ch 41 terrorism

Threat acronym

 Threat suppression

 Hemorrhage control

 Rapid extrication to safety

 Assessment by medical providers

 Transport to definitive care

B-NICE for weapons of mass destruction

 Biologic

 Nuclear

 Incendiary

 Chemical

 Explosive

examples of chemical agents

 Vesicants (blister agents)

 Respiratory agents (choking agents)

 Nerve agents

 Metabolic agents (cyanides

examples of bio agents

viruses, bacteria, toxins

Agents with a vapor hazard

enter through the respiratory tract in the form of vapors

Agents with a contact hazard (or skin hazard) give off very little vapor or no vapors

and enter the body through the skin.

Vesicants route of exposure

skin but then can produce vapor that enter respiratory tract

damage of vesicants

Cause burn like blisters to form on the victim’s skin and in the respiratory tract specifically in damp or moist areas of the body

signs of vesicant exposure

 Skin irritation, burning, and reddening

 Immediate, intense skin pain

 Formation of large blisters

 Gray discoloration of skin

 Swollen and closed or irritated eyes

 Permanent eye injury (including blindness

examples of vesicants

sulfur mustard(H), Lewisite (L) and phosgene oxime (CX)

Sulfur mustard (H)

Attacks and damages vulnerable cells within the bone marrow and depletes the body’s ability to reproduce white blood cells

exposure for sulfur mustard

inhaled, creating upper and lower airway compromise

Lewisite (L) and phosgene oxime (CX)

Produce immediate intense pain and discomfort when contact is made created blisters and gray discoloration

Vesicant agent treatment

decontamination, airway support, transport to burn centers

Pulmonary agents

gases that once inhaled they damage the lung tissue and fluid leaks into the lungs causing pulmonary edema

examples of pulmonary agents

chlorine, phosgene

chlorine symptoms

 Initially, produces upper airway irritation and a choking sensation

 Patient may later experience:

 Shortness of breath

 Chest tightness

 Hoarseness and stridor

 Gasping and coughing

 Pulmonary edema

symptoms of phosgene

Nausea

 Chest tightness

 Severe cough

 Dyspnea on exertion

 Pulmonary edema

treatment for pulmonary agents

remove patient, manage abc via oxygenation, ventilation and suctioning, do not allow patient to be active

nerve agents

deadly bc they can cause cardiac arrest within seconds to minutes of exposure

example of nerve agents

organophosphates in household bug sprays that Block an essential enzyme in the nervous system

symptoms of nerve agents

Salvation/seizures/sweating

lacrimation(excessive tearing)

urination

defecation/drooling/diarrhea

gastric issues

emesis(vomiting)

muscle twitching/miosis(pinpoint pupils)

Nerve agent treatment

DuoDote Auto-Injector (Antidote Treatment Nerve Agent Auto-Injector [ATNAA])

examples of metabolic agents

Hydrogen cyanide (AC) and cyanogen chloride (CK)

metabolic agents

affect the body’s ability to use oxygen, Commonly found in many industrial setting

symptoms of metabolic agents

Shortness of breath/gasping respirations

 Respiratory distress or arrest

 Tachypnea

 Flushed skin

 Tachycardia

dizziness

headache

vomiting

Altered mental status

 Seizures

 Coma

 Apnea

 Cardiac arrest

Cyanide agent treatment

remove from scene and abc’s

viruses

gerems that require a living host

example of viruses

smallpox, viral hemorrhagic fever

smallpox

spread via contamination items/people through skin contact to blisters or coughed droplets

signs and symptoms of smallpox

severe fever, small blisters on skin, duration of 4 weeks

Viral hemorrhagic fever (VHF)

Causes the blood in the body to seep out from the tissues and blood vessels after direct contact with infected body fluids

symptoms of vhf

flulike symptoms, progressing to more serious symptoms such as internal and external hemorrhaging

examples of bacteria

Inhalation and cutaneous anthrax, plague

Inhalation and cutaneous anthrax routes of entry

inhalation, cutaneous, and gastrointestinal.

symptoms of anthrax

flulike symptoms, fever, respiratory distress with tachycardia, shock, pulmonary edema

treatment for anthrax

antibiotics and vaccine on top of abc’s

bubonic plague

infects the lymphatic system and creates buboes.

Pneumonic plague

is a lung infection that results from inhalation of plague bacteria.

neurotoxins

Produced from plants, marine animals, molds, and bacteria

 Route of entry is ingestion, inhalation, or injection.

 Not contagious and have a faster onset of symptoms

examples of neurotoxins

Botulinum toxin, ricin

Botulinum toxin

potent neurotoxin produces by bacteria that Affects the nervous system’s ability to function leading to muscle paralysis and respiratory arrest

route of botulinum toxin

ingestion via food , inhalation via aerosol

ricin

Derived from mash from the castor bean

 Causes pulmonary edema and respiratory and circulatory failure, leading to de

signs and symptoms of ricin

inhaled: cough, muscle aches, tightness in chest

ingested: nausea, internal bleeding, vomiting

effects of radiation exposure varies depending on

the amount of radiation and the route of entry

signs of low exposure to radiation

nausea, vomiting, dizziness, headache