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Cover image for Treating victims of weapons of mass destruction : medical, legal, and strategic aspects
Title:
Treating victims of weapons of mass destruction : medical, legal, and strategic aspects
Publication Information:
Chichester, West Sussex : John Wiley & Sons, 2008
ISBN:
9780470066461

978047006646(pbk.)

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30000010164148 RC88.9.T47 T73 2008 Open Access Book Book
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Summary

Summary

During the last century, the weapons of war became increasingly sophisticated and their effects ever more remote from the actual user.  Militarization of nuclear atomic forces, chemicals and biological agents has considerably enlarged the arena of warfare, but of possibly even greater concern is the threat of such agents being deployed by terrorists.  This book was originally published in French in 2004: subsequent events, such as the London bombings in July 2005, have only reinforced the importance of all doctors and emergency personnel understanding the various agents that could be used and having the knowledge to deal with victims of an attack or even an industrial accident.  The book has therefore been translated into English to make it available to a wider audience. 

The book was coordinated by Chantal Bismuth, Professor of Medicine who has acted as an advisor for the Minister of Health in France and is an international consultant in toxicology.  Her co-editor, Patrick Barriot, is an anaesthetist with operational experience in the Paris Fire Brigade and the 11th division of Paratroops who is now responsible for the department of 'Biological risks from new technologies'.  The authors are representative of the doctors who would have to deal with the human casualties of warfare or a terrorist attack.  They review all weapons of mass destruction, both chemical and biological, including the use of bacteria, anthrax  and viruses such as variola and influenza. In each case, they describe the pathogenic agent, the human consequences, organizational aspects of care for the victims and best practice for treatment.  As one author reports, "The infections caused by potential biological warfare agents are seldom taught in the course of medical studies and the majority of physicians never encounter these types of pathology in their daily professional practice. Since its eradication, people are not trained to recognize smallpox or to make the differential diagnosis between anthrax and bronchitis."  Other chapters cover the effects of nuclear weapons and radiation on humans as well as the features of Gulf War syndrome. An important chapter deals with the organization of medical responses to chemical or biological attack: "Planning, equipping, and training responder services are the best responses to the dispersion of chemical and biological agents."

The book addresses all those involved in the security of the civilian population, the organization of rescue services and the treatment of victims. 


Table of Contents

Pierre-Marie GalloisChantal BismuthPatrick Barriot and Chantal BismuthPatrick Barriot and Chantal BismuthChantal BismuthArnaud Delahaye and Frederic BaudRobert L. Maynard and Timothy C. MarrsPatrick BarriotChantal Bismuth and Andreas SchaperDavid J. Baker and Caroline Telion and Pierre CarliFrederic Baud and Bruno MegarbaneChantal Bismuth and Stephen W. BorronPatrick Barriot and Chantal BismuthPatrick BarriotPatrick BarriotPatrick BarriotPatrick BarriotPatrick BarriotPatrick BarriotPatrick BarriotPatrick Barriot and Chantal BismuthVladimir VolkoffPatrick Barriot
Forewordp. ix
Prefacep. xiii
About the translatorp. xv
List of contributorsp. xvii
1 Ambiguous concepts and porous bordersp. 1
Conventional weapons and CBRN weaponsp. 1
'Surgical strikes' and weapons of mass destructionp. 5
From non-proliferation to counter-proliferationp. 7
2 Introduction to chemical weaponsp. 11
Chemical agents and dissemination devicesp. 11
Warfare utilization of chemical agentsp. 14
Terrorism and counter-terrorismp. 19
3 Chemical weaponsp. 23
History and doctrinesp. 23
An effective threatp. 24
Limits of use and effectsp. 24
Currently proven factsp. 27
Analysis of the different chemical agents utilized or currently availablep. 29
Chemical munitions and their delivery methodsp. 40
4 Chemical terrorism and cyanidep. 45
The products and their effects on the bodyp. 45
Clinical poisoningp. 46
Diagnosis of cyanide poisoningp. 47
Protection and victim decontaminationp. 48
Conclusionp. 50
5 Why chemical weapons were not used during World War II and the use of such weapons by terroristsp. 51
6 Toxinsp. 59
Ricinp. 59
Botulinum toxinsp. 60
Other toxinsp. 62
7 Gulf war syndromep. 65
Risk factorsp. 65
Complaints and factsp. 66
Proven factsp. 67
Infectious and parasitic pathologiesp. 67
Proposed toxic pathologiesp. 67
Data from previous warsp. 69
Politico-economic factorsp. 70
'Stressors'p. 70
Conclusionp. 71
8 Organizational aspects of the management of large numbers of victims during a chemical or biological accidentp. 73
Massive destruction? The realities of managing victims from a chemical or biological accidentp. 73
Properties of chemical and biological toxicantsp. 75
Practical response to a terrorist attackp. 75
Specific medical and supply problems during management of vital distress during a toxic attackp. 77
Victim triagep. 78
Management of vital distress in the decontamination zonep. 78
Management and handling of victims in the decontamination zonep. 80
Conclusionp. 81
9 Hospital management of chemical incident victimsp. 83
Appendix Hospital management of chemical riskp. 88
Websites for more information, sample forms, etc.p. 89
10 Non-conventional counter-terrorismp. 91
Is it legitimate for counter-terrorism to conduct an assault with non-conventional weapons?p. 92
11 Introduction to biological weaponsp. 95
Utilization of pathogenic agents for hostile endsp. 96
Modern programs for offensive researchp. 97
Political assassinations 'terrorism' and counter-terrorismp. 100
The different biological agentsp. 101
Production and dissemination of pathogenic agentsp. 102
Biological warfare against livestock and cropsp. 103
Biological weapons: are they weapons of mass destruction?p. 104
12 Clinical approach to pathogenic agentsp. 107
Symptomsp. 108
Pulmonary signsp. 110
Mucocutaneous signsp. 110
Neurological signsp. 111
Gastrointestinal signsp. 112
Preventive treatmentsp. 113
Urgent questionsp. 113
13 Variola (smallpox)p. 117
Biological warfare and terrorismp. 117
Human and animal virusesp. 118
Contagiousness and method of propagationp. 119
The illness occurs in two formsp. 119
The battle against smallpoxp. 120
Quarantinep. 120
Vaccinationp. 120
Associated treatmentsp. 123
14 Influenza and pneumonitisp. 125
Influenzap. 125
Epidemic riskp. 127
Countermeasures and preventionp. 128
Avian influenza ('bird flu'): the 20 key pointsp. 129
Epidemic of atypical pneumoniap. 135
15 Anthraxp. 153
Pathophysiologyp. 153
Militarization of anthraxp. 154
Anthrax booby-trapped lettersp. 154
Detection, identification and decontaminationp. 156
Treatmentp. 156
16 Biotechnologies: protection or threat?p. 159
Industrial and pharmaceutical applicationsp. 161
Fundamental research on pathogenic agentsp. 163
Biotechnologies and militarization of pathogenic agentsp. 165
Biotechnologies and development of new treatmentsp. 167
Biotechnologies and genetic therapyp. 168
Biotechnologies and development of identification and detection systemsp. 168
Risks due to this researchp. 170
Biotechnologies and open societiesp. 173
17 Nuclear and radiological weaponsp. 177
First- and second-generation weaponsp. 178
Third-generation weaponsp. 180
Neutron bombsp. 180
Bombs with an increased penetration effectp. 181
Radiological, or dirty, bombsp. 181
Electromagnetic bomb (e bomb)p. 182
The weapons and their delivery systemsp. 183
Nuclear arsenals in the worldp. 184
Terrorist projectsp. 186
From non-proliferation to counter-proliferationp. 189
18 The effects of nuclear and radiological weapons on humansp. 191
The effects of first- and second-generation weaponsp. 192
The effects of third-generation weaponsp. 195
The consequences of a terrorist actp. 196
Therapeutic managementp. 198
Decontaminationp. 199
Anti-radiation and anticontamination treatmentsp. 200
19 Chinks in the armorp. 203
Plansp. 204
Warning and chemical detectionp. 205
Warning and biological detectionp. 206
Warning and radiological detectionp. 207
Group protectionp. 207
Individual protectionp. 208
Decontaminationp. 211
Treatmentp. 214
Training response teamsp. 216
Exercises and simulationsp. 216
Offensive and defensive researchp. 217
Information managementp. 219
Postscriptp. 223
Appendix Questions and answersp. 227
Indexp. 231
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