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CBRNE Training Academy. Relating the Exotic to the Mundane. Objectives. Integrate Awareness, Hazard Recognition and SIN Illustrate the “All Hazards” approach Personal empowerment. Scenario #1. You are a security guard You work at the large county hospital
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CBRNE Training Academy Relating the Exotic to the Mundane
Objectives • Integrate Awareness, Hazard Recognition and SIN • Illustrate the “All Hazards” approach • Personal empowerment
Scenario #1 • You are a security guard • You work at the large county hospital • You control flow into the emergency department
Here’s what you see . . . • Patient presents with a cough • Fifth patient in last hour with cough • They all also have fever • They are all from the same place • What do you do now?
Approach • Awareness • Abnormal for time of year, hospital • Hazard Recognition • Cough and fever is infectious • S-I-N • Protect yourself (mask, isolate) • Protect others (isolate, masks, etc.) • Notify the triage nurse or supervisor
Gather information • They are all from the same shelter / prison • They are all from the same apartment building / office • They are all from the same day care / nursing home • They are all from Hong Kong • They are all from the same train
What is this? • “A cold?” • Influenza? • Tuberculosis? • Atypical pneumonia (Legionella)? • SARS? • Anthrax? • More importantly, does it matter?
Common ground • This is an infectious disease problem • The organism defines the menace • The intent defines the malice • A biological terrorism event is an “Infectious Disease Outbreak” • Initial approach is the same • Subsequent is modified by what you learn Anyone can sound the alarm
Scenario #2 • You work at the gift shop in the hospital lobby • It is a popular place for employees • They get discounts on medicine, food and drink • It is a slow day because of the blizzard
Here’s what you see. . . • An employee has tearing, and difficulty breathing • Third employee in last hour with similar problem • They all smell funny • You start to feel the same symptoms • What do you do now?
Approach • Awareness • This is not normal; you are healthy • Hazard Recognition • Something is causing irritation • This is being brought by the employees • S-I-N • Close up shop, find clean air • Remove contaminated clothing, seek care • Notify your supervisor, security, the ER, etc.
Gather information • They all work in the kitchen • They all work as groundskeepers • They all work in environmental services • They all work in the same lab • They all work in security • They all work in the mailroom
What is this? • Environmental allergy? • Pesticide? • Chlorine gas? • Tear gas? • Nerve agent? • More importantly, does it matter?
Common ground • This is an chemical exposure problem • The chemical defines the menace • The intent defines the malice • A chemical terrorism event is a “Hazardous Materials Incident” • Initial approach is the same • Subsequent is modified by what you learn Anyone can sound the alarm
Scenario #3 • You are an emergency physician • You are responsible for medical command of the local EMS units • It is three o’clock in the morning
Here’s what happens . . . • EMS calls • There was an explosion • They are bringing five critical patients • They are all coming from the same place • What do you do now?
Approach • Awareness • Know resources, staff and community • Hazard Recognition • Know what exists near the hospital • Know your EMS units and paramedics • S-I-N • Prepare • Activate trauma team, plan; get info • Let people know (administration, etc.)
What you learn • Construction site • Fireworks factory • Chemical production plant • Nuclear power plant • Subway car / Train station • Church / Synagogue • FBI building
What is this? • Explosive + Thermal? • Explosive + Thermal + Chemical? • Explosive + Thermal + Radiological? • More importantly, does it matter?
Common ground • This is an fire / explosive problem • The blast defines the menace • The intent defines the malice • A fire / explosion terrorism event is a “Mass Casualty-Trauma/Burn Incident” • Initial approach is the same • Subsequent modified by what you learn Anyone can sound the alarm
Summary • Be calm • Be aware • Recognize hazards • Remember to S-I-N and count to T-E-N • Healthcare focuses on the menace • Consistent, common approach • Anyone can sound the alarm