CCBRN

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CCBRN

• IDENTIFYING
• AND
• DEALING WITH CCBRN INCIDENTS

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Introduction

• The purpose of this lecture is to help us as fire
  fighters in identifying and dealing with CBRN
  incidents.

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The 1,2,3 SCENE SAFETY RULE

• Step 1 One casualty approach using normal
  procedures.
• Step 2 Two casualties approach with caution,
  report
• arrival and give CHALETS Assessment.
• Step 3 Three casualties do not go to the scene
  but to a
• perimeter RVP and wait further instructions.

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Immediate action

• Remain calm
• Protect yourself before going to the aid of
  others
• Put on PPE
• DO NOT go to the aid of casualties without PPE,
  await specialist help.
• Move back to cold zone and send initial CBRN
  report.

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ARRIVAL AT THE INCIDENT
If confronted with an incident there are a number
of generic triggers that may indicate an attack 

• Dead or dying animals,
• Unexplained multiple casualties suffering serious
  illnesses,
• Nausea, disorientation, difficulty in breathing
  or convulsions and
• Definite casualty patterns or no logical
  explanation for the amount of casualties.

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First responder objectives

• Secure the area
• Identify hot, warm and cold zones
• Initial identification of agent released
• Casualty rescue decontamination triage
  treatment evacuation
• Media and crowd control
• Avoid secondary contamination
• Protect evidence and scene of crime
• Beware of the threat form secondary devices

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CHALET assessment

• CASULATIES approximate number dead, injured
  and uninjured
• HAZARDS - Present and potential
• ACCESS EGRESS best access routes for
  emergency vehicles
• LOCATION exact location of incident
• EMERGENCY SERVICES present and required
• TYPE OF INCIDENT brief details

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Other factors to be aware of include the presence
of

• Unusual liquid, spray or vapour
• Droplets, pools of liquid or any oily film on the
  ground
• Clouds, fog or mist not related to the weather
  conditions.
• What are the weather conditions e.g. wind
  speed/direction.
• What is the direction of any plume

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The officer in charge should also consider the
possibility of

• A secondary attack
• The isolation of radio signals
• Ensuring that radio transmissions are isolated or
  kept to a minimum
• Ensure appropriate Personal protective equipment
  is worn
• Evacuate and isolate casualties within the inner
  cordon
• Prepare for Mass Decontamination
• Varying the position of appliances where there
  has been previous attendances to the premises

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CBRN report information

• Time
• History of incident witness statements or
  observations
• Type of release chem / bio etc
• Location of release site ( nearest 10 meters)
• Positive CB indicators
• Weather conditions
• Wind direction
• Wind speed
• Plume information
• RVP / ICP location
• Recommended safe route to RVP / ICP
• Recommended mass decon area
• CHALET casualty report

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The officer in charge should also lookout for any
casualties suffering the DUMBELS effect.

• Diarrhoea,
• Urination,
• Miosis or pin point pupils,
• Bronchospasm or wheezing,
• Emesis or vomiting,
• Lacrimation or,
• Salivation.

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• Suspicious devices or packages which may contain
  any
• Ø        Unexplained wiring or tubing.
• Ø        Compressed air cylinders with tubing.
• Ø        Liquid containers
• Ø        Aerosols
• Ø        Timers and batteries
• Unexplained munitions, ball bearings or metal
  fillings.

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Chemical agent indicators
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Biological agent indicator
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Radiological / nuclear
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• If the hazard cannot be identified through the
  normal means for example with the assistance of
  the Emergency Response Guidebook or the Chemdata
  system then alternative methods should be sort.

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Hazard Identification

• An Indicator Matrix has been developed to assist
  in identifying the agent. The Indicator Matrix
  is based on data provided by the Defense
  Protective Service at the Pentagon. It is
  designed to give the best approximation of the
  agent used but it is not to be considered
  definitive until confirmed by a hazardous
  materials officer or suitably qualified medical
  personnel.

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• To use the matrix simply put a check in each row
  in which the indicator is present. Grey boxes
  signify indicators that are not applicable to a
  given agent.
• At the bottom of each page total the number of
  check marks in each column then total all the
  marks from each page. The column with the
  highest percentage of indicators should be
  considered the agent most likely present.

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AGENT INDICATOR MATRIX  
Grey Boxes Not Applicable
AGENTS INDICATOR MATRIX




A Nerve agents B Blister agents C Cyanide D
Pulmonary agent E Riot control agent
12 3 6 0 4
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More detailed information on the Agent Indicator
Matrix and the effects and treatment of the
agents mentioned can be found in Janes Chem-Bio
Handbook
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Mass Decontamination

• At any of these incidents Mass Decontamination of
  the public may be required

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• The Fire Service in partnership with the
  Department of Health has accepted responsibility
  for the management
• of public mass decontamination, in the event of a
  radiological,
• biological or chemical attack,
• which is beyond the capabilities of the Ambulance
  Service alone.

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To enable the Fire Service and other agencies to
respond effectively to any large-scale terrorist
attack where mass decontamination is required, a
local Memorandum of understanding has been
produced and agreed upon by various organisations
in the area, these include

• Fire Rescue Services and Brigades,
• Ambulance Services,
• Police Forces,
• Emergency Planning Units and the Environmental
  Agency.

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To ensure successful Mass Decontamination, strict
controlled areas need to be established. Within
these controlled areas the implementation of
zones and cordons is paramount to its success
THE HOT ZONE This indicates the area where
personnel are likely to come into direct contact
with the hazardous materials. Personnel will
wear full protective clothing. i.e. Gas Tight
Suits, Breathing Apparatus etc.
THE WARM ZONE This indicates the area where
there is a low risk of exposure to the hazardous
material, or there is a possibility of cross
contamination from the casualty or equipment. It
is still necessary for personnel to be
appropriately protected in this area.

• THE COLD ZONE Indicates a sanitised area that
  is provided to allow for other emergency
  personnel and their advisors to work unhindered
  at an incident

The wind direction should be taken into account
with the decontamination area and Command
Control vehicles positioned upwind.
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Decontamination methods

• Wherever possible the Senior Ambulance Officer
  present should be consulted as to the best
  methods of decontamination available.
• 80 of the contaminant is removed if the casualty
  removes their outer clothing.
• The remaining 20 can be removed by washing the
  exposed skin.
• If time and numbers permit decontamination using
  buckets of warm soapy water and sponges should be
  used.

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• The appropriate decontamination agent is water
  and detergent. It is recommended that a mixture
  of 0.5 detergent in water is used which is
  approximately 50ccs of detergent in a standard
  bucket of water.
• This will usually be applied using a
  rinse/wipe/rinse method.
• If however the numbers or circumstances are such
  that the rinse/wipe/rinse procedure is not
  appropriate, then consideration should be given
  to the introduction of sprays from hose reels or
  showers. 

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• One method of providing mass decontamination
  showers is to erect a gantry using short
  extension ladders formed into an A frame and
  toped with roof ladders to provide the horizontal
  securing for hosereels that supply the water
  spray for decontamination

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• Both Fire and Ambulance Services will set up
  their own decontamination showers as normal, to
  run alongside Mass decontamination modules.
• In addition to Fire Service equipment other
  emergency services and agencies have their own
  equipment.

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The end