EMS Response to Terrorism Flashcards
Terrorism**
• “The unlawful use of force or violence against persons or property to intimidate
or coerce a government, the civilian population or any segments thereof, in furtherance of political or social objectives”
Domestic Terrorism*****
• “Groups or individuals whose terrorist activities are directed at a government or population, without foreign direction” – Environmental terrorists – Survivalists – Militias – Racial-hate groups – Extreme political or religious groups
International Terrorism****
• “Groups or individuals whose terrorist activities are foreign-based and/or directed
by countries or groups outside the targeted country or whose activities cross national borders.”
• Growing trend toward loosely organized, international networks of terrorists (for example, Al Qaeda)
Types of Terrorism Incidents
• Weapons of mass destruction (CBRNE) – Chemical – Biological – Radiological – Nuclear – Explosive – Criminal activities
First Responders as Targets
- First responders often principle targets of terrorist attacks
- Safety of EMS provider is most important consideration when responding to potential terrorist incident
Identify Threat Posed by Event
• Incident that is a potential act of terrorism is also a crime scene • Recognizing OTTO signs may help protect against secondary attack – Occupancy (or location) – Type of event – Timing of event – On-scene warning signs
Occupancy or Location
- Symbolic or historic targets
- Public buildings or assembly areas
- Controversial businesses
- Infrastructure systems
Type of Event
• Types of events with high suspicion of terrorist involvement
– Explosions and/or use of incendiaries
– Incidents involving firearms
– Nontrauma mass casualty incidents
Timing of Event
- National holidays
- Anniversary dates of previous attacks
- Incidents occurring in major public areas at busy points of business day
On-Scene Warning Signs
- Unexplained patterns of illness or death
- Unexplained signs and symptoms or skin, eye, or airway irritation
- Containers that appear out of place
Recognize Harms
Posed by Threat—TRACEM-P
• Thermal: caused by either extreme heat or extreme cold
• Radiological: from alpha particles, beta particles, or gamma rays, generally
produced by nuclear events
• Asphyxiation: caused by lack of oxygen in atmosphere
Recognize Harms
Posed by Threat—TRACEM-P
- Chemical: caused by toxic or corrosive materials
- Etiological: caused by disease
- Mechanical: caused by physical trauma (gunshot, bomb fragments)
- Psychological: results from any violent event
Time
• Minimize time in dangerous area or exposed to hazardous material, biological agent, or radiation
• Execute rapid entries to perform
reconnaissance or rescue
Distance
- Maximize distance from hazard area or projected hazard area
- Follow recommended guidelines regarding hazardous materials in Emergency Response Guidebook
Shielding
- Use appropriate shielding for specific hazards
- Can be vehicles, buildings, fire-protection clothing, hazmat suits, positive-pressure self-contained breathing apparatus, PPE
- Vaccinations against specific diseases
Chemical Incident
• Includes many classes of hazardous materials
– Can be inhaled, ingested, absorbed, injected
– Can include industrial chemical or warfare type agents
Harms of Chemical Incident
- Thermal (secondary): reactions create heat
- Asphyxiation (secondary): reactions deplete oxygen
- Chemical (primary): systemic effects
- Mechanical (secondary): corrosive chemicals weaken structures
- Psychological (secondary)
Self-Protection Measures
- Respiratory protection
- Protective clothing
- Be aware of possible contamination from patients
Biological Incident
• Presents as focused emergency or public health emergency
– Focused emergency: potential or actual point of origin located; attempts made to prevent or
minimize damage and spread
– Public health emergency: sudden demand upon public health infrastructure with no
apparent explanation
Biological Incident
• Causative agents
– Bacteria
– Viruses
– Toxins
Biological Incident
• Four major routes of entry to body – Absorption: skin contact – Ingestion: by mouth – Injection: from needles or projectiles – Inhalation: by breathing
Exposure/Contamination
- Exposure: substance taken into body through route of exposure
- Contamination: substance clings to surface areas of body or clothing
Harms of Biological Incident
• Chemical (secondary): scene of
clandestine laboratory
• Etiological (primary): agents classified as poisons
• Mechanical (secondary): explosives used to disperse agents
• Psychological (secondary)
Self-Protection Measures
• PPE and respiratory protection • Get as much information as possible • Prioritize protective measures – Self-protection – Buddy system – Availability of rapid intervention teams – Civilian protection
Radiological/Nuclear Incident
• Small nuclear devices (“suitcase bombs”)
stockpiled in foreign nations
• Radiologic dispersion more practical and difficult to detect as radiation symptoms are delayed for hours or days
– Sickness treatable if detected early
Self-Protection Measures
- Time, distance, shielding
- Radiologic detecting equipment helps determine effectiveness of measures
- Assume dissemination of radiological,biological, or chemical materials
- Follow decontamination procedures
Explosive Incident
- Wide variety of devices from small pipe bombs to large vehicle bombs
- May involve attacks on a fixed target or group of people
- May be designed to disperse biological, chemical, or radiological materials
Harms of Explosive Incident
- Thermal (primary): heat of detonation
- Asphyxiation (secondary): possibility of extremely dusty conditions
- Chemical (secondary): result of explosive reaction from chemicals present at detonation site
- Mechanical (primary): typically seen at bombing incidents
- Psychological (secondary)
