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Introduction: Little is known about prehospital availability and use of medications to treat patients from hazardous materials (hazmat) medical emergencies. The aim of this study was to identify the availability and frequency of use of medications for patients in hazmat incidents by paramedics with advanced training to care for these patients., Methods: A prospectively validated survey was distributed to United States paramedics with advanced training in the medical management of patients from hazmat incidents who successfully completed a 16-hour Advanced Hazmat Life Support (AHLS) Provider Course from 1999 to 2017. The survey questioned hazmat medication availability, storage, and frequency of use. Hazmat medications were considered to have been used if administered anytime within the past 5 years. For analyses, medications were grouped into those with hazmat indications only and those with multiple indications., Results: The survey email was opened by 911 course participants and 784 of these completed the survey (86.1 percent). Of these 784 respondents, 279 (35.6 percent) reported carrying dedicated hazmat medication kits, ie, tox-boxes, and 505 (64.4 percent) did not carry tox-boxes. For those medications specifically for hazmat use, hydroxocobalamin was most commonly available, either within or not within a dedicated tox-box. Of the 784 respondents, 313 (39.9 percent) reported carrying hydroxocobalamin and 69 (8.8 percent) reported administering it within the past 5 years. For medications with multiple indications, availability and use varied: for example, of the 784 respondents, albuterol was available to 699 (89.2 percent) and used by 572 (73.0 percent), while calcium gluconate was available to 247 (31.5 percent) and used by 80 (10.2 percent) within the last 5 years., Conclusion: Paramedics with advanced training in the medical management of patients in hazmat incidents reported limited availability and use of medications to treat patients in hazmat incidents.

Objective: Hazmat disaster preparedness is critical, especially as Hong Kong prepares for major international events, such as the 2008 Olympic Equestrian Games. No published medical study describes the identities and quantities of hazardous materials (HMs) in Hong Kong and lists what antidotes are needed for these dangerous goods (DGs). This study describes what HMs are most common in Hong Kong to prioritize disaster preparedness and training., Design: A descriptive, cross-sectional study., Setting: The Hong Kong Special Administrative Region, specifically Lantau, Lamma, and Hong Kong Islands., Sample: The Hong Kong Fire Services Department (HKFSD) Dangerous Goods Database (DGD)., Interventions: Descriptive statistical analyses with Stata 9.2., Main Outcome Measures: Identifying and quantifying HMs in the HKFSD DGD., Results: Most HMs do not have antidotes. The most common HMs with recognized antidotes are carbon monoxide, methylene chloride, fluorides, cyanides, nitriles, hydrazine, methanol, and nitrates. The most common categories of DGs are substances giving off inflammable vapors, compressed gases, and corrosive and poisonous substances., Conclusions: Hazmat disaster preparedness and training should emphasize these most common categories of DGs. Disaster planning should ensure adequate antidotes for HMs with recognized antidotes, ie, oxygen for carbon monoxide and methylene chloride; calcium gluconate and calcium chloride for fluorides; hydroxocobalamin or amyl nitrite, sodium nitrite, and sodium thiosulfate for cyanides and nitriles; pyridoxine for hydrazine; fomepizole or ethanol for methanol; and methylene blue for methemoglobinemia produced by nitrates. Supportive care is essential for patients exposed to HMs because most DGs do not have antidotes.

Objective: To determine the chemicals involved in fire department hazardous materials (hazmat) responses and analyze the concomitant emergency medical services' patient care needs., Methods: The setting was a mid-sized metropolitan area in the southwestern United States with a population base of 400,000 and an incorporated area of 165 square miles. The authors conducted a retrospective evaluation of all fire department hazmat reports, with associated emergency medical services patient encounter forms, and in-patient hospital records from January 1, 1992, through December 31, 1994., Results: The fire department hazardous materials control team responded to 468 hazmat incidents, involving 62 chemicals. The majority of incidents occurred on city streets, with a mean incident duration of 46 minutes. More than 70% of the responses involved flammable gases or liquids. A total of 32 incidents generated 85 patients, 53% of whom required transport for further evaluation and care. Most patients were exposed to airborne toxicants. Only two patients required hospital admission for carbon monoxide poisoning., Conclusion: Most hazmat incidents result in few exposed patients who require emergency medical services care. Most patients were exposed to airborne toxicants and very few required hospitalization. Routine data analysis such as this provides emergency response personnel with the opportunity to evaluate current emergency plans and identify areas where additional training may be necessary.