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Operational Level Refresher Presentation

Operational Level Refresher Presentation. Hazardous Materials for First Responders, 3 rd Ed. Terrorism and WMD Incidents. Terminal Objective

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Operational Level Refresher Presentation

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  1. Operational Level Refresher Presentation Hazardous Materials for First Responders, 3rd Ed.

  2. Terrorism and WMD Incidents Terminal Objective Given classroom instruction, the student will identify the dangers to first responders involving terrorist and CBRNE incidents based on the training provided. Operational Level

  3. Enabling Objectives • Identify hazards associated with an incident involving criminal or terrorist activity • Identify UN/DOT hazard class for chemical/biological/radiological materials • Identify characteristics of CBRNE materials • Identify evidence preservation procedures • Identify NFPA 1994 Protective Ensembles Operational Level

  4. Terrorism • The unlawful use of force against persons or property to intimidate or coerce a government, the civilian population or any segment thereof, in the furtherance of political or social objectives. According to the Federal Bureau of Investigation Operational Level

  5. Weapons of Mass Destruction • Any weapon or device that is intended, or has the capability, to cause death or serious bodily injury to a significant number of people through the release, dissemination, or impact of: • Toxic or poisonous chemicals or their precursors • A disease organism • Radiation or radioactivity According to the United States Code Operational Level

  6. Goals of Terrorist Operations • Recognition – national or international attention • Coercion – act in a desired manner • Intimidation – diminish public confidence • Provocation – force government security to act Operational Level

  7. Circumstances Faced that are Different from Routine Emergencies • Large numbers of casualties • Materials that first responders have little experience dealing with • Secondary events intended to incapacitate or delay emergency responders • Armed resistance • Use of weapons • Booby traps • Secondary contamination from handling patients Operational Level

  8. Potential Terrorist Targets • Public assembly occupancies and locations • Public buildings • Mass transit systems • Places with high economic impact • Telecommunications facilities • Places with historical or symbolic significance • Military installations • Airports • Industrial facilities Operational Level

  9. Cues to Consider thePossibility of Terrorism • A report of two or more medical emergencies in public locations such as a shopping mall, transportation hub, mass transit system, office building, assembly occupancy, or other public buildings • An unusually large number of people with similar signs and symptoms coming or being transported to physicians’ offices or medical emergency rooms (1 of 2) Operational Level

  10. Cues to Consider thePossibility of Terrorism • A reported explosion at a movie theater, department store, office building, government building, or a location with historical or symbolic significance (2 of 2) Operational Level

  11. CBRNE Incidents • Chemical • Biological • Radiological • Nuclear • Explosive Operational Level

  12. Categories of Terrorist Attacks • Biological • Nuclear • Incendiary • Chemical • Explosive Operational Level

  13. Biological Attacks • Type of biological agents • Viral agents • Bacterial agents • Rickettsias • Biological toxins • Indicators of terrorist activity involving biological agents • Numerous sick or dead animals, fish, or birds • Unscheduled spraying or abandoned spray devices • Vapor clouds or mists that are unusual for the area or for the time of day (1 of 6) Operational Level

  14. Biological Attacks • Indicators of terrorist activity involving biological agents • The absence of crops, wildlife, or insects that are common for the area, time of day, or time of year • Out of place and unattended packages, boxes, or vehicles • Packages that are leaking • Materials or equipment that are unusual for the area • Small explosions that disperse liquids, mists, or gases (2 of 6) Operational Level

  15. Biological Attacks • Indicators of terrorist activity involving biological agents • Unusual odors or tastes • Multiple casualties without obvious signs of trauma • Multiple victims who are exhibiting similar symptoms • Large numbers of persons seeking medical attention with similar symptoms that are not characteristic of the season (3 of 6) Operational Level

  16. Biological Attacks • Type A biological agents • Can be easily disseminated or transmitted person-to-person • Cause high mortality and subsequently have a major public health impact • Might cause public panic and social disruption • Requires special action for public health preparedness • Examples: Smallpox, anthrax, plague, botulism (4 of 6) Operational Level

  17. Biological Attacks • Type B biological agents • Are moderately easy to disseminate • Cause moderate morbidity and low mortality • Require specific enhancements of the Centers for Disease Control and Prevention’s diagnostic capacity and enhanced disease surveillance • Examples: Brucellosis, epsilon toxin of clostridium perfringens, glanders (5 of 6) Operational Level

  18. Biological Attacks • Type C biological agents — Emerging pathogens that could be engineered for mass dissemination in the future because of their: • Availability • Ease of production and dissemination • Potential for high morbidity and mortality and major health impact • Examples: Nipah virus, hantaviruses, tickborne hemorrhagic fever viruses (6 of 6) Operational Level

  19. Nuclear/Radiological Attacks • Three scenarios most likely: • Detonation of a conventional explosive device incorporating nuclear materials (commonly known as a dirty bomb) • An attack on a source of nuclear materials such as detonating a truck bomb in the vicinity of a nuclear power plant or radiological cargo in transport • Detonation (or threatening to detonate) a nuclear bomb, improvised nuclear device, or suitcase bomb (1 of 2) Operational Level

  20. Nuclear/Radiological Attacks • Types of nuclear/radiological bombs that terrorists might use • Dirty bomb • Atomic/nuclear device (bomb) • Improvised nuclear device (IND) • Suitcase bomb • Nuclear power plant sabotage or attack (2 of 2) Operational Level

  21. Incendiary Devices • Any mechanical, electrical, or chemical device used intentionally to initiate combustion and start a fire • Examples of easily made devices • Bottle, gasoline, rag, match (Molotov cocktail) • Low flashpoint flammable liquid and a candle • Match heads and sulfuric acid • Road flare ignited by a model rocket fuse (1 of 2) Operational Level

  22. Incendiary Devices • Indicators • Warning or threat of an attack • Accelerant odors • Multiple fires • Incendiary device components • Unexpectedly heavy burning or high temperatures • Unusually fast-burning fires • Unusual colored smoke or flames • Presence of propane or other flammable gas cylinders in unusual locations (2 of 2) Operational Level

  23. Chemical Attacks • The deliberate release of a toxic gas, liquid, or solid that can poison people and the environment • May involve chemical warfare agents or toxic industrial materials (TIMs) • Effects are usually noticed quickly, within minutes to hours • Results are usually disabling or fatal (1 of 5) Operational Level

  24. Chemical Attacks • Indicators of terrorist activity involving chemical agents • Numerous sick or dead animals, fish, or birds • Unscheduled spraying or abandoned spray devices • Vapor clouds or mists that are unusual for the area or the time of day • The absence of crops, wildlife, or insects that are common for the area, time of day, or time of year (2 of 5) Operational Level

  25. Chemical Attacks • Indicators of terrorist activity involving chemical agents • Out of place and unattended packages, boxes, or vehicles • Packages that are leaking • Materials or equipment that are unusual for the area • Small explosions that disperse liquids, mists, or gases • Unusual odors or tastes (3 of 5) Operational Level

  26. Chemical Attacks • Indicators of terrorist activity involving chemical agents • Multiple casualties without obvious signs of trauma • Multiple victims who are exhibiting similar symptoms • Large numbers of persons seeking medical attention with similar symptoms that are not characteristic of the season (4 of 5) Operational Level

  27. Chemical Attacks • Chemical-agent types • Nerve agents • Blister agents (vesicants) • Blood agents (cyanide agents) • Choking agents (pulmonary or lung-damaging agents) • Riot control agents (irritants) • Toxic industrial materials (normal hazardous materials used for terrorist purposes) (5 of 5) Operational Level

  28. Nerve Agents • Attack the nervous system by affecting the transmission of impulses • Routes of entry • Inhalation • Through the skin • Symptoms • Increased production of saliva • Runny nose • Feeling of pressure on the chest (1 of 3) Operational Level

  29. Nerve Agents • Tabun (GA) — Usually a low-volatility persistent chemical agent that is taken up through skin contact and inhalation of the substance as a gas or aerosol; DOT hazard class 6.1 • Sarin (GB) — Usually a volatile nonpersistent chemical agent mainly taken up through inhalation; class 6.1 • Soman (GD) — Usually a moderately volatile chemical agent that can be taken up by inhalation or skin contact; class 6.1 (2 of 3) Operational Level

  30. Nerve Agents • Cyclohexyl sarin (GF) — A low-volatility persistent chemical agent that is taken up through skin contact and inhalation of the substance either as a gas or aerosol • V-agent (VX) — A low-volatility persistent chemical agent that can remain on material, equipment, and terrain for long periods; class 6.1 (3 of 3) Operational Level

  31. Blister Agents (Vesicants) • Burn and blister the skin or any other part of the body they contact • Groupings • Mustard agents • Examples: Sulfur mustards (class 6.1), nitrogen mustards (class 6.1) • Arsenical vesicants • Examples: Lewisite (class 6.1), mustard/lewisite mixture, phenyldichloroarsine • Halogenated oximes • Example: Phosgene oxime (no hazard class found) (1 of 2) Operational Level

  32. Blister Agents (Vesicants) • Routes of entry • Are readily absorbed by all parts of the body • Symptoms • Inflammation • Blisters • General destruction of tissues (2 of 2) Operational Level

  33. Blood Agents • Chemical asphyxiants that interfere with oxygen utilization at the cellular level • Types • Arsine (SA) (class 2.3) • Hydrogen cyanide (AC) (class 6.1) • Cyanogen chloride (CK) (class 2.3) Operational Level

  34. Choking Agents • Chemicals that attack the lungs causing tissue damage • Types • Phosgene (CG) (class 2.3) • Chlorine (CL) (class 2.3) Operational Level

  35. Riot Control Agents(Irritating Agents) • Chemical compounds that temporarily make people unable to function by causing immediate irritation to the eyes, mouth, throat, lungs, and skin • Types • Chlorobenzylidene malononitrile (CS, tear gas) (class 6.1) • Chloroacetophenone (CN, mace) (class 6.1) • Dibenzoxazepine (CR) (class 6.1) • Chloropicrin (PS) (class 6.1) • Oleoresin capsicum (OC, pepper spray) (class 2.2) Operational Level

  36. Explosive Attack Classes • High explosives — Decompose extremely rapidly (almost instantaneously) • Examples: Plastic explosives, nitroglycerin, TNT, blasting caps, dynamite • Low explosives — Decompose rapidly, but don’t produce an explosive effect unless they’re confined; they deflagrate (burn rapidly) (1 of 3) Operational Level

  37. Explosive Attack Classes • Primary explosives — Are easily initiated and highly sensitive to heat • Examples: Lead azide, mercury fulminate, lead styphnate • Secondary explosives — Are designed to detonate only under specific circumstances; are less sensitive to heat or flame • Example: TNT • Propellants — Deflagrate rather than explode • Example: Black powder (2 of 3) Operational Level

  38. Explosive Attack Classes (3 of 3) Operational Level

  39. Improvised Explosive Devices(IEDs) • Are explosive devices that are constructed in an improvised manner • Are categorized by their container • Are homemade and usually constructed for a specific target • Usually have a firing train that consists of a fusing system, detonator, and main charge Operational Level

  40. Types of IEDs • Vehicle bombs • Pipe bombs • Satchel/backpack/knapsack/briefcase, or box bomb • Mail/package/letter bomb • Plastic bottle bombs • Fireworks • M-devices • CO2 grenades • Tennis ball bombs Operational Level

  41. Additional Actions at Terrorist or Criminal Activity Incidents • Notify authorities. • Law enforcement, other emergency responders, and EMS personnel • Other local, state/provincial, or federal/national agencies and health or medical providers • Additional trained and equipped personnel immediately (i.e., bomb technicians • Preserve crime scene evidence. (1 of 2) Operational Level

  42. Additional Actions at Terrorist or Criminal Activity Incidents • Take additional measures to isolate exposed people and animals. • Take additional measures to secure the scene. • Take additional precautions with regard to the possibility of secondary devices. • Exercise additional caution in regards to other potential hazards associated with terrorist and criminal activities. (2 of 2) Operational Level

  43. The Importance of Crime Scene Evidence Preservation • It is important for first responders to preserve evidence so that investigators can identify and successfully prosecute the guilty parties. Operational Level

  44. Guidelines forPreserving Evidence • Unless you must touch something, DON’T. • Avoid disturbing areas not directly involved in rescue activities. • Remember what the scene looked like upon first arrival as well as details about the progression of the incident. (1 of 3) Operational Level

  45. Guidelines forPreserving Evidence • Document your observations as quickly as you can. • Take photographs and videos of the scene as soon as possible. • When you must touch or move something, remember what you did. In your report, document where it was and where you put it. If you can, photograph it before you do anything. • Minimize the number of people working in the area, if possible. (2 of 3) Operational Level

  46. Guidelines forPreserving Evidence • Leave fatalities and their surroundings undisturbed. • Identify witnesses, victims, and the presence of evidence. • Preserve potentially transient physical evidence (e.g., evidence present on victims, evidence that may be compromised by weather conditions such as chemical residue, body fluids, or footprints). (3 of 3) Operational Level

  47. Biological Attack Incidents • Many people are potentially at risk • Traditional first responders who transport ill patients to medical facilities • Health care workers who care for patients in hospitals, residential facilities, outpatient settings, at home, or elsewhere • Laboratory personnel handling clinical specimens • Health department staff who visit patients in or out of health care facilities while conducting outbreak assessment or control measures (1 of 3) Operational Level

  48. Biological Attack Incidents • First responders and others involved in patient transport should take additional precautions. • Run the ambulance ventilation system on its highest setting using outside air circulation, which will minimize air changes in the vehicle. • For diseases that are transmitted by respiratory transmission, the patient should wear a surgical mask, disposable respirator, or, if needed for respiratory support, an oxygen mask that does not exhaust to ambient air. (2 of 3) Operational Level

  49. Biological Attack Incidents • First responders and others involved in patient transport should take additional precautions. • Responders transporting patients with different diseases may require different levels of worker respiratory protection. (3 of 3) Operational Level

  50. Nuclear/Radiological Incidents • Use radiation and contamination survey instruments to determine radiation levels. • Use the principles of time, distance, and shielding to protect against radiation exposure. • Stay away from ground zero. Enter the surrounding area only to save lives, and only if wearing appropriate PPE. Radiation levels may be very high in these areas. • Establish control zones like other incidents. (1 of 4) Operational Level

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