Abstract
Determine the effectiveness of decontamination, and perform thorough dry or wet decontamination, depending on the circumstances. Always remain cognizant of the fact that, even after decontamination has been completed, contamination may not have been completely eliminated. Perform periodic monitoring to determine whether secondary exposure has occurred in health care workers; if it appears that secondary exposure has occurred, then the PPE level must be increased and attempts must be made to identify and eliminate the source of the contamination. Finally, if the victims were exposed through ingestion, then consider the possibility that secondary exposure will occur during gastric lavage.
Highlights
In the Tokyo subway sarin attack in March 1995, many health care workers experienced secondary exposure [1]
This article discusses aspects related to the secondary exposure that occurred in the 1995 subway incident in Tokyo, and reviews the measures that health care workers must implement to protect themselves in the event of a chemical mass casualty incident
If the facility is uncertain regarding whether all of the contaminants were removed in the decontamination process, and it appears that health care workers may be subjected to secondary exposure, the possibility of incomplete decontamination must not be ruled out
Summary
In the Tokyo subway sarin attack in March 1995, many health care workers experienced secondary exposure [1]. The various organizations that responded to the incident were aware that the causative agent was a chemical substance, many cases of secondary exposure occurred because of lack of sufficient knowledge of the decontamination and protective measures that needed to be implemented. If the facility is uncertain regarding whether all of the contaminants were removed in the decontamination process, and it appears that health care workers may be subjected to secondary exposure, the possibility of incomplete decontamination must not be ruled out. Unlike most operating theatres, ICUs often do not have ventilation systems that are designed to remove excess gas Measures such as attaching a reservoir to the air outlet and emptying the reservoir by continuous suction should be implemented in the event of a chemical mass casualty event
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