The initial approach to a chemical and nuclear terrorism event

Preparing for chemical or radiologic terrorism requires awareness of the risk, commitment of resources to adequately prepare, and appropriate training that has been reinforced by well-designed drills [28]. Chemicals such as organophosphate insecticides (the poor man's nerve agents) are readily available in agricultural, urban, suburban, and industrial areas, often with little supervision or security. These chemicals might present a greater threat than do nerve agents in terms of resource depletion from a preparedness perspective. Radiation terrorism is worrisome because of the availability of radioactive materials, complex pattern of injury, lack of familiarity with such health hazards, and inconsistency of training. Every hospital specialty service will be in involved in the treatment of patients who have been exposed to radiation. It is essential to have a nuclear health physicist as a member of the emergency team and to be familiar with specialist resources such as the REAC/TS.