Terrorism Response and Disaster Management Flashcards
Terrorism
- Involves violent acts or acts dangerous to human life that violate the law
- Appears to be intended to intimidate or coerce a civilian population, government policy, or to affect the conduct of government by mass destruction, assassination, or kidnapping
Difference between domestic and international terrorism
Location
The deliberate creation and exploitation of fear through violence or threat of violence committed by a single actor who pursues political change linked to a formulated ideology, whether their own or that of a larger organization, and who does not receive orders, direction, or material support from outside sources
Lone wolf terrorism
Categories of terrorist attacks
- Religious extremist groups/doomsday cults
- Extremist political groups
- Cyber terrorists
- Single-issue groups
THREAT
- Threat suppression
- Hemorrhage control
- Rapid Extrication to safety
- Assessment by medical providers
- Transport to definitive care
Response plan for active shooter
THREAT
WMD
Weapon of mass destruction
WMC
Weapon of mass casualty
Any agent designed to bring about mass death, casualties, and/or massive damage to property and infrastructure
WMD or WMC
Different kinds of WMDs (mnemonic)
B-NICE or CBRNE
B-NICE
Biologic
Nuclear
Incendiary
Chemical
Explosive weapons
CBRNE
Chemical
Biologic
Radiologic
Nuclear
Explosive weapons
Preferred WMD for terrorists
Explosives
Manufactured substances that can have devastating effects on living organisms
Chemical agents
Types of chemical agents
- Vesicants (blister agents)
- Respiratory agents (choking agents)
- Nerve agents
- Metabolic agents (cyanides)
Organisms that cause disease
Biologic agents
Performed to artificially maximize the target population’s expose to the germ
Weaponization of biologic agents
Primary types of biologic agents
- Viruses
- Bacteria
- Toxins
Nations that hold close ties with terrorist groups
State-sponsored terrorism
RDD
Radiologic dispersal devices (dirty bombs)
Key to response to terrorism
Situational awareness
The planning of most acts of terror is ___
Covert
NTAS
National Terrorism Advisory System
Alerts from the NTAS contain ___
A summary of the threat and the actions that first responders, the government agencies, and the public can take to maintain safety
Observations to make on a call to determine the potential for a terrorist attack
- Type of location
- Type of call
- Number of patients
- Victim’s statements
- Preincident indicators
Most important clue that a terrorist attack has occurred
Number of patients
Second-best indicate that a terrorist attack has occured
Victim’s statements
Actions to take after determining a terrorist attack has occurred
- Scene safety
- Responder safety
- Notification procedures
- Establishing command
- Reassessing scene safety
How far to park from terrorist incident
Usually 1 to 2 blocks
Intended to primarily injure responders and to secure media coverage
Secondary device
Greatest threats facing you in a WMD attack
Contamination and cross-contamination
Occurs when you have direct contact with a WMD or are exposed to it
Contamination
Occurs when you come in contact with a contaminated person who has not yet been decontaminated
Cross-contamination
Who to notify of a terrorist attack first
Dispatcher
What info to provide dispatch about terrorist attack
- Nature of event
- Additional resources required
- Estimated number of patients
- Upwind route of approach or optimal route of approach
Liquids or gases that are dispersed to kill or injure
Chemical agents
The properties or characteristics of an agent can be described as ___
Liquid, gas, or solid
Describe how long the agent will stay on a surface before it evaporates
Persistency and volatility
How the agent most effectively enters the body
Route of exposure
Enter the body through respiratory tract in the form of vapors
Vapor hazard
Give off very little vapor or no vapors and enter the body through the skin
Contact hazard
Blister agents are also called ___
Vesicants
Primary route of exposure for blister agents
Skin
If vesicants are left on the skin or clothing long enough, ___
They produce vapors that can enter the respiratory tract
Vesicants cause ___
Burn-like blisters on the skin and in the respiratory tract
Vesicant agents
- Sulfur mustard (H)
- Lewisite (L)
- Phosgene oxime (CX)
Vesicants usually cause the most damage to ____
Damp or moist areas of the body
Signs of vesicant exposure on the skin
- Skin irritation, burning, and reddening
- Immediate, intense skin pain (with L and CX)
- Formation of large blisters
- Gray discoloration of skin (signs of permanent damage seen with L and CX)
- Swollen and closed or irritated eyes
- Permanent eye injury (including blindness)
Signs of vesicant exposure if inhaled
- Hoarseness and stridor
- Severe cough
- Hemoptysis
- Severe dyspnea
Commonly known as mustard gas
Sulfur mustard (H)
Sulfur mustard appearance
Brownish, yellowish oily substance
Mustard gas smell
Garlic or mustard
Mustard gas damage to the cells happens within ___
1 to 2 minutes
Absorption of mustard gas through the skin or mucous membranes happens within ___
Seconds
Mustard gas is a ___
Mutagen
How long after mustard gas exposure will the patient show signs and symptoms
4 to 6 hours
Mustard gas attacks cells within the bone marrow and depletes the body’s ability to produce ___
White blood cells
Primary complication associated with vesicant blisters
Secondary infection
Produce similar blister wounds to mustard gas, but have a more rapid onset of symptoms
Lewisite (L) and phosgene oxime (CX)
Which vesicants have antidotes?
- None for mustard gas or CX exposure
- British anti-lewisite for agent L
Who is best equipped to handle vesicant injuries
Burn centers
Gases that cause immediate harm to people exposed to them and include chlorine (Cl) and phosgene
Pulmonary agents
Pulmonary agents are also called ___
Choking agents
Primary route of exposure for choking agents
Respiratory tract
How to pulmonary agents affect the lungs?
Damage the tissue, and fluid leaks into lungs. Pulmonary edema develops
Chlorine has a distinct odor of ___
Bleach
Chorine creates a ___ when released as a gas
Green haze
Signs and symptoms of chorine exposure
Upon initial exposure:
1. Upper airway irritation and a choking sensation
Later:
1. Shortness of breath
2. Tightness in chest
3. Hoarseness and stridor
4. Gasping and coughing
Ammonia and bleach are similar to ___
Chlorine
Burning Freon creates ___
Phosgene
Onset of phosgene symptoms
Hours
Odor of phosgene
Freshly mowed grass or hay
Mild exposure of phosgene signs and symptoms
- Nausea
- Tightness in chest
- Severe cough
- Dyspnea on exertion
Severe expose of phosgene signs and symptoms
- Dyspnea at rest
- Excessive pulmonary edema
What might be coughed up with phosgene exposure?
White or pink-tinged fluid
Severe phosgene exposure can cause pulmonary edema so bad that ___
The patient may become hypovolemic and subsequently hypotensive
Best initial treatment for a patient exposed to a pulmonary agent
Remove from the environment
Do not allow a patient with choking agent to be ___
Active
Antidote for pulmonary agent
None
Position for patient of pulmonary agent
Position of comfort with the head elevated
Treatment for pulmonary agent
Manage ABCs and rapid transport (CPAP may help)
Deadliest chemicals
Nerve agents
Nerve agents are classified as ___
WMDs
Nerve agents cause ___
Cardiac arrest within seconds to minutes of exposure
Nerve agents are a class of chemicals called ___
Organophosphates
How do nerve agents work?
Block an essential enzyme in the body’s organs to become overstimulated and burn out
G agents from high to low volatility
- Sarin (GB)
- Soman (GD)
- Tabun (GA)
Highly volatile colorless and odorless liquid
Sarin (GB)
Lethal concentration of Sarin in air
About 28 to 35 mg/m^3 per minute for a two minute exposure by a healthy adult
Sarin is a ___ hazard
Vapor
The vapors are continually released over time
Off-gassing
Twice as persistent as sarin
Soman
Odor of soman
Fruity
Soman route of exposure
Contact and vapor
Irreversible binding to the cells
Aging
Half as lethal as sarin and 36 times more persistent
Tabun
Odor of tabun
Fruity
V agent (VX) appearance
Clear, oily agent that has no odor and looks like baby oil
How much worse is V agent to G agents
100 times more lethal and extremely persistent
VX is a ___ hazard
Contact
Persistence of VX
Weeks to months
Symptoms of exposure to nerve agents mnemonic
SLUDGEM
DUMBELS
SLUDGEM
Salivation, sweating, seizures
Lacrimation
Urination
Defecation, drooling, diarrhea
Gastric upset and cramps
Emesis
Muscle twitching, miosis
DUMBELS
Diarrhea
Urination
Miosis, muscle weakness
Bradycardia, bronchospasm, bronchorrhea
Emesis
Lacrimation
Seizures, salivation, sweating
What makes nerve agent seizure different?
Will continue until dead or until treatment is given
Nerve agent antidotes
- DuoDote Auto-Injector
- Antidote Treatment Nerve Agent Auto-Injector (ATNAA)
DuoDote Auto-Injector contains ___
- 2.1 mg of atropine (Block agent)
- 600 mg of pralidoxime chloride (2-PAM) (Eliminates agent from body)
