If terrorists attacked Utah Valley using biological or chemical weapons, residents might owe their lives to BYU nursing graduate Heather Burgon.

For her capstone project last semester, Burgon made a flipbook for ER nurses to use during such an event.

With the flipbook, nurses can find out almost instantly what agent patients were exposed to and how to treat them.

"Basically, the time part was the big factor," said Burgon, 22, from Las Vegas. "If someone comes in, you can't wait a long time to know what it is. You can't go look it up in the books. You have to know basically right away."

Burgon said the ER nursing director of Mountain View Hospital asked her to make the flipbook because the staff didn't know much about hazardous chemicals and biological agents, including insecticides used by farmers in the area.

"They've had people come in before that had been exposed to chemicals in the field," Burgon said. "And it's been really hard to treat them because they don't know enough about it, how to recognize what it is and how to treat it."

Burgon chose for the flipbook five chemicals, which include nerve agent, chlorine, lewisite, mustard gas and phosgene.

Five biological agents, anthrax, small pox, tularemia, botulism and the pneumonic plague, were also included and are the ones most likely to be used against the United States, according to the Center for Disease Control.

The flipbook was extremely well-designed, said Eva Stoneman, Burgon's faculty advisor and assistant professor of the College of Nursing.

"The format was the same for every chemical," Stoneman said. "She color-coded it so when you opened the book, you knew which page to go to."

The symptoms and treatments in Burgon's flipbook are available on government Web sites but wouldn't be easy to access online during an emergency.

Burgon staged a mock disaster after she made the flipbook. She sent actors into the emergency room who pretended to have been exposed to hazardous agents.

"One of the nurses was at the computer trying to find the information, and one of us handed her the notebook and said, 'Here it is,'" Stoneman said.

Burgon said the mock disaster helped the hospital staff recognize what else needed to be done to prepare for a biological or chemical terrorist attack.

"What they were talking about mostly while this was going on, was 'OK, if this was the real thing, we would need this, and we don't have that right now, these things, these supplies,'" Burgon said. "They said, 'We don't have enough medicine to treat all these people.'"

Through her project, Burgon learned many hospitals are not prepared for a biological or chemical event.

"All the researchers are saying that they're not prepared but they need to be," Burgon said. "It's really expensive because it takes things like special gloves, special masks."

For chemical events, hospitals need outdoor showers, which don't drain into the city sewerage, to decontaminate the victims before they go inside.

"I think it's just kind of daunting to them, that they're like, 'Wow, there's so much to do. Where do we start?'" Burgon said.

Burgon suggested hospitals start by doing research much like she did, taking advantage of the information published by the federal government.

She also said drills and mock disasters are crucial preparation for chemical emergencies.

Even with conscientious preparation, the magnitude of harm possible in a chemical or biological attack would overwhelm the system.

"I learned just a ton about the reality of warfare and the reality of things that could happen," Burgon said. "You realize what these things do to people and you just hope that it never happens."

Copyright Brigham Young University 25 Mar 2003