Weapons of Mass Destruction

1. Weapons of Mass Destruction

2. Weapons of Mass Destruction Definition: Any weapon, nuclear device, biological agent, or chemical that can kill a large number of people. Three types of delivery systems usually are considered for WMD, ballistic missiles, cruise missiles, and combat aircraft

3. Guided Rocket • A guided rocket powered delivery vehicle for use against ground targets. A large portion of its flight is in a ballistic trajectory. It’s the optimum delivery system for WMD.

4. Cruise Missile • A cruise missile is a guided missile that flies at a moderate speed and at low altitude, following the terrain beneath it. The Tomahawk is a cruise missile

5. Common Biological Agents Anthrax Botulism Toxin Plague Small pox Tularemia Viral Hemorrhagic fevers Ricin

6. Anthrax Primarily a disease of large hoofed animals Gram positive bacillus spore Human contact Inhalation: pulmonary anthrax Ingestion: gastrointestinal anthrax Skin: cutaneous anthrax

7. Anthrax Signs and Symptoms Inhalation: common cold like symptoms, after several days patient begins to have severe difficulty breathing Cutaneous: Raised itchy bump, 1-2 days painless ulcer with a black necrotic center Intestinal: Acute inflammation of the gastrointestinal tract, N/V, fever, abdominal pain, hemoptosis, severe diarrhea

8. Botulism Clostridium botulinum, gram positive anaerobic bacillus which form endospores When spores enter an anaerobic environment such as cans and jars it germinates producing a nerve toxin

9. Botulism Signs and Symptoms Develop within hours to day of ingesting the contaminated food Blurred vision, slurred speech, difficulty swallowing and chewing, labored breathing Toxin affects the nerves by inhibiting the neurotransmitter acetylcholine into the junctions of nerve and muscle Ultimately causes respiratory paralysis

10. Plague Transmitted by fleas from infected rodents to humans Bubonic Septicemic Pnuemonic (bioterrorism) Aerosol for dissemination After infection can be transmitted from infected individual via cough or sneeze

11. Tularemia Non spore forming bacterium Contact with diseased rodents, rabbits, ticks, mosquitoes, or deer flies Aerosol form of the bacterium most likely administration by bioterrorists

12. Tularemia Signs and Symptoms Very non specific often patients are treated for strep throat, rickettsail, lymphoid cancer or cat-scratch fever

13. Smallpox • Extremely cantagious disease. • Person to person transmission • Contact with bodily fluids • Exposure through aerosol

14. Smallpox Signs and Symptoms High fever and malaise Pink to red spots (macules) starting on face then progressing to trunk of body Progress to looking like pink pimples (vesicles) filled with fluid Finally progress to a deep pustule which emits pus

15. Hemorrhagic Fever The hemorrhagic fever viruses (HFVs) are a diverse group of viruses capable of causing a “viral hemorrhagic fever syndrome”. Each virus belongs to one of four distinct families: Filoviridae: Ebola and Marburg viruses Arenaviridae: Lassa fever virus and New World arenaviruses Bunyaviridae: Crimean Congo hemorrhagic fever virus, Rift Valley fever virus, and a group of related viruses referred to as “agents of hemorrhagic fever with renal syndrome” Flaviviridae: Dengue, Yellow fever, Omsk hemorrhagic fever, and Kyasanur Forest disease virus

16. Hemorrhagic Fevers Depending on the specific virus, illness may develop within 2 to 21 days after exposure to a hemorrhagic fever virus; however, specific disease manifestations may vary according to virus. The classic VHF syndrome is characterized by fever, fatigue, body aches, rashes, malaise, nausea, abdominal pain, and headaches. Progression of disease results in hemorrhagic manifestations that may include bleeding under the skin, in internal organs, or from body orifices. In severe cases, death results 1 to 2 weeks after the onset of symptoms, often caused by kidney failure, multiorgan system failure, or shock. Not all patients develop the classic VHF syndrome

17. Ricin Ricin is a poison that can be made from the waste left over from processing castor beans. It can be in the form of a powder, a mist, or a pellet, or it can be dissolved in water or weak acid. It is a stable substance. For example, it is not affected much by extreme conditions such as very hot or very cold temperatures

18. Ricin Ricin works by getting inside the cells of a person’s body and preventing the cells from making the proteins they need. Without the proteins, cells die. Eventually this is harmful to the whole body, and death may occur. Effects of ricin poisoning depend on whether ricin was inhaled, ingested, or injected.

19. Ricin Signs and Symptoms Inhalation: Within a few hours of inhaling significant amounts of ricin, the likely symptoms would be respiratory distress (difficulty breathing), fever, cough, nausea, and tightness in the chest. Heavy sweating may follow as well as fluid building up in the lungs (pulmonary edema).

20. Ricin Ingestion: Vomiting and diarrhea that may become bloody. Severe dehydration may be the result, followed by low blood pressure. Other signs or symptoms may include hallucinations, seizures, and blood in the urine. Within several days, the person’s liver, spleen, and kidneys might stop working, and the person could die. Skin and eye exposure: Ricin in the powder or mist form can cause redness and pain of the skin and the eyes. Death from ricin poisoning could take place within 36 to 72 hours of exposure, depending on the route of exposure (inhalation, ingestion, or injection) and the dose received. If death has not occurred in 3 to 5 days, the victim usually recovers.

21. Treatment of Biologicals In general the prehospital treatment for any of these biological agents will include supportive measures for ABC’s Because of the potential for infection appropriate protective equipment should be used

22. Chemical Agents Multiple forms of chemical and or nerve agents that could be used for a WMD Classified by the symptoms they cause Blistering agents Blood agents Nerve agents

23. Blistering Agents Mustard Gas Mustard Lewisite Nitrogen Mustard Burning and blistering of the eyes and skin Coughing and respiratory distress

24. Blood Agents Cyanogens chloride Hydrogen chloride Seizures Respiratory Arrest / Cardiac Arrest

25. Choking Agents Chlorine Diphosgene Phosgene Cause eye and airway irritation Respiratory irritation; coughing, hoarseness, dyspnea, chest tightness, and pulmonary edema

26. Nerve Agents Tabun Sarin Soman VX These agents act on all parts of the nervous system Pinpointed pupils, runny noses ,difficulty breathing, seizures, and convulsions

27. Blistering Agents Treatment Protective clothing / gas mask Avoid vapor clouds Begin the decontamination process Support the patients ABC’s Dress large blisters

28. Blood Agents Treatment Protective suits / masks Decontamination procedures Support patients ABC’s Cyanide Antidote Kits-- not approved for EMS

29. Choking Agents Treatment Protective clothing Immediate evacuation Support patients ABC’s

30. Nerve Agents Treatment Protective suits / gas masks Mark I Antidote Kit (2 Pam) Two auto injectors Atropine 2 mgs Pralidoxime Chloride 600 mg

31. Additional Weapons Nuclear Weapons Incendiary Devices Dirty Bombs A small incendiary device used to disperse radioactive material

32. Nuclear Attack Evacuation of residents around the targeted area If a nuclear blast occurs, seek cover preferably underground. You can take cover behind anything, lie flat on the ground and cover head. Fallout will take 15-20 minutes to arrive

33. Nuclear Attack Signs and Symptoms Blast type injuries and burns Radiation exposure Vomiting Headache Fatigue Weakness Thermal burn like effects Secondary infections Bleeding and hair loss

34. Nuclear Attack Treatment Protective equipment Radioactive decontamination procedures Support patients ABC’s

35. Conventional Incendiary Devices Terrorist organizations are prone to wipe out the rescuers through secondary blast devices Scene safety should be of paramount concern Burns and blast injuries Utilize standard MCI protocols