25 Multi Casualty Response Vehicle (M.C.R.V) 2 Air Med Unit MDA Mass Toxicological Response
  • 5.  Mass toxicological event = volatile agent Patients will be exposed to vapors Most of the volatile agents are irritant to mucus membranes Most important medical treatment – end of exposure Concentration of contaminant can be assessed based on the victims signs and symptoms MDA Mass Toxicological Response
  • 6.  Most of the victims will attempt to run away. Signs and symptoms allow “clinical detection” Organophosphate intoxication can be “clinically defined” MDA Mass Toxicological Response
  • 7.  Declaration of toxicological MCI (dispatch / incident commander)
  • 8. •Multi Casualty Incident Toxicological MCI•Victims from the same area anddifferent age groups EMT•Leading symptoms:- Eye irritation- Upper respiratory tract irritation NO YES•Little trauma• Secretion from mucous Clinical Assessment for membranes Signs and Symptoms• In addition:• Ocular pain / blurred vision Of Organophosphate• Shortness of breath• Vomiting/nausea/diarrhea Physician• Tremor/ convulsions Paramedic•More than 1 victim with CNS NO YES involvement
  • 9. Wherever victims show signs of live – PPE Level Can be reduced in order to allow short entrance to rescue victims: Powered Air Purifying Respirator (PAPR) Industrial Chemical + War- fare agents resistant : garment, gloves, booties ABEK2P3 filters MDA Mass Toxicological Response
  • 10.  Non ambulant patients – Disrobed on the scene Wet decontamination – if necessary at hospital’s gate Patients transported by personnel using PPE Follow up on working time of personnel MDA Mass Toxicological Response
  • 11.  PPE in all the ambulances Auto injectors for organophosphate intoxication and Cyanide kit in all ambulances Joint procedure Check lists Training to all team members as part of “normal training” Joint training and exercises MDA Mass Toxicological Response
  • 12. Disaster Management dept Organo Phosphate