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Chapter 53
Terrorism and
Disaster Response
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Weapons of Mass Destruction (WMD)
• Weapons of mass destruction (WMD)
– Materials used by terrorists that have
the potential to cause great harm over
a large area
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Categories of WMD
B-NICE
• Five main categories
– Biological
– Nuclear/radiological
– Incendiary
– Chemical
– Explosive
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Types of WMD
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Biological Weapons
• Involve the use of
bacteria, viruses,
rickettsia, or toxins to
cause disease or death
• Often odorless, tasteless,
and invisible
• The effects may not be
seen for hours or days.
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Biological Weapons
• Diseases can be spread by
– Inhalation
• Substances dispersed by spray devices
(aerosols)
– Ingestion
• Contaminated food or water supplies
– Absorption
• Direct skin contact with the substance
– Injection
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Biological Weapons
• Bacteria
– Germs that can cause
disease in humans, plants,
or animals
– Do not depend on other
organisms to live and grow
– Possible biological
weapons
• Anthrax
• Tularemia (rabbit fever)
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Biological Weapons
• Rickettsias
– Very small bacteria that require a living
host to survive
– Transmitted by bloodsucking parasites
• Fleas, lice, ticks
– Possible biological weapon
• Q fever
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Biological Weapons
• Viruses
– Depend on other organisms to live and
grow
– Possible biological weapons
• Smallpox
• Ebola virus
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Biological Weapons
• Toxins
– Substances produced by an animal, plant,
or microorganism
– Possible biological weapons
• Ricin
• Botulism
• Enterotoxin B
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Nuclear and Radiological Weapons
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Dirty bomb
– Radiological dispersal device
• Accidental radiation release
– Caused by a meltdown or
human error
• Aerosol
– Spray over a populated area
• Terrorist attack
– Deliberate attack
– Often delivered via a vehicle
carrying radioactive material
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Nuclear Radiation
53-12
Incendiary Weapons
• Incendiary materials
– Used to set fire to wood or other materials
• Example:
– Firebombs
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Chemical Weapons
• Chemical agents
– Poisonous substances that injure or kill
people
• Inhalation
• Ingestion
• Absorption through the skin or eyes
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Chemical Weapons
• Five broad categories
1. Nerve agents
2. Blister agents
3. Blood agents
4. Choking agents
5. Irritants
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Nerve Agents
• Interrupt nerve signals
• Cause a loss of consciousness within
seconds and death within minutes of
exposure
• Examples:
– Tabun
– Sarin
– Soman
– VX
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Blister Agents
• Effects are like those of a corrosive chemical
such as lye or a strong acid.
• Cause severe burns to eyes, skin, and
tissues of the respiratory tract
• Examples
– Distilled mustard
– Forms of nitrogen mustard
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Blood Agents
• Cause rapid respiratory arrest and death by
blocking absorption of oxygen to cells and
organs through the bloodstream
• Examples:
– Cyanide
– Arsine
– Hydrogen chloride
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Choking (Pulmonary) Agents
• Inhaled chlorine mixes with moisture in the
lungs and becomes hydrochloric acid.
– Causes fluid to build up in the lungs (pulmonary
edema)
– Interferes with the ability to exchange oxygen
– Results in asphyxiation that resembles drowning
• Examples
– Chlorine
– Phosgene
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Irritants
• Used for personal protection and by police in
riot control
• Cause burning and intense pain to exposed
skin areas
• Examples
– Mace
– Pepper spray
– Tear gas
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Factors Affecting Exposure
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Substance involved
Concentration of the substance
Duration of exposure
Number of exposures
Route of entry
– Inhalation, ingestion, injection, or absorption
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Factors Affecting Exposure
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Age
Gender
General health
Allergies
Smoking habits
Alcohol consumption
Medications
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Signs and Symptoms
Requiring Medical Attention
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Unconsciousness
Confusion
Lightheadedness
Anxiety
Dizziness
Changes in skin color
Shortness of breath
Burning of the upper
airway
• Coughing or painful
breathing
• Drooling
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Chest tightness
Loss of coordination
Seizures
Nausea, vomiting
Abdominal cramping
Diarrhea
Loss of bowel or
bladder control
• Dim, blurred, or double
vision
• Tingling or numbness
of the extremities
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Explosives
• Terrorists often use various types of explosives.
• Examples
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Grenades
Rockets
Missiles
Mines
Pipe bombs
Vehicle bombs
Package or letter bombs
Bombs carried in devices such as a knapsack or
backpack
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WMD Incident Response
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Your Responsibilities
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Safety
Isolate the scene.
Preserve evidence and deny entry.
Ask for additional help.
Coordinate efforts with other responders.
Recognize the signs of a potential WMD
incident.
– Alert the proper authorities.
• Recognize the potential of a secondary
explosion and an attack on EMTs.
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Pre-Arrival Response
• Listen for specific clues
that may indicate a
possible terrorist incident:
– Type of incident
– Incident location
– Number of reported
casualties
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Arrival Response
• Scene safety
– As you approach the scene, consider the
safest way to do so:
• Uphill
• Upwind
• Upstream
– Be aware of the terrain.
– Try to avoid “bottlenecks” or traps.
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Arrival Response
• Look for
– An unusually large number of
people with burns or “blast”
injuries
– Large numbers of people running
from the scene or on the ground
– Danger of fire, explosion,
electrical hazards, or structural
collapse
– Weapons, explosive devices
– Signs of corrosion
– Evidence of the use of chemical
agents
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Arrival Response
• Incident Factors
– Listen for
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Screaming
Explosion
Breaking glass
A hissing sound that
indicates pressure
releases
• Information from victims
or bystanders
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Arrival Response
• Think, Plan, Act, and Evaluate
– On arrival
• Consider need for scene control and the
establishment of a perimeter
• Give the exact location of the incident or
perimeter
• Notify all responders
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Location of the area of the suspected contamination
Safe routes for entry to the site
Where to stage
Potential hazards or danger
53-31
Arrival Response
• Other incident factors
– Time of day
– Temperature
– Wind intensity and direction
– Humidity
– Cloud cover
– Precipitation
53-32
Safety Zones
• Identify and establish safety zones.
– Hot zone
• Contamination zone (site of the incident)
• Dangerous area
• Must have high-level PPE to enter this area
– Warm zone
• Serves as entry and decontamination point
• All personnel must wear appropriate PPE
– Cold zone
• Safe zone
• Staging area for personnel and equipment
• Incident command post is located here
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Incident Command
• Initiate the National Incident Management
System (NIMS).
• Designate the incident commander.
• Announce the location of the command post.
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Approaching the Patient
53-35
Approaching the Patient
• Goals
– Terminating the patient’s exposure to the
contaminant
– Removing the patient from danger
– Providing emergency patient care
– Maintaining rescuer safety
53-36
Approaching the Patient
• Approach ONLY if the scene is safe.
• Be sure you are wearing appropriate
protective gear.
• Perform a primary survey.
• Provide emergency care.
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Safety
53-38
Key Safety Points
• Consider the possibility of multiple hazards.
• The contaminated area is restricted to
workers who are
– Wearing appropriate protective gear
– Actively involved in performing emergency
operations
• Identify the materials involved in the incident
ONLY from a safe distance.
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Decontamination
53-40
Decontamination (Decon)
• Purpose
– Reduce and prevent the spread of
contamination by physical and/or chemical
processes
• Performed ONLY by trained personnel
wearing the appropriate level of PPE
• Continued until determined to no longer be
necessary
53-41
Questions?
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