Wounded men and women could begin to arrive at the Loch Raven Boulevard hospital, where physicians have been trained to treat chemical and biological warfare exposure, within five days after American casualties are reported, hospital officials said.
"What we have here is a tremendous expertise," the Maryland congresswoman said yesterday after two hours of talks with officials and an inspection of admitting, isolation and intensive care rooms that have been readied for the casualties.
"This hospital knows how to handle trauma injuries, it has great expertise in infectious diseases and wounds resulting from chemical weapons. There is expertise here and at the Perry Point VA hospital in dealing with psychiatric care. And, when the wounds are healed, men and women can be rehabilitated here."
The congresswoman closely questioned Dr. Sandra T. Marshall, an internal medicine specialist, who has been trained by military experts at Aberdeen Proving Ground, on the effects and treatment of debilitating and lethal chemicals, such as mustard gas and nerve gasses.
"Those exposed to mustard gas will have blisters that cover their bodies and respiratory and intestinal burns," Marshall said. "Mustard gas can be delivered in multiple ways. It can come as a cloud, it can be put in food, it can be absorbed in a number of ways.
Nerve gases block nerve transmission so that those exposed would have neurological signs and symptoms, and, at high enough doses, would have respiratory collapse and difficulty breathing, she said.
Dr. Elizabeth Rogers, the hospital's chief of staff, said some people exposed to nerve gases will be completely cured by the time they arrive at the VA hospital because of what happens out in the field. Others will be so badly injured that they will not make it off the field.
"But, there will also be a large group," she said, "who, despite getting appropriate treatment at the right time, will have sufficient exposure that they will have problems that will last for a period of time. So, until their nerves can grow and they can find alternate ways to use their muscles, they will have trouble with breathing and they will get infections."
Mikulski, who chairs the VA subcommittee on appropriations, said that "significant costs will be incurred by the VA" to carry out its new mission and that she was in Baltimore to see how the plan will work at the Loch Raven VA and what that hospital's needs will be.
Mikulski said she has called a hearing for next Tuesday to find out from the secretary of the Veterans Administration how this plan, which will involve 159 VA hospitals, is working nationally.
The VA facilities in Baltimore will be a backup to the Walter Reed Army Medical Center, a military hospital in Washington. "When Reed maxes out, people will be coming to the VA hospital here and they also will be going to specialized trauma units for burns and surgery," the congresswoman explained.
Rogers said that veterans normally treated at the hospital will continue to get care, but there will be a curtailment of non-emergency, non-service connected admissions that would have to seek care at community hospitals.
"Patients who are nearing the end of their hospital stay could be discharged a few days sooner than otherwise," she said. "Other patients will be transferred to VA hospitals in the neighboring area."