Weapons of Mass Destruction Awareness for EMS Providers

Sponsored by the NYS Department of Health Bureau of Emergency Medical ServiceDeveloped by Dario Gonzalez, MD

DOMESTIC PREPAREDNESS

EMS RESPONDER AWARENESS

Nuclear, Biological & Chemical

EMS Responder Awareness

Goals and ObjectivesRecognize the “potential” for a Weapons of Mass Destruction /Domestic Terrorism (WMD/DT) event.Develop WMD/DT awareness Develop safe operation and response strategies.

Components

Awareness Level Responder ActionsScene SafetyThreat PotentialNBC Hazards

The Threat of NBC Terrorism

TOKYO SUBWAY SYSTEM

MARCH 1995

Sarin Gas Attack12 Dead, 5500 Affected

WHAT’S WRONG WITH THIS PICTURE?

The Most Important

Objective Is...YOUR

SAFETY!!!

Scene SafetyBasic safety strategies begin with each emergency responder performing their duties, without being injured or contaminated.

Scene SafetyStart with the right attitude:

PROTECT YOURSELFIN ORDER TO HELP OTHERS!!!

Exposures to civilians at the scenemay be unavoidable...

Exposures to emergency response personnel happen because of: (1) inadequate size-up

(2) lack of appreciation for the magnitude and critical nature of the event

BUT

What is the type and importance of the location?

Is it a landmark, stadium, public gathering, government office?

Look For The Following:

Is it an enclosed space?

Is it a critical facility?

Look For The Following:

What is the occupancy?

Is there chaotic crowd behavior?

What are the witnesses saying?

Look For The Following:

Are there multiple patients?

Are they all exhibiting similar signs & symptoms?

Flu-Like Syndrome Respiratory complaints

Look For The Following:

Look for the Following:Consider the possibility of a secondary

device.Are there any devices or containers

still at the sceneWhat is out

of place here?

Be S A F ESAFETY comes first

ASSESS the situation before doing anything

FOCUS your efforts on the hazard and avoiding contact with it

EVALUATE the situation and report to proper authorities

Basic Safety StrategiesDuring the initial approach to the scene perform a thorough...

10 SECOND SCENE SURVEY

Resist the urge tojump right in…

It is OK to stand by and wait for help

Protect Yourself!** So that you can provide care for others**

NBC WeaponsNuclear materials - damage cells

Biological agents – diseases

Chemicals - poisons

Weapons grade nuclear material isessentially unobtainable...

Radioactive materials / wastes are relatively easy to obtain and frequently transported thus pose a greater threat than nuclear weaponry

Nuclear Agents

HOWEVER

Chemical AgentsNERVE AGENTSSarin, Tabun, Soman, VXVESICANTSHD, Lewisite, Phosgene BLOOD AGENTSHydrogen Cyanide, Cyanogen ChlorideCHOKING AGENTSPhosgene, Chlorine

Biological AgentsAnthraxPlagueEbola

BotulinumSmallpox

Biological AgentsAgents produce non-specific symptoms“Flu-like” symptomsPrimary mode of transmissionis the respiratory tract

Potential Outcomes of Terrorist NBC Attack

Overwhelm emergency response systemLoss of faith in emergency response system and local government Disrupt normal local routine activities

Potential Outcomes of Terrorist NBC Attack

Mass casualtiesShut down and “decontaminate” facilitiesChaos and confusion

First Responder ActionsYOUR PRIORITY IS TO:

What Should Rescue Personnel Do?

STOP:DO NOT ENTER the at risk or hazard area.

Avoid contamination.Stay in designated areas.

Stay upwind & upgrade at all times.If you find a device do not touch it!

What Should Rescue Personnel Do?

The first wave of victims are usuallythe least injured or contaminated.

Try not to touch them.If possible, keep them isolated in one area.

Be alert for the effects of “off-gassing”.

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What Should Rescue Personnel Do?

Isolate the scene & deny entry to the hazard area.

Ensure that proper authorities have been notified of the incident.

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What Should Rescue Personnel Do?

Ensure that all responding agencies are notified of any additional hazards and instruct them as to the best route of entry.

AFTER “decontamination” of casualties, responders will provide appropriate treatment (as directed by medical personnel and local protocol).

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The 4 Don’tsDON’T

BECOME AVICTIM

DON’T RUSH IN

DON’TASSUME

ANYTHINGDON’T TEST

(taste, eat, smell,touch)

It’s O.K. to wait for help

Resist the urgeto jump right in !

EmergencySelf-DecontaminationBLOT

STRIP

FLUSH

COVER

Blot off the agent

Strip off all clothing

Flush the affected area withlarge amounts of water

Cover the affected area

SUMMARYMost likely target is an enclosed, public area.Recognizing symptoms may be the first clue.Mass casualties will result.

SUMMARYAwareness Level Responder Actions:

DO NOT JUMP IN!!!Recognize the incident potential.Protect yourself.Notify the proper authorities.Deny entry.

Lessons To Be Learned...