title: Operation Castle Cascade: managing multiple casualties from a simulated chemical weapons attack.
abstract: In the wake of the recent terrorist attack on the United States, there is an ever-increasing need for the defense against weapons of mass destruction. The use of explosive devices in combination with chemical agents could result in a community disaster with multiple traumatic and medical injuries. Military medical personnel may be the first called upon due to their unique training and equipment. Operation Castle Cascade was a large-scale exercise on a military instillation involving the apprehension of hostages and detonation of an explosive device containing dimethyl sulfate. We will provide details on the medical management of 50 patients with simulated chemical and traumatic injuries. Issues relating to on-site chemical identification, triage, decontamination, treatment, casualty collection, and transportation of casualties are addressed in this article.
authors.affiliation: Department of Emergency Medicine, Madigan Army Medical Center, Tacoma, WA 98431, USA.
authors.forename: David
authors.initials: D
authors.lastname: Siegel
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Younggren
authors.forename: Brian
authors.initials: B
authors.lastname: Ness
authors.forename: Valerie
authors.initials: V
authors.lastname: Kvool
mesh_terms: D002618:Chemical Warfare; D002619:Chemical Warfare Agents / Q000506:poisoning*; D003666:Decontamination / Q000379:methods*; D004189:Disaster Planning; D006801:Humans; D008889:Military Personnel / Q000193:education*; D013463:Sulfuric Acid Esters / Q000506:poisoning*; D014218:Triage; D014481:United States
chemical_list: D002619:Chemical Warfare Agents; D013463:Sulfuric Acid Esters; C007482:dimethyl sulfate