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| Expanded pathogen "fingerprinting" of microbes likely to be used by terrorists and dissemination of the resulting library to cooperating regional laboratories.
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| Symptom-based, automated decision aids that would assist clinicians in the early identification of unusual diseases related to biological and chemical terrorism.
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Mass-Casualty Decontamination and Triage Procedures
The removal of solid or liquid chemical agent from exposed individuals is the first step in preventing severe injury or death. Civilian Hazmat teams generally have basic decontamination plans in place, though proficiency may vary widely. Very few teams are staffed, equipped, or trained for mass decontamination. Hospitals need to be prepared to decontaminate patients, despite plans that call for field decontamination of all patients before transport to hospitals. However, few hospitals have formal decontamination facilities; even fewer have dedicated outdoor facilities or an easy way of expanding their decontamination operations in an event involving mass casualties.
Recommendation 5. R&D in decontamination and triage should concentrate on operations research to identify methods and procedures for triage and rapid, effective, and inexpensive decontamination of large groups of people, equipment, and environments.
Specific R&D needs:
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| The physical layout, equipment, and supply requirements for performing mass decon for ambulatory and nonambulatory patients of all ages and health in the field and in the hospital;
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| A standardized patient assessment and triage process for evaluating contaminated patients of all ages;
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| Optimal solution(s) for performing patient decon, including decon of mucous membranes and open wounds;
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| The benefit vs. the risk of removing patient clothing;
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| Effectiveness of removing agent from clothing by a showering process;
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| Showering time necessary to remove chemical agents;
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| Whether high-pressure/low-volume or low-pressure/high-volume spray is more appropriate for optimal cleaning of contaminated areas;
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