{"product_id":"hazardous-materials-medicine-isbn-9781119663928","title":"Hazardous Materials Medicine","description":"\u003cb\u003eHazardous Materials Medicine\u003c\/b\u003e \u003cp\u003e\u003cb\u003eComplete background on chemical exposures that create illnesses, including assessment, diagnosis, and treatment protocols\u003c\/b\u003e \u003c\/p\u003e\u003cp\u003eWritten on a level that can be understood by field practitioners and\/or first responders, \u003ci\u003eHazardous Materials Medicine: Treating the Chemically Injured Patient\u003c\/i\u003e provides an in-depth understanding of how to diagnose and treat toxic chemical exposures in a prehospital or emergency department setting. \u003c\/p\u003e\u003cp\u003eThe protocols used in this book conform to the guidelines set forth in the NFPA 470 standard, and the medical guidance developed by FEMA for Type I, II \u0026amp; III Deployable Hazmat Response  Teams. The hazardous materials medical protocols in this book have been fully vetted by three poison control toxicologists, multiple emergency physicians, and paramedics. \u003c\/p\u003e\u003cp\u003e\u003ci\u003eHazardous Materials Medicine: Treating the Chemically Injured Patient\u003c\/i\u003e covers sample topics  such as: \u003c\/p\u003e\u003cul\u003e\n\u003cli\u003eScene assessment, to help determine the cause of the exposure, and exposure assessment, to determine what physiologic systems are affected\u003c\/li\u003e \u003cli\u003eToxic syndromes\/toxidromes to appropriately treat the exposed patient, including corrosive and irritant, asphyxiant, cholinergic, and hydrocarbon and derivative toxidromes\u003c\/li\u003e \u003cli\u003eScience behind a chemical exposure, to allow for a complete understanding of both the chemistry and physiology of what is occurring because of the exposure\u003c\/li\u003e \u003cli\u003eInterfacing between the on-scene response team and the hospital, to ensure consistency and continuity of care from the field into the hospital\u003c\/li\u003e\n\u003c\/ul\u003e \u003cp\u003eEnabling public safety and health professionals to administer effective care while retaining their own personal safety, \u003ci\u003eHazardous Materials Medicine: Treating the Chemically Injured Patient\u003c\/i\u003e is  a must-have resource for emergency medical technicians, paramedics, hazmat technicians, and emergency physicians and nurses working in high-risk field situations with chemically injured patients. \u003c\/p\u003e\u003cp\u003eAuthor Biographies and Acknowledgments xvii\u003c\/p\u003e \u003cp\u003eForeword xxi\u003c\/p\u003e \u003cp\u003ePreface xxiii\u003c\/p\u003e \u003cp\u003e\u003cb\u003e1 HazMat Medicine and the HazMat Medic 1\u003c\/b\u003e\u003c\/p\u003e \u003cp\u003eIntroduction 1\u003c\/p\u003e \u003cp\u003eCase Study – Sarin Attack in the Tokyo Subway 3\u003c\/p\u003e \u003cp\u003eHistory 4\u003c\/p\u003e \u003cp\u003eEvents 7\u003c\/p\u003e \u003cp\u003eSituational Assessment Continuum 8\u003c\/p\u003e \u003cp\u003ePatient Presentation 9\u003c\/p\u003e \u003cp\u003eEvent Conditions (Scene Evaluation and Size- up) 9\u003c\/p\u003e \u003cp\u003eScene Assessment (Hazard Identification) 9\u003c\/p\u003e \u003cp\u003eSummary 10\u003c\/p\u003e \u003cp\u003e\u003cb\u003e2 Exposures 11\u003c\/b\u003e\u003c\/p\u003e \u003cp\u003eIntroduction 11\u003c\/p\u003e \u003cp\u003eCase Study – Derailment in South Carolina, a No- Notice Evacuation Event 11\u003c\/p\u003e \u003cp\u003ePatient Presentation 12\u003c\/p\u003e \u003cp\u003eThe Toxidrome Exam 14\u003c\/p\u003e \u003cp\u003eRespiratory System 14\u003c\/p\u003e \u003cp\u003eOverview 14\u003c\/p\u003e \u003cp\u003eRespiratory System Anatomy and Physiology 16\u003c\/p\u003e \u003cp\u003eExternal Respiratory System 16\u003c\/p\u003e \u003cp\u003eInternal Respiratory System 19\u003c\/p\u003e \u003cp\u003eChemical and Physical Form of Respiratory Exposure 22\u003c\/p\u003e \u003cp\u003eGases, Vapors, and Fumes 22\u003c\/p\u003e \u003cp\u003eSolid Particles 22\u003c\/p\u003e \u003cp\u003eAerosols\/Mists 23\u003c\/p\u003e \u003cp\u003eConcentration and Duration 23\u003c\/p\u003e \u003cp\u003eTypes of Injuries Resulting from Chemical Exposure 23\u003c\/p\u003e \u003cp\u003eChemically Induced Bronchiole Constriction 23\u003c\/p\u003e \u003cp\u003eAtelectasis and Disruption of Surfactant 24\u003c\/p\u003e \u003cp\u003eChemically Induced Pulmonary Edema (Noncardiogenic Pulmonary Edema) 25\u003c\/p\u003e \u003cp\u003eChemical Sensitivity 26\u003c\/p\u003e \u003cp\u003eTypes of Chemicals that Injure the Respiratory System 26\u003c\/p\u003e \u003cp\u003eAsphyxiants 26\u003c\/p\u003e \u003cp\u003eSimple Asphyxiants 26\u003c\/p\u003e \u003cp\u003eChemical Asphyxiants 27\u003c\/p\u003e \u003cp\u003eIrritants (Corrosives) 27\u003c\/p\u003e \u003cp\u003eRespiratory System Injury Recognition (Assessment) and Diagnostics 27\u003c\/p\u003e \u003cp\u003ePulse Oximetry 27\u003c\/p\u003e \u003cp\u003eSpecific Oximetry Considerations When Assessing HazMat Exposures 28\u003c\/p\u003e \u003cp\u003eCapnography 29\u003c\/p\u003e \u003cp\u003eMasimo™\/Rainbow Technology 32\u003c\/p\u003e \u003cp\u003eCardiovascular Abnormalities Related to Exposure 33\u003c\/p\u003e \u003cp\u003eDescription 33\u003c\/p\u003e \u003cp\u003eVasogenic Shock 33\u003c\/p\u003e \u003cp\u003eHypovolemic Shock 33\u003c\/p\u003e \u003cp\u003eHeart Failure 34\u003c\/p\u003e \u003cp\u003eNeurological Abnormalities Related to Exposure 34\u003c\/p\u003e \u003cp\u003eCentral Nervous System (CNS) Exposure 34\u003c\/p\u003e \u003cp\u003eCNS Depression 34\u003c\/p\u003e \u003cp\u003eCNS Stimulation 35\u003c\/p\u003e \u003cp\u003eParasympathetic Nervous System 35\u003c\/p\u003e \u003cp\u003eParasympathetic Stimulation 35\u003c\/p\u003e \u003cp\u003eParasympathetic Depression 36\u003c\/p\u003e \u003cp\u003eIntegumentary System (Skin) 36\u003c\/p\u003e \u003cp\u003eSkin Anatomy and Physiology 36\u003c\/p\u003e \u003cp\u003eStructure 37\u003c\/p\u003e \u003cp\u003eFunction 38\u003c\/p\u003e \u003cp\u003eTypes of Chemical Injuries to the Skin 38\u003c\/p\u003e \u003cp\u003eChemical- Related Irritation 38\u003c\/p\u003e \u003cp\u003eChemical Skin Burns 39\u003c\/p\u003e \u003cp\u003eOcular Exposure and Injury 41\u003c\/p\u003e \u003cp\u003eEye Anatomy and Physiology 42\u003c\/p\u003e \u003cp\u003eThe Globe 42\u003c\/p\u003e \u003cp\u003eThe Ocular Surface 42\u003c\/p\u003e \u003cp\u003eAssessment of Eye Injury After Exposure 43\u003c\/p\u003e \u003cp\u003eNormal Eye Assessment 44\u003c\/p\u003e \u003cp\u003eChemical Eye Burns 45\u003c\/p\u003e \u003cp\u003eSurface Toxins 46\u003c\/p\u003e \u003cp\u003eTreatment of Eye Exposure 48\u003c\/p\u003e \u003cp\u003eSpecialized Eye Equipment 49\u003c\/p\u003e \u003cp\u003eThe Morgan Lens 49\u003c\/p\u003e \u003cp\u003eNasal Cannula for Eye Irrigation 51\u003c\/p\u003e \u003cp\u003eGastrointestinal Exposure to Toxic Materials 51\u003c\/p\u003e \u003cp\u003eAbsorbing Chemicals and Nutrients 51\u003c\/p\u003e \u003cp\u003eLiver 51\u003c\/p\u003e \u003cp\u003ePhase I and II Detoxification 52\u003c\/p\u003e \u003cp\u003eEnvironmental Exposures 53\u003c\/p\u003e \u003cp\u003eThe Hot Environment – Hydration and Hyperthermia 53\u003c\/p\u003e \u003cp\u003ePhysiology 54\u003c\/p\u003e \u003cp\u003eAbsorption of Water 55\u003c\/p\u003e \u003cp\u003eAcclimation 57\u003c\/p\u003e \u003cp\u003eMetabolic Thermoregulation 58\u003c\/p\u003e \u003cp\u003eDetermining Severity of Heat 60\u003c\/p\u003e \u003cp\u003eEffects of Heat in an Encapsulated Suit 60\u003c\/p\u003e \u003cp\u003eFactors Contributing to Heat Emergencies\/Injuries 62\u003c\/p\u003e \u003cp\u003eTreatment 63\u003c\/p\u003e \u003cp\u003eThe Cold Environment 64\u003c\/p\u003e \u003cp\u003eExposure to Liquefied Gas and Cryogenics 64\u003c\/p\u003e \u003cp\u003eFrostbite Injuries 65\u003c\/p\u003e \u003cp\u003eAssessment 66\u003c\/p\u003e \u003cp\u003eTreatment 67\u003c\/p\u003e \u003cp\u003eSummary 67\u003c\/p\u003e \u003cp\u003e\u003cb\u003e3 Toxidromes 69\u003c\/b\u003e\u003c\/p\u003e \u003cp\u003eIntroduction 69\u003c\/p\u003e \u003cp\u003eCase Study – Silver Cyanide Exposure 69\u003c\/p\u003e \u003cp\u003eAssessment Capabilities 70\u003c\/p\u003e \u003cp\u003eBlood Pressure 70\u003c\/p\u003e \u003cp\u003eIncrease in Blood Pressure 71\u003c\/p\u003e \u003cp\u003eDecrease in Blood Pressure 71\u003c\/p\u003e \u003cp\u003ePulse 72\u003c\/p\u003e \u003cp\u003eToxidromes 72\u003c\/p\u003e \u003cp\u003eCorrosives and Irritants Toxidromes 72\u003c\/p\u003e \u003cp\u003eChlorine (Cl 2) 72\u003c\/p\u003e \u003cp\u003eAgent Identification 72\u003c\/p\u003e \u003cp\u003eHistory 73\u003c\/p\u003e \u003cp\u003ePathophysiology 73\u003c\/p\u003e \u003cp\u003eSigns and Symptoms 73\u003c\/p\u003e \u003cp\u003eWhere Is Chlorine Found 74\u003c\/p\u003e \u003cp\u003eDecontamination 75\u003c\/p\u003e \u003cp\u003eEmergency Field Treatment 75\u003c\/p\u003e \u003cp\u003eBasic Life Support 75\u003c\/p\u003e \u003cp\u003eAdvanced Life Support 75\u003c\/p\u003e \u003cp\u003eAmmonia (NH 3) 76\u003c\/p\u003e \u003cp\u003eAgent Identification 76\u003c\/p\u003e \u003cp\u003eHistory 76\u003c\/p\u003e \u003cp\u003ePhysiology 76\u003c\/p\u003e \u003cp\u003eSigns and Symptoms 76\u003c\/p\u003e \u003cp\u003eWhere Is Ammonia Found 77\u003c\/p\u003e \u003cp\u003eDecontamination 77\u003c\/p\u003e \u003cp\u003eEmergency Field Treatment 77\u003c\/p\u003e \u003cp\u003eAssessment\/Treatment 77\u003c\/p\u003e \u003cp\u003eBasic Life Support 77\u003c\/p\u003e \u003cp\u003eAdvanced Life Support 77\u003c\/p\u003e \u003cp\u003ePhosgene, aka. Carbonyl Chloride 78\u003c\/p\u003e \u003cp\u003eAgent Identification 78\u003c\/p\u003e \u003cp\u003eHistory 78\u003c\/p\u003e \u003cp\u003ePhysiology, Signs, and Symptoms 78\u003c\/p\u003e \u003cp\u003eWhere Phosgene Is Found 78\u003c\/p\u003e \u003cp\u003eDecontamination 79\u003c\/p\u003e \u003cp\u003eEmergency Field Treatment (Chloramine, Ammonia, and Phosgene) 79\u003c\/p\u003e \u003cp\u003eBasic Life Support 79\u003c\/p\u003e \u003cp\u003eAdvanced Life Support 79\u003c\/p\u003e \u003cp\u003ePediatric Considerations (Chlorine, Chloramine, Ammonia, Phosgene) 80\u003c\/p\u003e \u003cp\u003eHydrofluoric Acid and Fluorine- Based Chemicals 80\u003c\/p\u003e \u003cp\u003eHistory 80\u003c\/p\u003e \u003cp\u003ePathophysiology 80\u003c\/p\u003e \u003cp\u003eSigns and Symptoms of Exposure 82\u003c\/p\u003e \u003cp\u003eWhere Hydrofluoric Acid Is Commonly Found 82\u003c\/p\u003e \u003cp\u003eDecontamination and Significant Danger to Rescuers 83\u003c\/p\u003e \u003cp\u003eTreatment 83\u003c\/p\u003e \u003cp\u003eEye Injury Treatment (Hydrofluoric Acid) 83\u003c\/p\u003e \u003cp\u003eSkin Burn Treatment (Hydrofluoric Acid) 84\u003c\/p\u003e \u003cp\u003eRespiratory Injury Treatment (Hydrofluoric Acid) 84\u003c\/p\u003e \u003cp\u003eSystemic Injury from Hydrofluoric Acid (Hypocalcemia) 85\u003c\/p\u003e \u003cp\u003ePhenol (Carbolic Acid) 85\u003c\/p\u003e \u003cp\u003eHistory 85\u003c\/p\u003e \u003cp\u003ePathophysiology, Signs, and Symptoms 86\u003c\/p\u003e \u003cp\u003eWhere Phenol Is Commonly Found 86\u003c\/p\u003e \u003cp\u003eField Treatment and Decontamination 87\u003c\/p\u003e \u003cp\u003eAssessment\/Treatment or Phenol 87\u003c\/p\u003e \u003cp\u003eLacrimatory Agent Exposure 87\u003c\/p\u003e \u003cp\u003eChemical Currently Being Used 88\u003c\/p\u003e \u003cp\u003eEffect 88\u003c\/p\u003e \u003cp\u003eTreatment 88\u003c\/p\u003e \u003cp\u003eAsphyxiant Toxidromes 89\u003c\/p\u003e \u003cp\u003eEffects of Hypoxia 90\u003c\/p\u003e \u003cp\u003eSimple Asphyxiants 92\u003c\/p\u003e \u003cp\u003eExperience; Death at McDonald’s: “Five Lousy Feet” 93\u003c\/p\u003e \u003cp\u003eAssessment\/Treatment for Simple Asphyxiants 93\u003c\/p\u003e \u003cp\u003eChemical Asphyxiants 93\u003c\/p\u003e \u003cp\u003eCarbon Monoxide Poisoning 93\u003c\/p\u003e \u003cp\u003eHistory 94\u003c\/p\u003e \u003cp\u003ePathophysiology 94\u003c\/p\u003e \u003cp\u003eConcerns 96\u003c\/p\u003e \u003cp\u003eSigns and Symptoms 97\u003c\/p\u003e \u003cp\u003eWhere Carbon Monoxide Is Typically Found 98\u003c\/p\u003e \u003cp\u003eDecontamination and Danger to Responders 98\u003c\/p\u003e \u003cp\u003eField Treatment 98\u003c\/p\u003e \u003cp\u003eCyanide Poisoning – Hydrogen Cyanide, Cyanide Salts, and Cyanide Containing Gases 99\u003c\/p\u003e \u003cp\u003eHistory 100\u003c\/p\u003e \u003cp\u003ePathophysiology 101\u003c\/p\u003e \u003cp\u003eSigns and Symptoms 102\u003c\/p\u003e \u003cp\u003eDefinitive Diagnosis 103\u003c\/p\u003e \u003cp\u003eWhere Cyanide Is Commonly Found 103\u003c\/p\u003e \u003cp\u003eDecontamination of Patients 104\u003c\/p\u003e \u003cp\u003eEmergency Medical Field Treatment 104\u003c\/p\u003e \u003cp\u003eCyanoKit – Hydroxocobalamin (Preferred Treatment for Cyanide Poisoning) 105\u003c\/p\u003e \u003cp\u003e(Lily or Pasadena) Nitrite- Based Cyanide Antidote Kit (Used for hydrogen sulfide or (Cyanide if the CyanoKit Is Not Available) 106\u003c\/p\u003e \u003cp\u003eHydrogen Sulfide Poisoning 106\u003c\/p\u003e \u003cp\u003eHistory 107\u003c\/p\u003e \u003cp\u003ePathophysiology 107\u003c\/p\u003e \u003cp\u003eSigns and Symptoms 108\u003c\/p\u003e \u003cp\u003eWhere Hydrogen Sulfide Is Commonly Found 108\u003c\/p\u003e \u003cp\u003eDecontamination and Significant Danger to Rescuers 108\u003c\/p\u003e \u003cp\u003eField Treatment 108\u003c\/p\u003e \u003cp\u003eDefinitive Treatment and Follow- up Care 109\u003c\/p\u003e \u003cp\u003eNitrites, Nitrates, Nitrobenzene Poisoning 109\u003c\/p\u003e \u003cp\u003eHistory 109\u003c\/p\u003e \u003cp\u003ePathophysiology 110\u003c\/p\u003e \u003cp\u003eSigns and Symptoms 111\u003c\/p\u003e \u003cp\u003eWhere Are Nitrogen Compounds Found 111\u003c\/p\u003e \u003cp\u003eField Treatment 112\u003c\/p\u003e \u003cp\u003eCholinergic Toxidrome 113\u003c\/p\u003e \u003cp\u003eOrganophosphate Insecticide Poisoning 113\u003c\/p\u003e \u003cp\u003eExperience: Novichok Nerve Agent Used Against Russian Dissident Has Dark History 114\u003c\/p\u003e \u003cp\u003eExperience: Tokyo Subway, Site of an Attack Using Sarin Nerve Agent 115\u003c\/p\u003e \u003cp\u003ePathophysiology 115\u003c\/p\u003e \u003cp\u003eSigns and Symptoms 116\u003c\/p\u003e \u003cp\u003eLocation of Organophosphate Insecticides 117\u003c\/p\u003e \u003cp\u003eDecontamination and Significant Danger to Rescuers 117\u003c\/p\u003e \u003cp\u003eTreatment 118\u003c\/p\u003e \u003cp\u003eExperience: Malathion Overdose Treated Without Protopam 119\u003c\/p\u003e \u003cp\u003eTreatment 119\u003c\/p\u003e \u003cp\u003eCarbamate Poisoning 121\u003c\/p\u003e \u003cp\u003eTreatment 121\u003c\/p\u003e \u003cp\u003eHydrocarbons and Derivatives Toxidrome 122\u003c\/p\u003e \u003cp\u003eHydrocarbon Toxicity 122\u003c\/p\u003e \u003cp\u003ePathophysiology 123\u003c\/p\u003e \u003cp\u003eCardiac Effects 124\u003c\/p\u003e \u003cp\u003eCNS Effects 124\u003c\/p\u003e \u003cp\u003eEmergency Medical Care 124\u003c\/p\u003e \u003cp\u003eSigns and Symptoms 124\u003c\/p\u003e \u003cp\u003eTreatment 125\u003c\/p\u003e \u003cp\u003eToxic Alcohols 127\u003c\/p\u003e \u003cp\u003eTreatment 127\u003c\/p\u003e \u003cp\u003eEtiological Toxidrome 127\u003c\/p\u003e \u003cp\u003eOverview 127\u003c\/p\u003e \u003cp\u003eVancomycin- Resistant Enterococci (VRE) 130\u003c\/p\u003e \u003cp\u003eSymptoms 130\u003c\/p\u003e \u003cp\u003eDiagnosis 130\u003c\/p\u003e \u003cp\u003eTreatment 130\u003c\/p\u003e \u003cp\u003eMethicillin- Resistant Staphylococcus aureus (MRSA) 130\u003c\/p\u003e \u003cp\u003ePathophysiology 131\u003c\/p\u003e \u003cp\u003eSigns and symptoms 131\u003c\/p\u003e \u003cp\u003eTreatment 131\u003cbr\u003e \u003ci\u003eClostridium Difficile (C. Difficile) 131\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eOverview 131\u003c\/p\u003e \u003cp\u003eSymptoms 132\u003c\/p\u003e \u003cp\u003eOther Risk Factors 132\u003c\/p\u003e \u003cp\u003eComplications from C. Difficile Include 132\u003c\/p\u003e \u003cp\u003ePrevention 132\u003c\/p\u003e \u003cp\u003eNecrotizing Fasciitis 133\u003c\/p\u003e \u003cp\u003eOverview 133\u003c\/p\u003e \u003cp\u003eSymptoms 133\u003c\/p\u003e \u003cp\u003eCause 133\u003c\/p\u003e \u003cp\u003eTreatment 133\u003c\/p\u003e \u003cp\u003eMeans of Entry 133\u003c\/p\u003e \u003cp\u003eVirulence 134\u003c\/p\u003e \u003cp\u003eExposure 134\u003c\/p\u003e \u003cp\u003eRadiological Toxidrome 135\u003c\/p\u003e \u003cp\u003eOverview 135\u003c\/p\u003e \u003cp\u003eTypes of Radiation 136\u003c\/p\u003e \u003cp\u003eAlpha Particles 136\u003c\/p\u003e \u003cp\u003eBeta Particles 136\u003c\/p\u003e \u003cp\u003eGamma Rays 137\u003c\/p\u003e \u003cp\u003eNeutrons 137\u003c\/p\u003e \u003cp\u003eX- Rays 137\u003c\/p\u003e \u003cp\u003eMeasuring Radioactivity 137\u003c\/p\u003e \u003cp\u003ePrinciples of Protection 139\u003c\/p\u003e \u003cp\u003eLocation of Radiation and Common Sites for Accidents 140\u003c\/p\u003e \u003cp\u003eTypes of Injuries 140\u003c\/p\u003e \u003cp\u003eRescue and Emergency Treatment 142\u003c\/p\u003e \u003cp\u003eTreatment 143\u003c\/p\u003e \u003cp\u003eAssociated Toxic Conditions 144\u003c\/p\u003e \u003cp\u003eClosed Space Fires 144\u003c\/p\u003e \u003cp\u003eHistory 144\u003c\/p\u003e \u003cp\u003eFire Toxicology 145\u003c\/p\u003e \u003cp\u003eDanger to Firefighters 147\u003c\/p\u003e \u003cp\u003eTreatment 147\u003c\/p\u003e \u003cp\u003eWheezing Secondary to Toxic Inhalation 149\u003c\/p\u003e \u003cp\u003eOverview 149\u003c\/p\u003e \u003cp\u003eTachycardia Secondary to Chemical Exposure 150\u003c\/p\u003e \u003cp\u003eHypotension Caused by Exposure 151\u003c\/p\u003e \u003cp\u003eSeizures Post- Exposure 151\u003c\/p\u003e \u003cp\u003eOpioids Overdose\/Exposure 152\u003c\/p\u003e \u003cp\u003eHistory 152\u003c\/p\u003e \u003cp\u003eOpium Alkaloids 152\u003c\/p\u003e \u003cp\u003eSynthetic Opioids 153\u003c\/p\u003e \u003cp\u003eSemisynthetic Opioids 153\u003c\/p\u003e \u003cp\u003eToday’s Fentanyl and Carfentanil 154\u003c\/p\u003e \u003cp\u003eSigns and Symptoms 154\u003c\/p\u003e \u003cp\u003eSummary 155\u003c\/p\u003e \u003cp\u003eReference 156\u003c\/p\u003e \u003cp\u003e\u003cb\u003e4 Event Conditions 157\u003c\/b\u003e\u003c\/p\u003e \u003cp\u003eIntroduction 157\u003c\/p\u003e \u003cp\u003eCase Study – Fertilizer Explosion in West Texas 158\u003c\/p\u003e \u003cp\u003eOperational Hazards 159\u003c\/p\u003e \u003cp\u003eDispatch Information 159\u003c\/p\u003e \u003cp\u003eScene Safety 160\u003c\/p\u003e \u003cp\u003eUpon Arrival – Stop, Look, and Listen 162\u003c\/p\u003e \u003cp\u003eWeather Conditions 162\u003c\/p\u003e \u003cp\u003eWitnesses Accounts 163\u003c\/p\u003e \u003cp\u003eRisk Awareness 163\u003c\/p\u003e \u003cp\u003eThe North American Emergency Response Guidebook (ERG) 173\u003c\/p\u003e \u003cp\u003eNIOSH Pocket Guide 175\u003c\/p\u003e \u003cp\u003eCameo 176\u003c\/p\u003e \u003cp\u003eMarplot 177\u003c\/p\u003e \u003cp\u003eAloha 177\u003c\/p\u003e \u003cp\u003eWiser 177\u003c\/p\u003e \u003cp\u003eToxNet and the Hazardous Substance Database 177\u003c\/p\u003e \u003cp\u003eResources 178\u003c\/p\u003e \u003cp\u003eSummary 178\u003c\/p\u003e \u003cp\u003e\u003cb\u003e5 Hazard Identification 181\u003c\/b\u003e\u003c\/p\u003e \u003cp\u003eIntroduction 181\u003c\/p\u003e \u003cp\u003eCase Study – Phosgene Exposure 182\u003c\/p\u003e \u003cp\u003eStates of Matter 182\u003c\/p\u003e \u003cp\u003eSolid 184\u003c\/p\u003e \u003cp\u003eLiquids 186\u003c\/p\u003e \u003cp\u003eVapors and Gases 186\u003c\/p\u003e \u003cp\u003eMists and Aerosols 186\u003c\/p\u003e \u003cp\u003eGases 186\u003c\/p\u003e \u003cp\u003eCompressed Gas 186\u003c\/p\u003e \u003cp\u003eLiquified Gas 186\u003c\/p\u003e \u003cp\u003eCryogenic Gas 187\u003c\/p\u003e \u003cp\u003eChemical and Physical Properties 187\u003c\/p\u003e \u003cp\u003eChemical Properties 188\u003c\/p\u003e \u003cp\u003epH (Corrosivity) 188\u003c\/p\u003e \u003cp\u003e0005505303.indd 11 03-03-2023 13:18:02\u003c\/p\u003e \u003cp\u003eIgnition Temperature (IT) 188\u003c\/p\u003e \u003cp\u003eFlashpoint (FP) 188\u003c\/p\u003e \u003cp\u003eHeat Transfer 188\u003c\/p\u003e \u003cp\u003ePhysical Properties 188\u003c\/p\u003e \u003cp\u003eAppearance 189\u003c\/p\u003e \u003cp\u003eViscosity 189\u003c\/p\u003e \u003cp\u003eMelting Point (MP) 189\u003c\/p\u003e \u003cp\u003eFreezing Point (FrPt) 189\u003c\/p\u003e \u003cp\u003eBoiling Point (BP) 189\u003c\/p\u003e \u003cp\u003eFlammable Range 190\u003c\/p\u003e \u003cp\u003eDensity 190\u003c\/p\u003e \u003cp\u003eSpecific Gravity (SG) 190\u003c\/p\u003e \u003cp\u003eVapor Density (VD) 191\u003c\/p\u003e \u003cp\u003eVapor Pressure (VP) 192\u003c\/p\u003e \u003cp\u003eExpansion Ratios 193\u003c\/p\u003e \u003cp\u003eProperties and Their Medical Implications 193\u003c\/p\u003e \u003cp\u003eVapor Pressure, Medical Implications 194\u003c\/p\u003e \u003cp\u003eVapor Density, Medical Implications 195\u003c\/p\u003e \u003cp\u003eSpecific Gravity, Medical Implications 195\u003c\/p\u003e \u003cp\u003eSolubility, Medical Implications 195\u003c\/p\u003e \u003cp\u003eHistory of Toxicology 196\u003c\/p\u003e \u003cp\u003eExposure vs. Contamination 197\u003c\/p\u003e \u003cp\u003eToxin vs. Poison 198\u003c\/p\u003e \u003cp\u003eToxicity of a Poison or Toxin 198\u003c\/p\u003e \u003cp\u003eStandards, Guidelines, and Acts Regulating Hazardous Materials 200\u003c\/p\u003e \u003cp\u003eNFPA and OSHA 200\u003c\/p\u003e \u003cp\u003eEnvironmental Protection Agency (EPA) 200\u003c\/p\u003e \u003cp\u003eTime Weighted Average 201\u003c\/p\u003e \u003cp\u003eShort- Term Exposure Limits (STELs) 201\u003c\/p\u003e \u003cp\u003eImmediately Dangerous to Life and Health (IDLH) 201\u003c\/p\u003e \u003cp\u003eControl Banding 203\u003c\/p\u003e \u003cp\u003eBasic Toxicology Definitions 205\u003c\/p\u003e \u003cp\u003eAcute Exposure 206\u003c\/p\u003e \u003cp\u003eSub- Chronic\/Sub- Acute 208\u003c\/p\u003e \u003cp\u003eChronic Exposure 209\u003c\/p\u003e \u003cp\u003eNoel, Noael, Loael 209\u003c\/p\u003e \u003cp\u003eLevels of Concern 210\u003c\/p\u003e \u003cp\u003eDose Response and Exposure 210\u003c\/p\u003e \u003cp\u003eGraded Response 211\u003c\/p\u003e \u003cp\u003eQuantal Response 211\u003c\/p\u003e \u003cp\u003eResponse Curve 212\u003c\/p\u003e \u003cp\u003eLethal Concentrations and Lethal Doses 213\u003c\/p\u003e \u003cp\u003eChemical Time lines 214\u003c\/p\u003e \u003cp\u003eAdditional Toxic Effects 216\u003c\/p\u003e \u003cp\u003eToxic Influences 217\u003c\/p\u003e \u003cp\u003eGeneral Health 217\u003c\/p\u003e \u003cp\u003eDiet 217\u003c\/p\u003e \u003cp\u003ePrevious Exposure 218\u003c\/p\u003e \u003cp\u003eAge 218\u003c\/p\u003e \u003cp\u003eGender 219\u003c\/p\u003e \u003cp\u003eGenetics 220\u003c\/p\u003e \u003cp\u003eSleep 220\u003c\/p\u003e \u003cp\u003eBiochemistry 221\u003c\/p\u003e \u003cp\u003eDetoxification 221\u003c\/p\u003e \u003cp\u003ePhase I and Phase II Reactions 221\u003c\/p\u003e \u003cp\u003eDetoxification by the Lungs 224\u003c\/p\u003e \u003cp\u003eChemical Toxic Qualities 224\u003c\/p\u003e \u003cp\u003eChemical Excretion 225\u003c\/p\u003e \u003cp\u003eNanotoxicology 225\u003c\/p\u003e \u003cp\u003eDetermining the Level of Medical Surveillance 226\u003c\/p\u003e \u003cp\u003eRisk Assessment and Detection 226\u003c\/p\u003e \u003cp\u003eIdentification of Hazards 227\u003c\/p\u003e \u003cp\u003eAssess Hazards to Determine the Risks 227\u003c\/p\u003e \u003cp\u003eDevelop Controls to Manage the Risks 227\u003c\/p\u003e \u003cp\u003eImplementing Controls 227\u003c\/p\u003e \u003cp\u003eSupervise and Evaluate the Process 228\u003c\/p\u003e \u003cp\u003eSummary 230\u003c\/p\u003e \u003cp\u003e\u003cb\u003e6 Team Capabilities 231\u003c\/b\u003e\u003c\/p\u003e \u003cp\u003eIntroduction 231\u003c\/p\u003e \u003cp\u003eCase Study – Sodium Nitrate Overdose 231\u003c\/p\u003e \u003cp\u003eTechnician Operational Considerations 232\u003c\/p\u003e \u003cp\u003ePersonnel Protective Equipment (PPE) 232\u003c\/p\u003e \u003cp\u003eRehabilitation 235\u003c\/p\u003e \u003cp\u003eDecontamination 236\u003c\/p\u003e \u003cp\u003eOccupational Safety and Health Administration 237\u003c\/p\u003e \u003cp\u003eNational Fire Protection Association 237\u003c\/p\u003e \u003cp\u003eEnvironmental Protection Agency 237\u003c\/p\u003e \u003cp\u003eScience Behind Decontamination 237\u003c\/p\u003e \u003cp\u003eTypes of Decontamination 239\u003c\/p\u003e \u003cp\u003eGross Decontamination 239\u003c\/p\u003e \u003cp\u003eSecondary Decontamination 240\u003c\/p\u003e \u003cp\u003eTertiary Decontamination 240\u003c\/p\u003e \u003cp\u003eEmergency Decontamination 240\u003c\/p\u003e \u003cp\u003eTechniques 240\u003c\/p\u003e \u003cp\u003ePhysical Decontamination 241\u003c\/p\u003e \u003cp\u003eFactors to Consider During Decontamination 241\u003c\/p\u003e \u003cp\u003eEquipment Uses 242\u003c\/p\u003e \u003cp\u003eChoosing a Decontamination Site Location 243\u003c\/p\u003e \u003cp\u003eDetection and Monitoring 243\u003c\/p\u003e \u003cp\u003eThe Approach 244\u003c\/p\u003e \u003cp\u003eThe System of Detection 245\u003c\/p\u003e \u003cp\u003eRadiation 246\u003c\/p\u003e \u003cp\u003epH 247\u003c\/p\u003e \u003cp\u003eOxygen 247\u003c\/p\u003e \u003cp\u003eOrganic Compounds 247\u003c\/p\u003e \u003cp\u003eBiologicals 249\u003c\/p\u003e \u003cp\u003eDetection and Monitoring Responses 249\u003c\/p\u003e \u003cp\u003eCurrent Detection Technologies 250\u003c\/p\u003e \u003cp\u003eRadiation Detectors 250\u003c\/p\u003e \u003cp\u003epH Paper and Impregnated Papers 252\u003c\/p\u003e \u003cp\u003eKI Paper or Oxidizer Paper 252\u003c\/p\u003e \u003cp\u003eWet Chemistry 252\u003c\/p\u003e \u003cp\u003eElectrochemical Sensors 253\u003c\/p\u003e \u003cp\u003eCatalytic Bead 253\u003c\/p\u003e \u003cp\u003eColorimetric Tubes 254\u003c\/p\u003e \u003cp\u003ePhotoionization Detection (PID) 254\u003c\/p\u003e \u003cp\u003eFlame Ionization Detection (FID) 255\u003c\/p\u003e \u003cp\u003eIon Mobility Spectroscopy (IMS) 255\u003c\/p\u003e \u003cp\u003eInfrared Spectroscopy (FT- IR) 256\u003c\/p\u003e \u003cp\u003eRaman Spectroscopy 256\u003c\/p\u003e \u003cp\u003ePositive Protein 257\u003c\/p\u003e \u003cp\u003eHandheld Immunoassay (HHA) 257\u003c\/p\u003e \u003cp\u003ePolymerase Chain Reaction (PCR) 258\u003c\/p\u003e \u003cp\u003eMass Causality Incidents 259\u003c\/p\u003e \u003cp\u003eTriage Considerations (Non- START Triage) 259\u003c\/p\u003e \u003cp\u003eStilp and Bevelacqua Exposure Score 259\u003c\/p\u003e \u003cp\u003eCardiovascular 260\u003c\/p\u003e \u003cp\u003eBreathing (Respiratory) 261\u003c\/p\u003e \u003cp\u003eRx – Immediate Basic Treatment 261\u003c\/p\u003e \u003cp\u003eNeurological 261\u003c\/p\u003e \u003cp\u003eMass Decontamination 261\u003c\/p\u003e \u003cp\u003eInitial Operations 261\u003c\/p\u003e \u003cp\u003eHazMat Alert 262\u003c\/p\u003e \u003cp\u003eHospital Interface 263\u003c\/p\u003e \u003cp\u003eCasualty Collection Points (Field Treatment Site) 266\u003c\/p\u003e \u003cp\u003eTemporary Medical Care Units (Alternate Care Facilities) 266\u003c\/p\u003e \u003cp\u003eThe Medical Reserve Corp 266\u003c\/p\u003e \u003cp\u003eHospital Decontamination Considerations 268\u003c\/p\u003e \u003cp\u003ePPE in the Hospital Environment 268\u003c\/p\u003e \u003cp\u003eHospital Isolation Rooms 269\u003c\/p\u003e \u003cp\u003eNotification and Preparation 269\u003c\/p\u003e \u003cp\u003eHospital Scenario Possibilities 270\u003c\/p\u003e \u003cp\u003eHospital Decontamination Corridor 271\u003c\/p\u003e \u003cp\u003eHospital Decontamination Sequence Model 272\u003c\/p\u003e \u003cp\u003eSummary 274\u003c\/p\u003e \u003cp\u003e\u003cb\u003e7 HazMat Safety Officer 275\u003c\/b\u003e\u003c\/p\u003e \u003cp\u003eIntroduction 275\u003c\/p\u003e \u003cp\u003eCase Study – Lieutenant Dan 275\u003c\/p\u003e \u003cp\u003eMedical Assessment 276\u003c\/p\u003e \u003cp\u003e0005505303.indd 14 03-03-2023 13:18:02\u003c\/p\u003e \u003cp\u003eMedical Surveillance 278\u003c\/p\u003e \u003cp\u003eInitial Baseline Physical and Annual Physical 279\u003c\/p\u003e \u003cp\u003ePre- Entry Physical 281\u003c\/p\u003e \u003cp\u003eConsiderations of the Entrance Physical 283\u003c\/p\u003e \u003cp\u003ePost- Entry Physicals 285\u003c\/p\u003e \u003cp\u003eUse of Findings 286\u003c\/p\u003e \u003cp\u003ePreventive Health Screening 288\u003c\/p\u003e \u003cp\u003ePost- Exposure Physicals 288\u003c\/p\u003e \u003cp\u003eBiological Monitoring 289\u003c\/p\u003e \u003cp\u003eTeam Exit and Retirement Physicals 290\u003c\/p\u003e \u003cp\u003eProgram Review 290\u003c\/p\u003e \u003cp\u003eADA, Civil Rights, and Health Insurance Portability and Accountability Act (hipaa) 290\u003c\/p\u003e \u003cp\u003eCritical Incident Stress Debriefing 291\u003c\/p\u003e \u003cp\u003eDeveloping a Medical Surveillance Program 293\u003c\/p\u003e \u003cp\u003eSummary 294\u003c\/p\u003e \u003cp\u003e\u003cb\u003e8 Terrorism 297\u003c\/b\u003e\u003c\/p\u003e \u003cp\u003eIntroduction 297\u003c\/p\u003e \u003cp\u003eCase Study – Salmonella Salad Bar 298\u003c\/p\u003e \u003cp\u003eTerrorism Using Chemical Warfare Agents 299\u003c\/p\u003e \u003cp\u003eNerve Agents (Cholinergic Toxidrome) 299\u003c\/p\u003e \u003cp\u003eMilitary Nerve Agents 299\u003c\/p\u003e \u003cp\u003ePhysical Properties and Routes of Entry 300\u003c\/p\u003e \u003cp\u003eDecontamination 301\u003c\/p\u003e \u003cp\u003eTreatment 301\u003c\/p\u003e \u003cp\u003eBlood Agents – Asphyxiants Toxidrome 301\u003c\/p\u003e \u003cp\u003eMilitary Blood Agents 301\u003c\/p\u003e \u003cp\u003ePhysiology 302\u003c\/p\u003e \u003cp\u003ePhysical Properties and Routes of Entry of Cyanide Agents 302\u003c\/p\u003e \u003cp\u003eDecontamination 302\u003c\/p\u003e \u003cp\u003eTreatment 302\u003c\/p\u003e \u003cp\u003eChoking Agents – Irritant Gas Toxidrome 302\u003c\/p\u003e \u003cp\u003eMilitary Choking Agents 303\u003c\/p\u003e \u003cp\u003ePhysiology of Respiratory Irritant Injury 304\u003c\/p\u003e \u003cp\u003ePhysical Properties and Routes of Entry 304\u003c\/p\u003e \u003cp\u003eDecontamination 304\u003c\/p\u003e \u003cp\u003eTreatment 304\u003c\/p\u003e \u003cp\u003eVesicants – Corrosive Toxidrome (Military Blister Agents) 305\u003c\/p\u003e \u003cp\u003eMilitary Blister Agents (Vesicants) 305\u003c\/p\u003e \u003cp\u003ePhysiology of Blister Agent Exposure 306\u003c\/p\u003e \u003cp\u003ePhysical Properties and Routes of Entry 306\u003c\/p\u003e \u003cp\u003eDecontamination 306\u003c\/p\u003e \u003cp\u003eTreatment 306\u003c\/p\u003e \u003cp\u003eLacrimators (Riot Control Agents) 306\u003c\/p\u003e \u003cp\u003eCN and CS 307\u003c\/p\u003e \u003cp\u003eOc 307\u003c\/p\u003e \u003cp\u003eDecontamination 307\u003c\/p\u003e \u003cp\u003eTreatment 308\u003c\/p\u003e \u003cp\u003eTerrorism Using Biological Agents 308\u003c\/p\u003e \u003cp\u003eBacteria 308\u003c\/p\u003e \u003cp\u003eViruses 309\u003c\/p\u003e \u003cp\u003eBiological Toxins 309\u003c\/p\u003e \u003cp\u003eBacterial Agents 309\u003c\/p\u003e \u003cp\u003eAnthrax (B. anthracis) 309\u003c\/p\u003e \u003cp\u003eCholera (Vibrio cholerae) 310\u003c\/p\u003e \u003cp\u003ePneumonic\/Bubonic Plague (Y. pestis) 310\u003c\/p\u003e \u003cp\u003eTularemia (F. tularensis) 311\u003c\/p\u003e \u003cp\u003eQ Fever (Coxiella burnetii rickettsia) 311\u003c\/p\u003e \u003cp\u003eSalmonellae (Salmonella typhimurium) 311\u003c\/p\u003e \u003cp\u003eViral Agents 312\u003c\/p\u003e \u003cp\u003eSmallpox (Variola virus) 312\u003c\/p\u003e \u003cp\u003eVenezuelan Equine Encephalitis (VEE) 312\u003c\/p\u003e \u003cp\u003eViral Hemorrhagic Fevers (VHFs) 313\u003c\/p\u003e \u003cp\u003eBiological Toxins 313\u003c\/p\u003e \u003cp\u003eBotulinum Toxin 313\u003c\/p\u003e \u003cp\u003eStaphylococcal Enterotoxin B (SEB) 314\u003c\/p\u003e \u003cp\u003eRicin 315\u003c\/p\u003e \u003cp\u003eTrichothecene Mycotoxins (T2) 315\u003c\/p\u003e \u003cp\u003eExplosives and Incendiary Devices 316\u003c\/p\u003e \u003cp\u003eBomb Incidents 316\u003c\/p\u003e \u003cp\u003eAnatomy of Explosives 316\u003c\/p\u003e \u003cp\u003eExpected Effects from Explosions 317\u003c\/p\u003e \u003cp\u003ePhysiology of Blast Effects 318\u003c\/p\u003e \u003cp\u003eBlast Effects 318\u003c\/p\u003e \u003cp\u003eSummary 320\u003c\/p\u003e \u003cp\u003eEpilogue 323\u003c\/p\u003e \u003cp\u003eIndex 325\u003c\/p\u003e  \u003cp\u003e\u003cb\u003eRichard Stilp \u003c\/b\u003eMA, RN started his career in the fire service in 1976 and has worked in many positions in the fire service including firefighter\/paramedic, engineer, lieutenant, district chief, and fire chief. During his career he served as a paramedic program chair for a local college, emergency department registered nurse, executive director of the fire academy, worked in administration for a large hospital system. \u003c\/p\u003e\u003cp\u003e\u003cb\u003eArmando Bevelacqua \u003c\/b\u003eis a 38 year veteran of the fire service, writes free-lance, publishing articles, instructional materials and educational textbooks in the field of hazmat response. Has served during the course of his career as a firefighter-paramedic, HazMat technician, High Angle rescue, below grade rescue, Dive rescue, chief officer and flight medic.   \u003c\/p\u003e\u003cp\u003e\u003cb\u003eComplete background on chemical exposures that create illnesses, including assessment, diagnosis, and treatment protocols\u003c\/b\u003e \u003c\/p\u003e\u003cp\u003eWritten on a level that can be understood by field practitioners and\/or first responders, \u003ci\u003eHazardous Materials Medicine: Treating the Chemically Injured Patient\u003c\/i\u003e provides an in-depth understanding of how to diagnose and treat toxic chemical exposures in a prehospital or emergency department setting. \u003c\/p\u003e\u003cp\u003eThe protocols used in this book conform to the guidelines set forth in the NFPA 470 standard, and the medical guidance developed by FEMA for Type I, II \u0026amp; III Deployable Hazmat Response  Teams. The hazardous materials medical protocols in this book have been fully vetted by three poison control toxicologists, multiple emergency physicians, and paramedics. \u003c\/p\u003e\u003cp\u003e\u003ci\u003eHazardous Materials Medicine: Treating the Chemically Injured Patient\u003c\/i\u003e covers sample topics  such as: \u003c\/p\u003e\u003cul\u003e\n\u003cli\u003eScene assessment, to help determine the cause of the exposure, and exposure assessment, to determine what physiologic systems are affected\u003c\/li\u003e \u003cli\u003eToxic syndromes\/toxidromes to appropriately treat the exposed patient, including corrosive and irritant, asphyxiant, cholinergic, and hydrocarbon and derivative toxidromes\u003c\/li\u003e \u003cli\u003eScience behind a chemical exposure, to allow for a complete understanding of both the chemistry and physiology of what is occurring because of the exposure\u003c\/li\u003e \u003cli\u003eInterfacing between the on-scene response team and the hospital, to ensure consistency and continuity of care from the field into the hospital\u003c\/li\u003e\n\u003c\/ul\u003e \u003cp\u003eEnabling public safety and health professionals to administer effective care while retaining their own personal safety, \u003ci\u003eHazardous Materials Medicine: Treating the Chemically Injured Patient\u003c\/i\u003e is  a must-have resource for emergency medical technicians, paramedics, hazmat technicians, and emergency physicians and nurses working in high-risk field situations with chemically injured patients.\u003c\/p\u003e","brand":"Wiley","offers":[{"title":"Default Title","offer_id":47989348040933,"sku":"NP9781119663928","price":110.0,"currency_code":"USD","in_stock":false}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/1842\/7735\/files\/9781119663928.jpg?v=1761783761","url":"https:\/\/k12savings.com\/es\/products\/hazardous-materials-medicine-isbn-9781119663928","provider":"K12savings","version":"1.0","type":"link"}