SECONDARY EXPOSURE OF MEDICAL STAFF TO SARIN VAPOR IN THE EMERGENCY ROOM

Objective: To clarify the risk of secondary exposure of medical staff to sarin vapor in the emergency room, and to warn emergency room staff s of the hazard.Design: Retrospective observational survey. Setting: E mergency department of a university hospital in a metropolitan area of Japan. Participants: Fifteen doctors treating victims of a terrorist attack with sarin in the Tokyo subways on the day of the attack. Measu rements and results: Of the 15 doctors who worked in the emergency roo m treating the victims, 13 became simultaneously aware of symptoms dur ing the resuscitation of two victims who were exposed to sarin. Among 11 doctors (73%) who complained of dim vision, the pupils were severel y miotic (<2 mm) in 8 (73%). Other symptoms included rhinorrhea in eig ht (53%), dyspnea or tightness of the chest in four (27%), and cough i n two (13%). Atropine sulfate was given to six, and pralidoxime was gi ven to one of these six doctors. To decontaminate the emergency room o f sarin vapor, ventilation was facilitated and all belongings of the p atients were sealed up. None of the doctors noticed worsening of their symptoms thereafter. Conclusions: Careful attention to the risks of s econdary exposure to toxic gas in the emergency room and prompt decont amination if such exposure should occur are necessary in the case of l arge-scale disasters caused by sarin.