Bioterrorism Drill Case 2 Nerve Agent: Patient Roles

You were attending a Bulls game at the United Center. During half time, you noticed a strange gas floating down from the catwalk. The gas smelled like garlic. People around you started coughing and some appeared to pass out. Everyone began running for the exits. Once you got outside, you started coughing a little, so you decided to head to the local Emergency Department (ED). You present to the ED with: SLIGHT cough but NO breathing difficulty Weakness Slight nausea Some vomiting / diarrhea Abdominal cramps Some urinary incontinence Miosis Some lacrimation Excessive salivation If asked about vital signs, please show the opposite side of this card. 2Y You were attending a Bulls game at the United Center. During half time, you noticed a strange gas floating down from the catwalk. The gas smelled like garlic. People around you started coughing and some appeared to pass out. Everyone began running for the exits. Once you got outside, you started coughing a little, so you decided to head to the local Emergency Department (ED). You present to the ED with: SLIGHT cough but NO breathing difficulty Weakness Slight nausea Some vomiting / diarrhea Abdominal cramps Some urinary incontinence Miosis Some lacrimation Excessive salivation If asked about vital signs, please show the opposite side of this card. 2Y

General impression: Patient is vomiting, lacrimating, drooling, and is incontinent of stool and urine. Vital Signs: Pulse: 70 Respirations: 20 BP: 135/86 Temp: 98ºF, PO Pupils: Pin point General impression: Patient is vomiting, lacrimating, drooling, and is incontinent of stool and urine. Vital Signs: Pulse: 70 Respirations: 20 BP: 135/86 Temp: 98ºF, PO Pupils: Pin point

You were attending a Bulls game at the United Center. During half time, you noticed a strange gas floating down from the catwalk. The gas smelled like garlic. People around you started coughing and some appeared to pass out. Everyone began running for the exits. As you ran for the door, you also began coughing and having trouble breathing. Once you got outside, your breathing became more difficult, so you decided to head to the local Emergency Department (ED). You present to the ED with: Fasciculations of arms and legs SEVERE breathing difficulty Weakness Nausea / Vomiting / Diarrhea Abdominal cramps Urinary incontinence Miosis Lacrimation Excessive salivation If asked about vital signs, please show the opposite side of this card. 2R You were attending a Bulls game at the United Center. During half time, you noticed a strange gas floating down from the catwalk. The gas smelled like garlic. People around you started coughing and some appeared to pass out. Everyone began running for the exits. As you ran for the door, you also began coughing and having trouble breathing. Once you got outside, your breathing became more difficult, so you decided to head to the local Emergency Department (ED). You present to the ED with: Fasciculations of arms and legs SEVERE breathing difficulty Weakness Nausea / Vomiting / Diarrhea Abdominal cramps Urinary incontinence Miosis Lacrimation Excessive salivation If asked about vital signs, please show the opposite side of this card. 2R

General impression: Patient is in severe respiratory distress, vomiting, lacrimating, drooling, is incontinent of stool and urine, and has fasciculations of their arms and legs. Vital Signs: Pulse: 36 Respirations: 40 BP: 150/90 Temp: 98ºF, PO Pupils: Pin point General impression: Patient is in severe respiratory distress, vomiting, lacrimating, drooling, is incontinent of stool and urine, and has fasciculations of their arms and legs. Vital Signs: Pulse: 36 Respirations: 40 BP: 150/90 Temp: 98ºF, PO Pupils: Pin point

You were attending a Bulls game at the United Center. During half time, you noticed a strange gas floating down from the catwalk. The gas smelled like garlic. People around you started coughing and some appeared to pass out. Everyone began running for the exits. As you ran for the door, you also began coughing and having trouble breathing. Once you got outside, your breathing became more difficult and you began to feel weak, so you decided to head to the local Emergency Department (ED). You present to the ED with: Fasciculations of arms and legs SEVERE breathing difficulty Weakness Nausea / Vomiting / Diarrhea Abdominal cramps Urinary incontinence Miosis Lacrimation Excessive salivation While being decontaminated or triaged, please be towards the back of the group. After 2 or 3 minutes, you collapse and have a seizure and will remain unresponsive for the rest of the drill. If asked about vital signs, please show the opposite side of this card. 2B You were attending a Bulls game at the United Center. During half time, you noticed a strange gas floating down from the catwalk. The gas smelled like garlic. People around you started coughing and some appeared to pass out. Everyone began running for the exits. As you ran for the door, you also began coughing and having trouble breathing. Once you got outside, your breathing became more difficult and you began to feel weak, so you decided to head to the local Emergency Department (ED). You present to the ED with: Fasciculations of arms and legs SEVERE breathing difficulty Weakness Nausea / Vomiting / Diarrhea Abdominal cramps Urinary incontinence Miosis Lacrimation Excessive salivation While being decontaminated or triaged, please be towards the back of the group. After 2 or 3 minutes, you collapse and have a seizure and will remain unresponsive for the rest of the drill. If asked about vital signs, please show the opposite side of this card. 2B

General impression: Patient is unresponsive. Vital Signs: Pulse: 10 Respirations: 0 BP: 40/P Temp: 98ºF, PO Pupils: Pin point General impression: Patient is unresponsive. Vital Signs: Pulse: 10 Respirations: 0 BP: 40/P Temp: 98ºF, PO Pupils: Pin point

You were not in attendance at the Bulls game, but saw a crowd running towards the hospital. Fearing you were exposed to “anthrax or a nuclear blast or something,” you ran to the Emergency Department. You are hysterical and terrified. At some point early in the drill, bust through the decontamination area and enter the treatment area. Touch as much as possible and approach a treating physician… remember, you are terrified and are worried you may die. Once you have been escorted by security out of the treatment area, please calm down and comply with physician requests. At first, they can’t get you to sit still long enough to assess your vital signs. Later, once you’ve calmed down, if asked about vital signs, please show the opposite side of this card. 2g You have had a cold for the last few days, but got free tickets to the Bulls game, so you went. During half time, you noticed a strange gas floating down from the catwalk. The gas smelled like garlic. People around you started coughing and some appeared to pass out. Everyone began running for the exits. Once you got outside, you felt fine, but wanted to make sure you were ok, so you decided to head to the local Emergency Department (ED). You present to the ED with: Slight headache, but you’ve had that for 4 days Runny nose Slight cough Basically, you are fine except for a cold you’ve had a cold for a while and you are worried about what happened. If asked about vital signs, please show the opposite side of this card. 2G

General impression: No apparent distress, but extremely worried. Vital Signs: Pulse: 110 Respirations: 20 BP: 142/86 Temp: 99ºF, PO Pupils: Normal General impression: No apparent distress, but the patient is concerned they may have been exposed to something that could make them sick. Vital Signs: Pulse: 90 Respirations: 18 BP: 124/86 Temp: 98ºF, PO Pupils: Normal