EMS Response to Terrorism Flashcards

Question

Radiological/Nuclear Incident

Answer 1

• 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

Answer 2

* Time, distance, shielding * Radiologic detecting equipment helps determine effectiveness of measures * Assume dissemination of radiological,biological, or chemical materials * Follow decontamination procedures

Answer 3

* 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

Answer 4

* 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)

Answer 5

• Responder needs both pre blast and postblast protection – Preblast: operations occurring after written or verbal warning received but before explosion takes place – Postblast: operations occurring after at least one detonation

Answer 6

``` • Respiratory route – Most effective, most common means • Ingestion route • Dermal route • Human-to-human contact ```

Answer 7

* Most effective when targeted through inhalation route * Particles in 3–5 micron size * Such airborne dissemination can be created by applying energy to material * Heat, explosives, sprayers can aerosolize materials

Answer 8

• Can be gaseous, liquid, or solid • Vapor pressures and densities can vary across the spectrum • Volatility – Low boiling point and high vapor pressure will evaporate more readily – Allows agent to have greater airborne release potential

Answer 9

``` • Choking agents – Predominately respiratory • Vesicating (blister) agents – Cause chemical changes in cells of exposed tissue • Cyanides – Prevent use of oxygen within cells ```

Answer 10

• Nerve agents – Inhibit enzyme critical to proper nerve transmission, causing out-of-control parasympathetic nervous system • Riot control agents – Irritating materials and lacrimators (tear-flow increasers)

Answer 11

``` • Signs and symptoms of exposure – Salivation – Lacrimation – Urination – Defecation – GI Upset – Emesis – Miosis ```

Answer 12

``` • Role of EMS primarily supportive • Some material can replicate itself creating greater potential for transmission from person to person ```

Answer 13

* Military nuclear device * Improvised nuclear device * Radiological dispersal device (dirty bomb) * Sabotage

Answer 14

``` • Radiologic exposure affects bone marrow, gastrointestinal system, central nervous system ```

Answer 15

• Blast injury patterns – Lung injury: bradycardia, apnea, and hypotension from blast wave – Ear injury: rupture of tympanic membrane – Abdominal injury: rupture of gas-containing section of intestine – Brain injury: concussion or mild traumatic brain injury (MTBI) from blast wave

Answer 16

* Controlling scene, isolating hazards, and attempting to conduct controlled evacuation is resource-intensive and requires law enforcement personnel * Law enforcement must establish and control perimeter throughout incident

Answer 17

• Generally required by established directives, procedures, and statutes • Request for additional specialized agencies carried out by communications center based upon early reports of EMTs on scene

Answer 18

``` • Identification of agent – Observe indicators of particular agent or presence of chemical containers or lab materials • Protection of critical assets – People, vehicles, equipment/supplies – Requires close partnership between EMS and security agencies ```

Answer 19

``` • Gross decontamination by EMS personnel – Removing surface contamination via mechanical means and initial rinsing – Amount of surface contamination significantly reduced ```

Answer 20

``` • Victims displaying signs of hazardous substance exposure? • Unconscious victims? • Victims exhibiting SLUDGEM signs? • Blistering, reddening of skin, discoloration or skin irritation? • Victims having difficulty breathing? ```

Answer 21

``` • Medical mass casualties or fatalities with minimal or no trauma • Responder casualties • Dead animals and vegetation • Unusual odors, color of smoke, vapor clouds ```

Answer 22

* Occupancy (location) * Type of event * Timing * On-scene clues

Answer 23

``` • Wait until appropriate authority says scene is safe • Follow incident command protocols • Wear appropriate PPE • Beware possible secondary explosive devices • Search all patients for explosives or weapons ```

Answer 24

``` • Understand TRACEM-P harms • Time, distance, shielding • Use specific tactics for each CBRNE threat ```

Answer 25

• There have been terrorist attacks throughout history. After 9/11 the world has been a different place because of the threat of terrorism. • CBRNE helps recall the types of agents and weapons that can be used by terrorists. TRACEM-P helps recall the types of hazards of these agents.

Answer 26

• You must be sure to protect yourself from terrorist attacks as well as secondary attacks which are designed to injure or kill rescuers and further the physical and psychological impact of the attack.

Answer 27

• Responders often are targets of terrorists. Safety must be the highest priority. Use scene clues to identify potential terrorist incidents. • Adapt protective measures to the specific threat. Know the protective principles of CBRNE events.

Answer 28

• Important priorities for responders at a terrorist incident are life safety, incident stabilization, and protection of property. • Isolation, perimeter control, and appropriate notifications are important priorities in managing a terrorist incident.

Answer 29

• Force protection is an extension of general safety procedures. It refers to the safety and security of both providers and resources.

Answer 30

• How can I best protect myself from danger and hazards during a terrorist incident? • What is my role in the incident response plan for a terrorist incident?

Answer 31

• You arrive at an office where multiple patients are complaining of the same symptoms. They state their office received several threats due to its role in a controversial foreign relations incident. You and your partner recognize the similar symptoms and decide these may be linked.

Answer 32

• What is your best course of action next? | Should you remove yourself from the scene at this point or remain with your patients?

Answer 33

religious base pg 1065

Answer 34

``` Chemical Biological Radiological Nuclear Explosive ```

Answer 35

atlanta think about the things that folks may have against this business be careful of the secondary device - constantly monitor your situation********especially if you are somewhere that people could dislike

Answer 36

Occupancy (or location) Type of event timing of event on-scene warning signs Think before you ask

Answer 37

gamma radiation is the worst** ``` thermal radiological asphxiation Chemical Etiological Mechanical Psycological ```

Answer 38

TDS Time Distance Shielding

Answer 39

``` 4 routes of entry inhaled ingested injected absorption ```

Answer 40

presents as a focused emergency or public health emergency

Answer 41

packaging or producing a material, such as a chemical, biological, or radiological agent, so that it can be used as a weapon; for example, by dissemination in a bomb detonation or as an aerosol sprayed over an area or introduced into a ventilation system. O'Keefe, Michael F. (2011-04-21). Emergency Care (12th Edition) (Page 1077). Prentice Hall. Kindle Edition. 1077 sm respiratory particles anthrax 3-5 micron

Answer 42

choking - chlorine vesciating - blister agent chemical agent causes damage to what part of the body cyanides - celluar axsphyxiants - mess with HbG can't put them on O2 and they don't get better - can only nerve agents - produced in germany to kill rats originally acetylcholinesterase - nerve agent binds it - down effect for parasympathetic riot ctl agents -

Answer 43

nerve agents slow everything down make Some nerve agents act on the parasympathetic nervous system. For example, the enzyme acetylcholinesterase is inhibited by the nerve agent and fails to break down the neurotransmitter acetylcholine. This causes an overstimulation of the parasympathetic nervous system and a specific set of signs and symptoms. SLUDGEM is a mnemonic used to remember the signs and symptoms of nerve agent poisoning. The letters stand for: S alivation–due to stimulation of the salivary glands L acrimation–due to stimulation of the lacrimal glands U rination–due to relaxation of the internal sphincter muscle of the urethra D efecation–due to relaxation of the anal sphincter G I upset–changes to smooth muscle tone in the GI tract E mesis–vomiting because of GI system effects M iosis–abnormal contraction of the pupils know the first four salivation, lacrimation, urination, defecation

Answer 44

zoonotic bacteria which produces spores. When aerosolized (3 - 5 microns) it can be inhaled and is deadly if not tx early (12-41 hr eclipse)

Answer 45

Plague bacterium (Yersinia pestis) is a zoonotic bacteria carried by rats & ground squirrels and transmitted to humans by fleas

Answer 46

Botulinum Bacterial toxin The botulinum toxin is one of the deadliest compounds known. It has an LD (50) (lethal dose for 50 percent of the test population) of 0.001 mcg/kg or . By weight, botulinum is 15,000 to 100,000 times more toxic than the nerve agents.