Background After 11 September 2011, Italy prepared a Public Health Plan for national defence and regional storage facilities for antidotes. These are managed by a physician and a pharmacist. In Friuli Venezia Giulia-Italy, the pharmacist is responsible for the safety of the antidotes, the national database, collaborates with the physician in planning for emergencies and makes antidotes available for immediate transfer to the site of the incident. Sarin, a nerve gas, even at a very low concentration, causes death rapidly if the victim isn’t treated immediately with atropine and subsequently within the first 4–5 hours with pralidoxime.
Purpose To verify, by means of a simulation, that there were sufficient stocks of atropine, and the accessibility, distribution and the appropriateness of the treatment.
Materials and Methods We simulated a terrorist attack with sarin at the railway station in Udine, the seriousness equivalent to the attack in Tokyo on 20 March 1995.
Results In Tokyo, 107 people out of approximately 6000 involved in the attack with sarin, needed treatment with atropine. 80% were treated with only 2 mg, for a total of 170 mg, while 21 needed more than 2 mg. Nobody was given more than 9 mg. In total, 350 mg of atropine was immediately necessary on the site of the attack, equivalent to 350 phials of 1 mg. In our simulation, the time for access and preparation of the antidote was about 10 minutes from the moment of the alert. The transfer and distribution time to the site was less than 15 minutes due to favourable road access, geographical factors and the short distance from the station to the storage facility.
Conclusions The pharmacist is responsible for immediate availability, accessibility and distribution of the antidotes to the site of emergency, and awareness of appropriate treatment.
No conflict of interest.
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