Advanced life support for acute toxic injury (TOXALS???)

Insertion of six different supraglottic airway devices whilst wearing chemical, biological, radiation, nuclear‐personal protective equipment: a manikin study

“…Both Baker et al [1] and Byers et al [2] have challenged the traditional management of contaminated casualties, which is a 'decontaminate and then treat' model, rather than advocating a strategy of 'treat whilst decontaminating' or 'treat and then decontaminate'. The rationale for early Advanced Life Support of critically ill CBRN casualties is to reduce the high mortality rate associated with delayed treatment, primarily from airway obstruction and hypoxia [3][4][5].…”

“…There is growing international concern regarding the potential use of chemical, biological, radiation or nuclear (CBRN) agents by terrorist groups, as well as the established risk from the commercial transport of these materials. Both Baker et al [1] and Byers et al [2] have challenged the traditional management of contaminated casualties, which is a 'decontaminate and then treat' model, rather than advocating a strategy of 'treat whilst decontaminating' or 'treat and then decontaminate'. The rationale for early Advanced Life Support of critically ill CBRN casualties is to reduce the high mortality rate associated with delayed treatment, primarily from airway obstruction and hypoxia [3][4][5].…”

Airway control in case of a mass toxicological event: superiority of second-generation supraglottic airway devices

“…Early airway (AW) management is a key clinical intervention and includes not only AW control, assisting ventilation, and oxygen supplementation but also stomach drainage by gastric tube to avoid aspirations of excessive secretions [7].…”

Utility of the Pentax-AWS in performing tracheal intubation while wearing chemical, biological, radiation and nuclear personal protective equipment: a randomised crossover trial using a manikin

“…Prompt advanced airway interventions following a CBRN incident can be directly associated with increased patient survival 3. However, time-critical airway interventions should be instigated within the warm zone prior to decontamination, while wearing CBRN-personal protective equipment (PPE),4 5 because decontamination following a CBRN incident requires a minimum of 12 min per casualty to complete 6…”