10 steps to handle a bioterrorism attack

There are 10 critical steps to ensure your ED is prepared for a bioterrorism attack, according to Sue C. Felt, RN, MS, MPH, CIC, associate hospital epidemiologist and infection control coordinator at San Francisco General Hospital. They are as follows:

1. Maintain an index of suspicion. "In otherwise healthy persons, some associations are very suggestive, especially when seen in clusters, high numbers, or unusual presentations," says Felt.

2. Protect yourself and your patients. "Use appropriate personal protective equipment, and consider prophylaxis such as vaccines or appropriate antibiotics," suggests Felt.

3. Adequately assess the patient. "Pay special attention to respiratory and nervous systems, skin, and hematologic and vascular status," says Felt.

4. Decontaminate as appropriate.

5. Establish a diagnosis. "Think epidemiologically as well as clinically," says Felt.

6. Render prompt treatment.

7. Provide good infection control.

8. Alert the proper authorities. "This almost always means a first call to the public health department," Felt advises.

9. Assist in epidemiologic investigations. This includes counting cases, making comparisons, and developing hypotheses, says Felt.

10. Share bioterrorist planning, knowledge, and teaching with others in the community, especially first responders.