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].