title: The comprehensive medical preparedness in chemical emergencies: 'the chain of chemical survival'.
abstract: Medical management of victims of chemical incidents includes supportive therapy, decontamination and antidote administration. Chemical weapons of mass destruction are available to many countries and are a possible alternative to conventional weapons for terrorist groups. During the last 5 years, some Italian institutions have made big efforts to establish a national system of antidote stockpiling and distribution. Little or no efforts have been addressed to other aspects of the medical management of patients exposed to chemical agents, such as decontamination, personal protective equipment, and specific supportive therapy. Although antidotes are indispensable instruments for some poisonings, as nerve agent and botulin intoxication, antidote stockpiling cannot be considered the only objective of a comprehensive medical preparedness for chemical emergencies. This paper addresses the medical priority when approaching victims of chemical emergencies. The priority actually is to establish a chain of chemical survival in which antidote administration is one out of several links.
authors.affiliation: Department of Clinical toxicology--Poison Centre and Emergency Department, Catholic University School of Medicine, Rome, Italy. a.barelli@tox.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Barelli
authors.forename: Immacolata
authors.initials: I
authors.lastname: Biondi
authors.forename: Maurizio
authors.initials: M
authors.lastname: Soave
authors.forename: Chiara
authors.initials: C
authors.lastname: Tafani
authors.forename: Francesca
authors.initials: F
authors.lastname: Bononi
mesh_terms: D000931:Antidotes / Q000600:supply & distribution; D051337:Chemical Terrorism; D003666:Decontamination; D004189:Disaster Planning; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D004638:Emergency Treatment; D015386:Hazardous Substances / Q000506:poisoning*; D006801:Humans; D007558:Italy; D017751:Safety Management
chemical_list: D000931:Antidotes; D015386:Hazardous Substances