emergency medical response disasters, terrorism and weapons of mass destruction

Emergency Medical Response

Disasters, Terrorism andWeapons of Mass Destruction


You Are the Emergency Medical Responder

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.

Lesson 46: Disasters, Terrorism and Weapons of Mass Destruction


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.


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)


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)


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


Emergency Support Functions

1. Transportation2. Communications3. Public works and engineering4. Firefighting5. Emergency management6. Mass care, emergency assistance,

housing and human services7. Logistics management and resource

support


Emergency Support Functions (cont’d)

8. Public health and medical services9. Search and rescue10.Oil and hazardous materials response11.Agriculture and natural resources12.Energy13.Public safety and security14.Long-term community recovery15.External affairs


Three Main Categories of Disasters Natural

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

Biological


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


Weapons of Mass Destruction

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


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


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


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


Explosives and Incendiary Weapons

High-order explosives: supersonic over-pressurization shock wave

Low-order explosives: subsonic explosion


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


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


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)


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.


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.


EnrichmentPandemic Flu

Three pillars: Preparedness and communication Surveillance and detection Response and containment

Phases: Early detection Treatment with antiviral medications Infection control measures Vaccination


EnrichmentPersonal Preparedness

Get a kit Make a plan Be informed

emergency medical response disasters, terrorism and weapons of mass destruction

Documents

emergency assistance

emergency vehicles

medical services

medical care

response activities

nationwide response

evacuation slide

hazardous materials