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Single-Breath-Count Test: An Important Adjunct in the Triaging of Patients in a Mass-Casualty Incident Due to Botulism

Published online by Cambridge University Press:  28 June 2012

Paul P. Rega ,
Christopher E. Bork ,
Kelly Burkholder-Allen ,
Michael S. Bisesi  and
Jeffrey P. Gold
Paul P. Rega*
Affiliation:
College of Medicine, Department of Public Health, University of Toledo, Toledo, Ohio
Christopher E. Bork
Affiliation:
College of Medicine, Department of Public Health, University of Toledo, Toledo, Ohio
Kelly Burkholder-Allen
Affiliation:
College of Medicine, Department of Public Health, University of Toledo, Toledo, Ohio
Michael S. Bisesi
Affiliation:
College of Medicine, Department of Public Health, University of Toledo, Toledo, Ohio
Jeffrey P. Gold
Affiliation:
College of Medicine, Department of Public Health, University of Toledo, Toledo, Ohio
*
5658 Bernath Court, Toledo, Ohio 43615, USA E-mail: Paul.Rega@utoledo.edu OR NDMSMD@aol.com
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Abstract

Clostridium botulinum toxins, the most poisonous substance known to humankind, are considered to be a [US] Centers for Disease Control and Prevention Category A bioterrorist agent. Despite this concern, little has been published with regard to the tactical aspects of triaging a mass-casualty event involving botulism victims arriving at an emergency department. Because neuromuscular-ventilatory failure is a principal reason for botulism's early morbidity and mortality, using a quick and sensitive test to evaluate this possibility is imperative. The purpose of this article is to propose the adoption of the Single-Breath-Count Test (SBCT). The ease and validity of the use of the SBCT in evaluating complications associated with various neuromuscular disorders make it an attractive adjunct for triage during a mass-casualty incident due to botulism. While education, immune globulin, antitoxin, and invasive airway techniques are well-recognized steps in treating botulism, incorporating a time-honored technique such as the SBCT, will be an important addition to the triage process.

Keywords

botulismmass-casualty incidentsingle-breath-count testtoxintriageventilatory failure
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 25 , Issue 3 , June 2010 , pp. 219 - 222
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2010

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