Priorities

The priorities for the hospital response in a major chemical incident are the following:

• Containment of the incident and prevention of secondary contamination
• Triage with basic first aid
• Decontamination where it has not taken place on scene
• Recognition of toxidromes and seeking of advice
• Appropriate treatment supportive or antidotal
• Transfer to definitive treatment
• A safe end to the hospital response
• Continuation of business after the event

Learning bite

Most poisons do not have antidotes, so standard decontamination and resuscitative principles apply [Evidence grade: 4, grade of recommendation: D].