title: Single-Breath-Count Test: an important adjunct in the triaging of patients in a mass-casualty incident due to botulism.
abstract: Clostridium botulinum toxins, the most poisonous substance known to humankind, are considered to be a [US] Centers for Disease Control and Prevention Category A bioterrorist agent. Despite this concern, little has been published with regard to the tactical aspects of triaging a mass-casualty event involving botulism victims arriving at an emergency department. Because neuromuscular-ventilatory failure is a principal reason for botulism's early morbidity and mortality, using a quick and sensitive test to evaluate this possibility is imperative. The purpose of this article is to propose the adoption of the Single-Breath-Count Test (SBCT). The ease and validity of the use of the SBCT in evaluating complications associated with various neuromuscular disorders make it an attractive adjunct for triage during a mass-casualty incident due to botulism. While education, immune globulin, antitoxin, and invasive airway techniques are well-recognized steps in treating botulism, incorporating a time-honored technique such as the SBCT, will be an important addition to the triage process.
authors.affiliation: College of Medicine, Department of Public Health, University of Toledo, Toledo, Ohio, USA. Paul.Rega@utoledo.edu
authors.forename: Paul P
authors.initials: PP
authors.lastname: Rega
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Bork
authors.forename: Kelly
authors.initials: K
authors.lastname: Burkholder-Allen
authors.forename: Michael S
authors.initials: MS
authors.lastname: Bisesi
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Gold
mesh_terms: D001906:Botulism / Q000503:physiopathology / Q000628:therapy*; D001944:Breath Tests / Q000379:methods; D006801:Humans; D054527:Mass Casualty Incidents; D008403:Mass Screening / Q000458:organization & administration; D012129:Respiratory Function Tests; D014218:Triage / Q000379:methods*