Disasters, Terrorism and Weapons of Mass Destruction

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Disasters, Terrorism andWeapons of Mass
Destruction
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You Are the Emergency Medical Responder
Lesson 46 Disasters, Terrorism and Weapons of
Mass Destruction

• You are an EMR dispatched to the scene of an
  explosion. On arrival you are staged with other
  emergency vehicles one block away. You are told
  that police suspect that a building was targeted
  by an extremist group and it is uncertain if
  there were injuries from the blast.

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Terrorism

• The unlawful use of force and violence against
  persons or property to intimidate or coerce
  government, the civilian population or any
  segment thereof, in furtherance of political or
  social objectives.

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Preparation for Disasters and Terrorism

• Federal Emergency Management Agency (FEMA)
• Responsible for coordinating the response in the
  U.S.
• National Response Framework (NRF)
• National Disaster Medical System (NDMS)

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National Incident Management System

• Comprehensive national framework for managing
  incidents
• Outline of structures for response activities for
  command and management
• Provision of consistent, nationwide response at
  all levels
• Contains 15 Emergency Support Functions (ESFs)
• As EMRs you are supported by ESF 8 (public
  health and medical services)

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Areas of NIMS

• Incident command systems (ICS)
• Multiagency coordination system (MACS)
• Unified command, training, identification and
  management of resources
• Mutual aid and assistance
• Situational awareness
• Qualifications and certification
• Collection, tracking and reporting of incident
  information
• Crisis action planning
• Exercises

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Emergency Support Functions

1. Transportation
2. Communications
3. Public works and engineering
4. Firefighting
5. Emergency management
6. Mass care, emergency assistance, housing and
   human services
7. Logistics management and resource support

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Emergency Support Functions (contd)

1. Public health and medical services
2. Search and rescue
3. Oil and hazardous materials response
4. Agriculture and natural resources
5. Energy
6. Public safety and security
7. Long-term community recovery
8. External affairs

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Three Main Categories of Disasters

• Natural
• Human-caused (terrorist attacks, HAZMAT incidents
  and MCIs)
• Biological

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The Role of theEmergency Medical Responder

• Leadership if first responder on the scene
• If you are not the first responder on the scene
• Assist the leader
• Assume other roles
• Triage patients
• Provide medical care
• Provide patient reception at staging facilities
• Prepare patients for evacuation

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Weapons of Mass Destruction

• Known by the acronym CBRNE
• Chemical
• Biological
• Radiological/Nuclear
• Explosives

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Chemical Agents

• Nerve agents act upon the nervous system
• Blister agents as the name implies
• Blood agents disrupt cellular respirations
• Pulmonary agents lung tissue damage
• Incapacitating agents pepper spray, tear gas

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Biological Weapons

• Class A weapons highest level of threat
• Anthrax, smallpox
• Class B weapons moderate level
• Food/water pathogens, ricin toxin
• Class C weapons easy spread
• Yellow fever, hanta virus, tick-borne viruses

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Radiological/Nuclear Agents

• Damage due to the following
• Air blast
• Heat
• Ionizing radiation
• Ground shock
• Secondary radiation
• Acute radiation syndrome follows a predictable
  pattern that unfolds over several days and weeks

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Explosives and Incendiary Weapons

• High-order explosives supersonic
  over-pressurization shock wave
• Low-order explosives subsonic explosion

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Response to CBRNE/WMD Incident

• Preparation
• Medical direction
• Personal preparation
• Equipment
• Transportation and communication
• Equipment and supplies
• Arrival on the scene
• Scene safety
• Providing care

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Nerve Agent Poisoning

• Initial effects dependent on dose and route
• Inhalation via gas
• Absorption through skin
• Ingestion from liquids or food
• Dose and amount of exposure leads to varying
  effects

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Care for Nerve Agent Poisoning

• Ventilation
• Antidotes
• Atropine
• Pralidoxime chloride
• Decontamination is critical for skin exposure
• Continued monitoring and transport (if ingested)
• Nerve agent auto-injector kit (for self- or
  peer-administration of nerve agent antidote)

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Activity

• You and several other EMRs are providing care to
  patients at the scene involving exposure to a
  nerve agent. You observe a fellow EMR begin to
  sweat excessively and cough. He starts
  complaining of headache and nausea. You also
  notice a runny nose, watery eyes and pinpoint
  pupils. You suspect that he is exhibiting signs
  of nerve agent poisoning.

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You Are the Emergency Medical Responder

• There is some question about the cause of the
  explosion but police strongly suspect that is was
  a terrorist attack using a WMD, most likely a
  high-order explosive. While in the staging area
  you observe a large trash bag near a dumpster in
  close proximity to staged apparatus.

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EnrichmentPandemic Flu

• Three pillars
• Preparedness and communication
• Surveillance and detection
• Response and containment
• Phases
• Early detection
• Treatment with antiviral medications
• Infection control measures
• Vaccination

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EnrichmentPersonal Preparedness

• Get a kit
• Make a plan
• Be informed