all simulated ambulance patients, there were no significantdifferences for 4 out of the 6 vehicles. For the two vehicles thatdemonstrated a difference, EMTs showed greater accuracythan EMT-Ps for one of the two. Preliminary analysis revealeda tendency for underestimation to exceed the overestimation.For all vehicles, 17 estimates (of a possible 270) were correct orwithin one pound of the actual weight. SPSS was used toanalyze the data. Pearson’s correlation, t tests, and chi-squarewere used. Number of years of experience was associatedwith the highest degree of accuracy, followed by age. Therewere no significant differences in the level of training. Whenthe level of training was controlled, the association ofexperience and age with accuracy remained. Conclusion:There is no difference in the accuracy of weight estimation ofadult patients in the prehospital setting with respect to levelof training.

Objective: From August 11 to 17, 2003, Santo Domingo,Dominican Republic, hosted the XIV Pan-American Games.With the participation of 42 nations, and the presence ofnearly 10,000 athletes, trainers, and foreign dignitaries, theevent is considered the fourth most important athleticcompetition in the world. Methods: Under the aegis of theSecurity Directorate, and with support from nationaland international security agencies, a Weapons of MassDestruction (WMD) unit was developed and deployed forthe games. Results: The Unit command structure utilized thestandard military command format of S1-S5 codes, designat-ing Personnel, Intelligence, Planning-Operations, Logistics,and Communication Officers, respectively. For operationalsupport two strike teams (Alpha and Bravo) were active atany given time, each team consisting of 5 members (teamleader, field physician, explosive ordinance officer, and twotactical officers). One civilian and two military hospitals werethe designated receiving centers for the event. With theassistance of the WMD unit, ED staff were trained in WMD-event management and decontamination procedures. Aninitial 40-hour instructor ‘‘train-the-trainer’’ program wascreated, directed towards 100 military officers, who sub-sequently trained the more than 500 WMD first responders.An encrypted Web-based program was developed to assist inbioterrorism epidemiological surveillance, recording patientdemographics and assessing chief complaints against thoseexpected from CDC Category A bioterrorism agents. Tocomplement standard chemical and biological detection kits,live animals were used as biological monitoring stations.Indigenous fish were employed to monitor the water supply,while small birds were strategically placed throughout thelocale, under constant video surveillance. Technicians fromthe Dominican Nuclear and Atomic Affairs Commissionperformed radiation monitoring in the Pan-American Villageas well the Olympic Stadium during the opening and closingceremony of the Games. Conclusion: In part due to theextensive pre-planning and development of the WMD unit,the games were uneventful and a true success.

51 AN EMS TRANSFER AUTHORIZATION CENTRE IN RESPONSE TO

THE TORONTO SARS OUTBREAK Bruce Farr, Michael Neill,John Loch, Russell D. MacDonald, Bruce Sawadsky, ChrisMazza, Karim Daya, Chris Olynyk, Sandra Chad, TorontoEMS

Objective: To describe the rapid development and im-plementation of an innovative EMS command, control, andtracking system to mitigate the risk of iatrogenic spread ofSARS amongst health care facilities, health care workers, andpatients in Ontario, Canada, due to interfacility patienttransfers. Methods: A working group of stakeholders inhealth care and transport medicine developed and im-plemented a medically-based command and control centre

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49 USE OF AN IMPROVISED PORTABLE REUSABLE HEAT EXCHANGER

FOR WARMING IV FLUIDS Richard B. Schwartz, DouglasOlson, Brad Z. Reynolds, Medical College of Georgia

Objective: In military and wilderness settings, warming IVfluids can be very difficult. We proposed that IV fluids couldbe warmed sufficiently (at the time of use) by an improvisedheat exchanger. Methods: The heat pack is made froma solution of sodium acetate in a sealed flexible plastic cover.When activated the heat pack becomes a semi-solid andwarms to a temperature of approximately 548C. We wrappedthis heat pack with IVextension tubing of various lengths andplaced it in an insulated bag to create the heat exchanger. Literbags of normal saline and the heat packs were cooledovernight in a refrigerated room to a temperature of 7.58C.Length of IV extension tubing and the flow rate were bothvaried. Trials were run to determine the ideal length of tubingto achieve optimal fluid temperature at variable flow rates.Results: Two trials were run, the first with 5.5 meters ofextension tubing and the second with 11 meters of extensiontubing. In each trial normal saline was infused at 100 cc/hr,500 cc/hr, and at bolus rate. In the first trial at 100 cc/hr themaximal temperature of 448 was reached at 21 minutes. At 30minutes the temperature was 43.28. The maximal temperatureof the 500 cc/hr infusion was 37.98 at 9 minutes and the tem-perature at 30 minutes was 32.28. The maximal temperature atthe bolus infusion rate was 22.48 at 9 minutes and the liter wasinfused in 10 minutes with a final temperature of 22.18. In thesecond trial at 100 cc/hr the maximal temperature was 40.18,and it was reached at 21 minutes. At 30 minutes the temper-ature was 38.48. The maximal temperature of the 500 cc/hrinfusion was 35.68 at 18 minutes and the temperature at 30minutes was 33.98. The maximal temperature at the bolusinfusion rate was 30.68 at 10 minutes and the liter was infusedin 13 minutes with a final temperature of 30.38. Conclusion:An improvised, commercially available, portable heat ex-changer will warm IV fluids at the time of infusion.

50 WEAPONS OF MASS DESTRUCTION PREPAREDNESS AND RE-

SPONSE FOR THE XIV PAN-AMERICAN GAMES, SANTO DOMINGO

2003 Amado A. Baez, Matthew D. Sztajnkrycer, Hum-berto H. Perez-Compres, Ediza M. Giraldez, Mayo GraduateSchool of Medicine

for all interfacility (including acute and long-term care)patient transfers in Ontario, Canada. Development andimplementation took place in three distinct but overlappingphases: needs assessment, design and implementation, andexpansion and ongoing operations. Results: The needsassessment, design, and implementation were completed inless than 48 hours using existing EMS infrastructure and