The Army chemical/biological SMART (SMART-CB) team: the nurse's role

A chemical or biologic attack probably will be covert, rather than overt. Because presenting signs and symptoms may mimic minor nonspecific illnesses or naturally produced disease syndromes and may not appear for several days, it is likely that nurses in emergency rooms and primary care settings will be among the first to come into contact with victims of a chemical or biologic agent exposure. Early recognition, reporting, decontamination, self-protection, prophylaxis, and treatment are imperative. After the terrorist attack on September 11, 2001, the anthrax incidents, and the heightened publicity of chemical and biologic agent attacks brought on by media coverage, the need for highly trained and well-prepared medical personnel has increased dramatically. Army nurses have led the way in training and expanding the capabilities of specialized medical response teams. Team members require ongoing training, state-of-the-art protective equipment and medical supplies, and constant practice to maintain the high state of readiness required to respond rapidly and effectively to chemical or biologic threats. Army SMART-CB nurses and their team members are well prepared to provide lifesaving care in highly contaminated areas. It is no longer a question of if but rather when and where the next attack will occur.