Report on 640 Victims of the Tokyo Subway Sarin Attack

Okumura, Tetsu; Takasu, Nobuo; Ishimatsu, Shinichi; Miyanoki, Shou; Mitsuhashi, Akihiro; Kumada, Keisuke; Tanaka, Kazuaki; Hinohara, Shigeaki

doi:10.1016/s0196-0644(96)70052-5

Cited by 561 publications

(368 citation statements)

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“…20 Nearly 90% of Tokyo victims bypassed EMS efforts and self-triaged to unsuspecting hospitals, highlighting the importance of keeping hospitals informed of events at the scene. 1,20 Prepare responders that mass casualty care is not routine care. Patients triaged by the CFD were initially transported from the scene without receiving any further treatment.…”

Section: Medical Care Of the Sick And Injuredmentioning

confidence: 99%

“…In 1995, the sarin nerve agent attack on commuters on the Tokyo subway system demonstrated that a chemical attack was possible on civilian targets. 1,2 Because terrorism relies on fear as a weapon, even the threat to use such agents can produce the desired effect. Consequently, the public health system, hospitals, and emergency medical services must be prepared to respond to all reported terrorist attacks, even if a given incident is subsequently established as a hoax.…”

mentioning

confidence: 99%

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Chemical weapon functional exercise—Cincinnati: observations and lessons learned from a “typical medium-sized” city's response to simulated terrorism utilizing weapons of mass destruction

FitzGerald¹,

Sztajnkrycer²,

Crocco³

2003

Public Health Reports

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Section: Medical Care Of the Sick And Injuredmentioning

confidence: 99%

mentioning

confidence: 99%

Chemical weapon functional exercise—Cincinnati: observations and lessons learned from a “typical medium-sized” city's response to simulated terrorism utilizing weapons of mass destruction

FitzGerald¹,

Sztajnkrycer²,

Crocco³

2003

Public Health Reports

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“…In hindsight, the activation of the disaster plan by the nearest hospital might have been unnecessary since nearly all patients were transported to the MIH. However, initially it was unclear if the MIH would open and previous studies have shown that hospitals closest to the incident were overrun by selfreferrers [8,31] and emergency medical services [32,33].…”

Section: Discussionmentioning

confidence: 99%

Indoor fire in a nursing home: evaluation of the medical response to a mass casualty incident based on a standardized protocol

Koning

Ellerbroek

Leenen

2014

Eur J Trauma Emerg Surg

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Purpose This retrospective study reports the outcome of a mass casualty incident (MCI) caused by a fire in a nursing home. Methods Data from the medical charts and registration system of the Major Incident Hospital (MIH) and ambulance service were analyzed. The evaluation reports from the MIH and an independent research institute were used. The protocol for reports from major accidents and disaster was used to standardize the reporting [Lennquist, in Int J Disaster Med 1(1): [79][80][81][82][83][84][85][86] 2003]. Results The emergency services were quickly at the scene. The different levels of pre-hospital management performed a tight coordination. However, miscommunication led to confusion in the registration and tracking of patients. In total, 49 persons needed medical treatment, 46 were treated in the MIH. Because of (possible) inhalation injury nine patients needed mechanical ventilation and nine patients were hospitalized to exclude delayed onset of pulmonary symptoms. No incident related deaths occurred. The intensive care unit of the MIH was initially understaffed despite the efforts of the automated calling system and switchboard operators. The handwritten registration of incoming staff was incomplete and should be performed digitally. Some staff members were unfamiliar with the MIH procedures. The medical chart appeared too extensive. Miscommunication between chain partners resulted in the delayed sharing of (semi) medical information. Conclusion The different levels of incident managers performed a tight coordination. The MIH demonstrated its potency to provide emergency care for 46 patients and 9 intubated patients. No deaths or persistent disabilities occurred. Areas of improvement were recognized both in the pre-hospital as the hospital phase.

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“…Twelve people were killed and over 5,000 required emergency medical evaluation (18). Most of the exposed individuals presented with miosis, and many had headaches.…”

Section: Ch2-ch2-ci S Ch2-ch2-cimentioning

confidence: 99%

“…It is also noteworthy that these major agent classes have not changed in over 50 years (1,2. What has changed recently is our perception of the potency of the chemical agents (3), the inclusion of more women in the military, and the likelihood that targets may include civilians (4). We have also become concerned with the nonlethal, persistent, and delayed effects that may be produced (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). These issues are put into better perspective with some background knowledge of the effects of chemical weapons on humans, particularly via routes of exposure likely to be encountered following wartime release.…”

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confidence: 99%

Hazards of chemical weapons release during war: new perspectives.

Reutter

1999

Environ Health Perspect

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The two major threat classes of chemical weapons are mustard gas and the nerve agents, and this has not changed in over 50 years. Both types are commonly called gases, but they are actually liquids that are not re ly voatile. These agents were designed specifically to harm people by any route of exposure and to be effective at low doses. Mustard gas was used in World War I, and the nerve agents were developed shortly before, during, and after World War II. Our perception of the potency of chemical weapons has changed, as well as our concern over potential effects of prolonged exposures to low doses and potential target populations that indude women and cildren. Many of the toxicologic studies and human toxicity esmates for both mustard and nerve agents were designed for the purpose of quickly developing maximal casualties in the least sensitive male soldier. The 'toxcity" of the chemical weapons has not changed, but our perception of 'toxicity" has.

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Report on 640 Victims of the Tokyo Subway Sarin Attack

Cited by 561 publications

References 1 publication

Chemical weapon functional exercise—Cincinnati: observations and lessons learned from a “typical medium-sized” city's response to simulated terrorism utilizing weapons of mass destruction

Chemical weapon functional exercise—Cincinnati: observations and lessons learned from a “typical medium-sized” city's response to simulated terrorism utilizing weapons of mass destruction

Indoor fire in a nursing home: evaluation of the medical response to a mass casualty incident based on a standardized protocol

Hazards of chemical weapons release during war: new perspectives.

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