Chapter 41 | EMS Response to Terrorism Flashcards

• Types of terrorism and examples of terrorist tactics and doctrine • How to identify the type of threat posed by a terrorist event • Use of time/distance/shielding for protection at a terrorist event • How to respond to and deal with threats from a terrorist event • Applying strategy, tactics, and countermeasures at a terrorist event • Self-protection and safety awareness at a terrorist event

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1
Q

Define:

terrorism

A

the unlawful use of force or violence against persons or property to intimidate or coerce a government, the civilian population, or any segment thereof, in furtherance of political or social objectives

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2
Q

Define:

domestic terrorism

A

terrorism directed against one’s own government or population

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3
Q

Define:

international terrorism

A

terrorism that is purely foreign-based or directed

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4
Q

Define:

WMD

(abbreviation

A

weapons of mass destruction

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5
Q

Define:

weapons of mass destruction (WMD)

A

weapons, devices, or agents intended to cause widespread harm and/or fear among a population

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6
Q

Define:

multiple devices

A

destructive devices (such as bombs) including both those used in the initial attack and those placed to be activated after an initial attack

set to injure emergency responders caring for victims of initial attack

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7
Q

Define:

secondary devices

A

destructive devices (such as bombs) placed to be activated after an initial attack and timed to injure emergency responders and others who rush in to help care for those targeted by an initial attack

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8
Q

Define:

OTTO

(acronym)

A
  • occupancy (or location)
  • type of event
  • timing of event
  • on-scene warning signs

(used to determine likeliness of terrorist attack)

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9
Q

Define:

NTAS

(abbreviation)

A

National Terrorism Advisory System

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10
Q

List:

NTAS alert categories

3 points

A
  • bulletin
  • elevated alert
  • imminent alert
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11
Q

Define:

NTAS Bulletin

A

NTAS alert which describes current developments or general trends regarding threats of terrorism

lowest priority

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12
Q

Define:

NTAS Elevated Alert

A

NTAS alert which warns of a credible terrorism threat against the United States

middle priority

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13
Q

Define:

NTAS Imminent Alert

A

NTAS alert which warns of a credible, specific, and impending terrorism threat against the United States

highest priority

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14
Q

Fill in the blank:

[BLANK] is a fun little acronym to remember forms of technologic hazardous agents.

(spell it out)

A

CBRNE is a fun little acronym to remember forms of technologic hazardous agents.

Chemical, Biologic, Radiologic, Nuclear, & Explosive

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15
Q

Define:

CBRNE

(acronym)

A
  • chemical
  • biologic
  • radiologic
  • nuclear
  • explosive

(used to forms of technologic hazardous agents)

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16
Q

List:

[BLANK] is a fun little acronym to remember the harms posed by HAZMAT incident.

(and spell it out)

A

TRACEM-P is a fun little acronym to remember the harms posed by HAZMAT incident.

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17
Q

List:

means of protecting EMT from exposure to hazardous materials

3 points

A
  • time: minimize time spent at a dangerous scene
  • distance: maximize your distance from the hazard area or the projected hazard area
  • shielding: use protective clothing and other means of protection from substances
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18
Q

Fill in the blank:

[BLANK] is a fun little acronym to remember signs/symptoms of nerve agent poisoning.

(also used for pesticide poisoning in agricultural settings)

A

SLUDGEM is a fun little acronym to remember signs/symptoms of nerve agent poisoning.

Salivation, Lacrimation, Urination, Defecation, GI upset, Emesis, Miosis

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19
Q

Define:

SLUDGEM

(acronym)

A
  • Salivation: wet mouth
  • Lacrimation: crybaby
  • Urination: little fireman
  • Defecation: dropping logs
  • GI upset: angry tummy
  • Emesis: blowing chunks
  • Miosis: abnormal contractions of the pupils

(used to remember signs/symptoms of nerve agent poisoning (+pesticides)

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20
Q

List:

features which increase appeal of infectious agent for use in terrorist attacks

7 points

A
  • infectivity
  • virulence
  • toxicity
  • incubation period
  • transmissibility
  • lethality
  • stability
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21
Q

Define:

anthrax

A

naturally-occurring zoonotic disease found commonly in livestock

(survives through everything and good option for malicious use)

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22
Q

Define:

zoonotic disease

A

disease able to move through animal-human barrier

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23
Q

Define:

sporulating bacteria

A

bacteria which creates a hard, seedlike shell over themselves that make them very resistant to breakdown by UV light and other inults

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24
Q

Fill in the blank:

The form of anthrax that is of greatest concern is the [BLANK] form.

(route of entry)

A

The form of anthrax that is of greatest concern is the inhalational form.

If anthrax can be aerosolized in small enough particles (3–5 microns in diameter) so they can be inhaled and retained in the deeper portions of the respiratory tract, then this form of anthrax can be transmitted by the respiratory route. This form of anthrax is very lethal.

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25
Q

Fill in the blanks:

With all forms of anthrax, [BLANK] works well to counteract the effects, provided that [BLANK].

(treatment and requirement)

A

antibiotic therapy works well to counteract the effects, provided that antibiotics are given early enough in the disease process.

the problem with inhalational anthrax is that it commonly presents with nonspecific respiratory symptoms (and might not be recognized as anthrax)

the start of antibiotic administration may be delayed and (if it is not started before the “anthrax eclipse”) such therapy may have little benefit

the eclipse is a (brief) 12- to 39-hour period during the disease process in which recovery seems to be occurring and the patient feels much better — but the symptoms return shortly after the eclipse and death follows in 2–3 days

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26
Q

Fill in the blank:

Outbreaks of cholera typically are seen in [BLANK].

(what kind of environments)

A

Outbreaks of cholera typically are seen in developing nations (particularly those without effective sanitary systems).

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27
Q

Fill in the blank:

Proper supportive care for cholera should be aimed at correcting [BLANK] and utilize [BLANK].

A

Proper supportive care for cholera should be aimed at correcting dehydration-related problems and utilize oral rehydration salts.

treat dehydration with rehydrating salts

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28
Q

Fill in the blank:

The incidence of human-to-human transmission of cholera is [HIGH/LOW].

A

The incidence of human-to-human transmission of cholera is low.

responders should avoid direct contact with bodily fluid and excrement

29
Q

True or false:

Yersinia pestis (plague) is a zoonotic bacterium carried by rats and ground squirrels.

A

true

30
Q

True or false:

Plague is transmitted to humans by fleas.

A

true

31
Q

True or false:

Plague is transmitted to humans by Jews who poisoned the wells.

A
32
Q

Fill in the blank:

The incubation period for plague is [BLANK], depending on the form.

(amount of time)

A

The incubation period for plague is 2–10 days, depending on the form.

33
Q

Fill in the blank:

The pneumonic form of the plague has an incubation period of [BLANK].

(amount of time)

A

The pneumonic form of the plague has an incubation period of as little as 2-3 days.

34
Q

True or false:

The pneumonic form of the plague is highly transmissible from human to human by aerosolized droplets generated by coughing.

A

true

respiratory precautions are indicated

35
Q

True or false:

The pneumonic form of the plague is not generally transmissible from human to human by aerosolized droplets.

A

false

its highly transmissible and respiratory precautions are indicated

36
Q

True or false:

As a biologic weapons agent, Q fever is similar to anthrax.

A

true

really damn strong (can remain viable in harsh environments for months)

37
Q

True or false:

Q fever can withstand harsh environments for months.

A

true

really damn strong

38
Q

True or false:

Q fever is generally susceptible to exposure to harsh environments.

A

false

really damn strong (can remain viable in harsh environments for months)

39
Q

Fill in the blank:

The incubation period for Q fever is about [BLANK].

(amount of time)

A

The incubation period for Q fever is about 10–20 days.

40
Q

True or false:

Q fever typically results in uneventful recovery.

A

true

41
Q

True or false:

Q fever is frequently fatal.

A

false

typically results in uneventful recovery

42
Q

List:

blast injury patterns

4 points (what usually gets hurt)

A
  • lung injury
  • ear injury
  • abdominal injury
  • brain injury
43
Q

Define:

strategy

A

broad general plan designed to achieve desired outcomes

44
Q

Define:

tactic

A

specific operational actions to accomplish assigned tasks

45
Q

Define:

permeation

A

movement of a substance through a surface or (on a molecular level) through intact materials

46
Q

Choose:

The best way for a terrorist to weaponize and disseminate a chemical nerve agent to expose a large number of people would be to:

A: put it in a paper bag in a crowded mall and puncture the bag with a stick.

B: throw a paper bag loaded with nerve agent onto a busy subway train.

C: throw a Molotov cocktail loaded with nerve agent into a windshield of a passenger bus.

D: steal a truck that sprays for mosquitos and aerosolize the nerve agent into a crowded subdivision.

A

D

47
Q

Choose:

You are responding to a suspected terrorist incident, and first reports indicate this is a biologic incident. Which PPE will you need?

A: Fire-protection clothing

B: Lead shielding

C: HEPA mask

D: Self-contained breathing apparatus

A

C

48
Q

Choose:

Which of the following features increases the appeal of an infectious agent for use in terrorist attacks?

A: Low potency

B: Instability

C: High infectivity

D: Low virulence

A

C

49
Q

Choose:

The type of radiation that requires lead shielding for your protection is:

A: gamma.

B: delta.

C: beta.

D: alpha.

A

A

50
Q

Choose:

Which of the following may be a clue that an incident is the result of terrorist violence?

A: Function of the target

B: Number of people present

C: Occurrence on the anniversary of a significant or symbolic historical event

D: All of the above

A

D

51
Q

Choose:

Biologic warfare is most effective when the agent can gain access through which of the following routes?

A: Respiratory tract

B: Blood

C: Skin

D: Gastrointestinal tract

A

A

52
Q

Choose:

Which two types of terrorism does the Federal Bureau of Investigation define as occurring in the United States?

A: Psychological and economic

B: Violence and intimidation

C: Chemical and biologic

D: Domestic and international

A

D

53
Q

Choose:

Which of the following best defines domestic terrorism?

A: Interpersonal violence between family members

B: Acts of violence perpetrated by American citizens against the government of another country

C: Politically motivated act of violence that occurs within the United States

D: Groups or individuals directing violent acts at their own population or government

A

D

54
Q

Choose:

You arrive on the scene of an unknown emergency. As you scan the surrounding area, you notice a large number of people wearing unique armbands and shouting anti-government comments though you are not aware of any public gathering scheduled for today.

Your suspicions of a potential terrorist incident are the result of:

A: the location of the call.

B: on-scene warning signs.

C: the timing of the event.

D: the type of event.

A

B

55
Q

Choose:

Environmental terrorists, survivalists, militias, and racial-hate groups are examples of:

A. international terrorists.

B. state-sponsored terrorist groups.

C. domestic terrorists.

D. religious freedom fighters.

A

C

56
Q

Choose:

Potential high-risk targets of terrorists typically include:

A. controversial businesses.

B. infrastructure systems.

C. public buildings.

D. any of these.

A

D

57
Q

Choose:

Why is April 19 a day when the U.S. government stands at heightened security awareness for government facilities?

A. It is the anniversary of the Pearl Harbor attack.

B. It is the anniversary of the bombing of the Murrah building in Oklahoma City.

C. It is the anniversary of the initial World Trade Center bombing.

D. It is the anniversary of the Bay of Pigs incident.

A

B

58
Q

Choose:

Responding EMTs who arrive on the scene of an incident should watch for signs that they may be dealing with a suspicious incident.

Examples of suspicious incidents include all of the following except:

A. car crashes involving more than two patients with serious traumatic injuries.

B. unexplained symptoms of skin or eye irritation.

C. unexplained vapor clouds, mists, and plumes.

D. unexplained signs of airway irritation.

A

A

Car crashes involving more than two patients with serious traumatic injuries is the exception. Unexplained symptoms of skin or eye irritation; unexplained vapor clouds, mists, and plumes; and unexplained signs of airway irritation are all examples of signs that EMTs may be dealing with a suspicious incident.

59
Q

Fill in the blank:

Danger from alpha particles, beta particles, or gamma rays is caused by [BLANK] harm.

(think of source or means of transmission)

A

Danger from alpha particles, beta particles, or gamma rays is caused by radiological harm.

60
Q

Choose:

The mainstays of self-protection at a radiological incident include all of the following except:

A. time.

B. Standard Precautions.

C. distance.

D. shielding.

A

B

61
Q

Choose:

You are on the scene where there is a suspicion that someone may have been exposed to anthrax.

Which is the most lethal route of exposure to anthrax?

A: skin contact

B: ingestion

C: inhalation

D: injection

A

C

62
Q

Choose:

The quality of being poisonous, especially the degree of strength of a toxic microbe or of a poison, is referred to as:

A. infectivity.

B. toxicity.

C. virulence.

D. transmissibility.

A

C

63
Q

Choose:

The relative ease with which an agent causes death in a susceptible population is referred to as the:

A. stability of the product.

B. infectivity of the agent.

C. lethality of the agent.

D. virulence of the virus.

A

C

64
Q

Choose:

Which virus did the World Health Organization declare eradicated worldwide in 1980 through immunization efforts?

A. Polio

B. Anthrax

C. Viral hemorrhagic fever

D. Smallpox

A

D

65
Q

Choose:

Which of the following is not a common mechanism for performing decontamination?

A. Demulsification

B. Chemical reaction

C. Disinfection

D. Absorption and adsorption

A

A

nice try but emulsification is a mechanism

66
Q

Choose:

You have responded to a building collapse. The three-story office building is believed to have been vacant at the time of the collapse. The fire department personnel believe that there was an explosion that caused the front of the building to cave in.

In addition to mechanical harm, all of the following are types of harm that can result from an explosive incident except:

A. thermal harm.

B. asphyxiation.

C. water damage.

D. chemical hazards.

A

C

67
Q

Choose:

You have responded to a building collapse. The three-story office building is believed to have been vacant at the time of the collapse. The fire department personnel believe that there was an explosion that caused the front of the building to cave in. After the scene is safe, you are called to the back of the building, where you find a 68-year-old man who lives in the alleyway there. He is coughing and complaining of breathing problems. It is obvious that he may have inhaled a large quantity of dust when the building collapsed.

What is another danger to this patient?

A. His skin may be vety dirty or greasy.

B. There are often toxic particles, such as asbestos, in the dust.

C. The water he was drinking may be contaminated.

D. He may be developing hypothermia.

A

B

68
Q

Choose:

You were called to the scene of a 45-year-old female who is very weak and is complaining of a fever. She has a number of bruises, and the sclera of her eyes seem to be leaking blood from the tiny capillaries. She works in a lab and has been doing some top secret experiments recently.

What could be the cause of this sickness?

A. Smallpox

B. Rabies

C. Encephalitis

D. A viral hemorrhagic fever

A

D