Chapter 41: Terrorism Response + Disasters

Domestic, international

__ terrorism are incidents that occur within the US, whereas __ terrorism is carried out by terrorists in a country other than their own

Religious, separatists, infrastructure, single issue

Common goals of terrorism

1. Violent __ groups/doomsday cults

2. Extreme political groups, i.e. __ or seeking certain freedoms

3. Technology terrorists, or cyber terrorists that attack technological __

4. __-__ groups, such as violent anti-abortion groups or animal rights activities

Weapons of Mass Destruction (WMDs)

Any agent meant to bring large death, casualties, or massive damage to property and infrastructure

Biological

Nuclear

Incendiary

Chemical

Explosive

BNICE - Weapons of Mass Destruction

Explosives

Historically the preferred WMD has been __ through use of suicide bombers or truck bombs

nerve, retreat, hazmat

Arrival to scene with multiple patients having seizures. This may be related to use of __ agent and best course of action is to __ and upgrade with a __ component

Chemical Agents

Include nerve, vesicants, respiratory, and metabolic agents

Vesicants

Primary route of exposure via skin, can also produce vapors that can be inhaled causing similar effects on the respiratory tract

S/S: Blisters on the skin with immediate intense pain, damage to moist areas of the body; If inhaled cause severe dyspnea and hemoptysis

Sulfur mustard

Smells of garlic, very persistent, mutagen, s/s 4-6 hours, attacks bone marrow depletes ability to produce WBCs, secondary infections (vesicant)

Lewisite

highly volatile, instant s/s, antidote exists (vesicant)

Phosgene oxime

highly volatile, instant s/s, no antidote (vesicant)

Pulmonary Agents

primary route of exposure is through the respiratory tract causing lung damage and pulmonary edema

Mixed bleach and ammonia

You arrive on scene of a home where the resident has been overcome by fumes while cleaning. There is a greenish haze in the house and a strong odor of bleach. What has this happy homemaker done that has created this hazard?

Chlorine gas

chemical agent creates green haze and causes upper airway constriction

Phosgene

chemical agent smells of hay or freshly mown grass.

S/S are delayed (in hours) and severe pulmonary edema to point of expelling it from their lungs and become hypovolemic → hypotensive

Organophosphates

Nerve agent that block an essential enzyme in the NS leading to it to overact and cause burnout and death with small amounts within seconds to minutes

Seize, miosis, constriction

Patients with organophosphate exposure can continue to __ until they die. Most common sign of nerve agent exposure is __, an unexplained __ of the pupils that can last for weeks.

Atropine

In nerve agent antidote and acts by blocking nerve agent, may need multiple doses

2-PAM (pralidoxime)

In nerve agent antidote and acts by eliminating agent from the body

Cyanide

Metabolic agent that affects the body’s ability to use oxygen by binding with the cells ; colorless

S/S dizziness and vomiting to dyspnea, seizures, and cardiac arrest within minutes

Decontaminated

Never treat a patient that has not been properly __

Biologic agents

Used as WMD’s to infect large populations with harmful and deadly diseases

include viruses, bacteria, and toxins

Flu, region

EMS can assess for potential biologic agents by watching for an “unexplained__” among a particular __

Viruses

Require a living host to survive and move from host to host through direct contact, like respiratory droplets or vectors

Smallpox

Blisters start at face and extremities (most contagious phase), high fever, aches (virus)

Viral Hemorrhagic Fevers (VHF)

Cause blood to seep from tissues and blood vessels, flu-like s/s progressing to internal/external bleeding (virus)

Bacteria

Do not require a host to multiply and survive; treated with antibiotics and usually begin with flu-like symptoms

Anthrax

Inhalation, absorption, consumption, dormant spore until in the body, pulmonary form =90% death rate presents as severe cold (bacterial)

Bubonic, pneumonic

The ___ plague is not contagious, attacks lymph system, causing swelling and sepsis, not likely to be used

The __ plague is more likely to be used, inhalation, contagious, higher death rate

Neurotoxins

Produced from plants, marine animals, molds and bacteria, and most deadly substance known to humans

Botulinum

Most potent neurotoxin, causes paralysis starting at the face and travels downward paralyzing the respiratory muscles (neurotoxin)

Ricin

Made from the castor bean, starts with flu-like s/s, kills within 3 days w/o intervention of pulmonary edema, respiratory and circulatory failure (neurotoxin)

Dirty bomb

Designed to create fear of contamination of radioactive material, made using easy to access radioactive waste or minute amounts of material

Alpha Ionization

Sheet of paper or skin needed for protection, must be ingested to be harmful

Beta Ionization

Clothes needed for protection

Gamma Ionization

Lead or inches of concrete needed for protection

Neutron Ionization

Several feet of concrete needed for protection

Ionizing radiation

Energy emitted from unstable materials attempting to stabilize themselves through decay; takes billions of years

Nuclear Energy

artificially made by splitting radioactive atoms resulting in immense heat; gives off all forms of radiation

Acute radiation

S/S of __ __ sickness range from nausea, vomiting and diarrhea to second/third degree burns, cancer and death