emt chapter 41: terrorism attacks and disaster management

Terrorism (Definition)

Violent acts dangerous to human life that violate law and are intended to intimidate civilians, influence government policy, or affect government actions through destruction, assassination, or kidnapping.

Domestic Terrorism

Terrorist acts occurring within the United States.

International Terrorism

Terrorist acts originating outside the United States.

Religious Extremist Groups

Groups motivated by religious ideology; may use violence to achieve goals.

Doomsday Cults

Groups believing in apocalyptic events; may commit violent acts.

Extremist Political Groups

Groups seeking political change through violence or coercion.

Single-Issue Terrorist Groups

Groups like anti-abortion extremists, animal rights radicals, anarchists, racists, ecoterrorists.

Cyber Terrorists

Use computers and internet to cause harm, disruption, or fear.

Lone Wolf Terrorist

An individual acting alone; motive often unclear; may seek revenge.

Active Shooter Event

A situation where one or more individuals are actively killing or attempting to kill others in a populated area.

Common Active Shooter Targets

Schools, music festivals, shopping centers, public gatherings.

Active Shooter Aftermath

Many attackers commit suicide afterward.

THREAT Acronym

Threat suppression; Hemorrhage control; Rapid extrication; Assessment by medical providers; Transport to definitive care.

EMS Ballistic PPE

EMS may use ballistic vests and helmets during active shooter responses.

Interagency Training (Added)

EMS, fire, and police must train together for coordinated response.

Weapons of Mass Destruction (WMD)

Agents designed to cause mass death, casualties, or large-scale damage.

CBRNE

Chemical, Biological, Radiological, Nuclear, Explosive categories of WMDs.

Explosives as WMD

Most commonly used WMD worldwide.

Chemical Agent Types

Vesicants (blister agents), respiratory agents (choking), nerve agents, metabolic agents (cyanides).

Nuclear/Radiologic Terrorism

Examples include Hiroshima and Nagasaki; materials easier to obtain than expected; dirty bombs cause panic.

Dirty Bomb (Added)

Explosive combined with radioactive material to contaminate an area.

EMT Terrorism Response Principles

Basic care stays the same; scene awareness is critical.

Recognizing Terrorism Event

Terror acts planned covertly; know DHS threat level; observe scene for unusual signs.

Scene Observations

Location, type of call, number of patients, unusual behavior, secondary devices (added).

Scene Safety During Terrorism Event

Stage vehicle far away; wait for law enforcement; don’t approach scene; stay uphill and upwind.

Responder Safety Rule

Prevent contact with hazardous materials; avoid touching items.

Notify Dispatch Of

Event details, number of patients, needed resources, best approach route.

Vesicants (Blister Agents)

Cause painful blisters on skin/mucous membranes.

Sulfur Mustard (H)

Brown-yellow oily substance; common vesicant; causes skin burn-like injuries.

Lewisite (L)

Another blister agent.

Vesicant Treatment

No antidotes for mustard or CX; ensure full decontamination before treatment.

Pulmonary Agents (Choking Agents)

Gases causing lung irritation and respiratory issues.

Chlorine (CI)

First chemical warfare agent; causes airway irritation, choking, SOB, nausea.

Phosgene

Created by combustion; causes severe respiratory distress.

Pulmonary Agent Treatment

Manage airway/ABCs, ventilate, suction as needed.

Nerve Agents

Most lethal chemical agents; can cause cardiac arrest within seconds to minutes.

Organophosphates

Found in pesticides; block essential nervous system enzymes.

Nerve Agent Signs (Added)

SLUDGEM: salivation, lacrimation, urination, defecation, GI upset, emesis, miosis.

Metabolic Agents (Cyanides)

Hydrogen cyanide (AC) and cyanogen chloride (CK); prevent the body from using oxygen.

Metabolic Agent Symptoms

Dizziness, light-headedness, headache, vomiting, respiratory distress.

Biologic Agents

Can be undetected; spread quickly person-to-person; example: COVID-19.

Virus: Smallpox

Highly contagious; PPE required: gloves, HEPA respirator, eye protection.

Viral Hemorrhagic Fevers (VHF)

Cause bleeding, clotting problems, organ failure.

Neurotoxins

Some of the most deadly substances; derived from plants, animals, molds, bacteria.

Examples of Neurotoxins (Added)

Botulinum toxin, ricin, marine toxins.

EMT Role in Biologic Incidents

Monitor signs/symptoms; look for influenza-like illnesses; report clusters.

Points of Distribution (POD)

Sites that distribute medications, vaccines, supplies, resources in mass emergencies.

Radiologic/Nuclear Devices

Use materials that release harmful radiation energy.

Types of Radiation

Alpha (least harmful), beta (more penetrating), gamma (very strong), neutron (deep penetration, extremely damaging).

EMS Radiation Rule (Added)

Time, distance, shielding — limit exposure