Management of victims of urban chemical attack: the French approach.

Since the early 1980s several disasters involving mass release of toxic substances have focused the attention of different administrations and the fire services into producing protocols and guidelines for action in civilian situations. The bomb attack in the Tokyo subway, in March 1995, made it clear that a terrorist attack using highly toxic agents is now feasible. Management of disasters in the civil sector in France is based upon two interlinked plans: the Red Plan, which covers on-site organisation, and the White Plan, which concerns the interface with hospital services. Special procedures have been developed to adapt the Red and White Plans for use in the event of toxic attack and concern the deployment of emergency responding personnel, the provision of life support and antidotes in the contaminated zone, the prevention of secondary contamination and the transport and reception of victims at the hospital. Based on the established principle of pre-hospital resuscitation and well-tried assistance plans, this doctrine allows a safe and effective response to terrorist attacks as well as to other toxic release incidents.