Page 220 - PJ MED OPS Handbook 8th Ed

Pneumonia-like Agents:
• Anthrax
• Plague
• Tularemia
• Q-fever
Encephalitis-like Agents:
• Smallpox
• Venezuelan Equine Encephalitis (VEE)
Biological Toxins:
• Botulinum
• Staphylococcal Enterotoxin B (SEB)
• Ricin
• Trichothecene Mycotoxins (T2)

Miscellaneous Biological Agents:
• Cholera
• Brucellosis
• Viral Hemorrhagic Fevers (VHF)
Emergency Care:
A number of principles are important when faced with patients exposed to biological agents. Recog-
nition is crucial to the successful management of these patients and a top priority is self-protection.
Physicians or trained health care personnel will be needed to prescribe the proper antibiotic and
antitoxin treatment crucial in treating biological agent exposure. Infectious disease and biological
agent experts plus laboratory support will also be needed to help positively identify the agent and
recommend further treatment. As much as practical in the field, isolate biological patients from
unaffected individuals. The usual principles of emergency care apply to the care of these patients.
Priority goes to securing and maintaining an airway and ensuring adequate ventilation. A mainstay
of treatment for many biological agents is use of specific antibiotics or antitoxins. These treatments
require the expertise of a physician or PA in selecting the right drug, dose, and route. It is beyond the
scope of practice and beyond the expectations of PJs to initiate this therapy. The PJ does play a cru-
cial role in summoning the assistance of a physician when necessary, and can assist the physician’s
treatment of biological patients with antibiotics or antitoxins.

Nuclear Injuries
Nuclear detonation energy is released as light and thermal energy, a shock wave with severe wind
blast, and direct radiation, followed by fallout. Potential injuries include light damage to the eye,
burns to the skin, blast injury and radiation exposure. These injury mechanisms often combine
during nuclear detonation, presenting an assessment and care challenge. The role of the PJ at the di-
saster is to provide search and rescue, triage, evacuation, decontamination, and limited emergency
care. Nuclear detonation yields injury or death through three mechanisms. They are:
1. Radiation
2. Blast
3. Thermal burns

218 n Pararescue Medical Operations Handbook / 8th Edition