Chapter 53

Terrorism and Disaster Response

53-1

Weapons of Mass Destruction (WMD)

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Weapons of mass destruction (WMD)

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Materials used by terrorists that have the potential to cause great harm over a large area 53-2

Categories of WMD B-NICE

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Five main categories

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B iological

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N uclear/radiological

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I ncendiary

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C hemical

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E xplosive 53-3

Types of WMD 53-4

Biological Weapons

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Involve the use of bacteria, viruses, rickettsia, or toxins to cause disease or death

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Often odorless, tasteless, and invisible

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The effects may not be seen for hours or days.

53-5

Biological Weapons

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Diseases can be spread by

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Inhalation

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Substances dispersed by spray devices (aerosols)

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Ingestion

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Contaminated food or water supplies

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Absorption

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Direct skin contact with the substance

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Injection 53-6

Biological Weapons

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Bacteria

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Germs that can cause disease in humans, plants, or animals

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Do not depend on other organisms to live and grow

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Possible biological weapons

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Anthrax Tularemia (rabbit fever) 53-7

Biological Weapons

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Rickettsias

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Very small bacteria that require a living host to survive

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Transmitted by bloodsucking parasites

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Fleas, lice, ticks

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Possible biological weapon

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Q fever 53-8

Biological Weapons

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Viruses

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Depend on other organisms to live and grow

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Possible biological weapons

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Smallpox

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Ebola virus 53-9

Biological Weapons

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Toxins

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Substances produced by an animal, plant, or microorganism

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Possible biological weapons

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Ricin

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Botulism Enterotoxin B 53-10

Nuclear and Radiological Weapons

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Dirty bomb Radiological dispersal device

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Accidental radiation release Caused by a meltdown or human error

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Aerosol Spray over a populated area

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Terrorist attack Deliberate attack

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Often delivered via a vehicle carrying radioactive material 53-11

Nuclear Radiation 53-12

Incendiary Weapons

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Incendiary materials

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Used to set fire to wood or other materials

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Example:

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Firebombs 53-13

Chemical Weapons

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Chemical agents

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Poisonous substances that injure or kill people

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Inhalation Ingestion Absorption through the skin or eyes 53-14

Chemical Weapons

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Five broad categories 1. Nerve agents 2. Blister agents 3. Blood agents 4. Choking agents 5. Irritants 53-15

Nerve Agents

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Interrupt nerve signals Cause a loss of consciousness within seconds and death within minutes of exposure

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Examples:

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Tabun

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Sarin

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Soman

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VX 53-16

Blister Agents

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Effects are like those of a corrosive chemical such as lye or a strong acid.

Cause severe burns to eyes, skin, and tissues of the respiratory tract

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Examples

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Distilled mustard

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Forms of nitrogen mustard 53-17

Blood Agents

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Cause rapid respiratory arrest and death by blocking absorption of oxygen to cells and organs through the bloodstream

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Examples:

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Cyanide

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Arsine

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Hydrogen chloride 53-18

Choking (Pulmonary) Agents

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Inhaled chlorine mixes with moisture in the lungs and becomes hydrochloric acid.

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Causes fluid to build up in the lungs (pulmonary edema)

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Interferes with the ability to exchange oxygen Results in asphyxiation that resembles drowning

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Examples

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Chlorine Phosgene 53-19

Irritants

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Used for personal protection and by police in riot control Cause burning and intense pain to exposed skin areas Examples

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Mace

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Pepper spray

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Tear gas 53-20

Factors Affecting Exposure

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Substance involved Concentration of the substance Duration of exposure Number of exposures Route of entry

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Inhalation, ingestion, injection, or absorption 53-21

Factors Affecting Exposure

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Age Gender General health Allergies Smoking habits Alcohol consumption Medications 53-22

• • • • • • • • • •

Signs and Symptoms Requiring Medical Attention Unconsciousness Confusion Lightheadedness Anxiety Dizziness Changes in skin color Shortness of breath Burning of the upper airway Coughing or painful breathing Drooling

• • • • • • • • •

Chest tightness Loss of coordination Seizures Nausea, vomiting Abdominal cramping Diarrhea Loss of bowel or bladder control Dim, blurred, or double vision Tingling or numbness of the extremities 53-23

Explosives

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Terrorists often use various types of explosives. Examples

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Grenades Rockets Missiles Mines Pipe bombs Vehicle bombs Package or letter bombs Bombs carried in devices such as a knapsack or backpack 53-24

WMD Incident Response 53-25

Your Responsibilities

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Safety Isolate the scene.

Preserve evidence and deny entry.

Ask for additional help.

Coordinate efforts with other responders.

Recognize the signs of a potential WMD incident.

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Alert the proper authorities.

Recognize the potential of a secondary explosion and an attack on EMTs.

53-26

Pre-Arrival Response

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Listen for specific clues that may indicate a possible terrorist incident:

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Type of incident

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Incident location

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Number of reported casualties 53-27

Arrival Response

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Scene safety

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As you approach the scene, consider the safest way to do so:

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Uphill Upwind Upstream

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Be aware of the terrain.

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Try to avoid “bottlenecks” or traps.

53-28

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Arrival Response Look for

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An unusually large number of people with burns or “blast” injuries

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Large numbers of people running from the scene or on the ground

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Danger of fire, explosion, electrical hazards, or structural collapse

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Weapons, explosive devices Signs of corrosion Evidence of the use of chemical agents 53-29

Arrival Response

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Incident Factors

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Listen for

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Screaming Explosion Breaking glass A hissing sound that indicates pressure releases

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Information from victims or bystanders 53-30

Arrival Response

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Think, Plan, Act, and Evaluate

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On arrival

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Consider need for scene control and the establishment of a perimeter

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Give the exact location of the incident or perimeter

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Notify all responders

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Location of the area of the suspected contamination

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Safe routes for entry to the site Where to stage Potential hazards or danger 53-31

Arrival Response

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Other incident factors

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Time of day

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Temperature

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Wind intensity and direction

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Humidity

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Cloud cover

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Precipitation 53-32

Safety Zones

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Identify and establish safety zones.

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Hot zone

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Contamination zone (site of the incident) Dangerous area Must have high-level PPE to enter this area

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Warm zone

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Serves as entry and decontamination point All personnel must wear appropriate PPE

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Cold zone

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Safe zone

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Staging area for personnel and equipment Incident command post is located here 53-33

Incident Command

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Initiate the National Incident Management System (NIMS).

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Designate the incident commander.

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Announce the location of the command post.

53-34

Approaching the Patient 53-35

Approaching the Patient

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Goals

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Terminating the patient’s exposure to the contaminant

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Removing the patient from danger

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Providing emergency patient care

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Maintaining rescuer safety 53-36

Approaching the Patient

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Approach ONLY if the scene is safe.

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Be sure you are wearing appropriate protective gear.

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Perform a primary survey.

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Provide emergency care.

53-37

Safety 53-38

Key Safety Points

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Consider the possibility of multiple hazards.

The contaminated area is restricted to workers who are

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Wearing appropriate protective gear

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Actively involved in performing emergency operations Identify the materials involved in the incident ONLY from a safe distance.

53-39

Decontamination 53-40

Decontamination (Decon)

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Purpose

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Reduce and prevent the spread of contamination by physical and/or chemical processes

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Performed ONLY by trained personnel wearing the appropriate level of PPE

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Continued until determined to no longer be necessary 53-41

Questions? 53-42