lo8 other stuff

4.8 has good video

indicators for chemical attack

• groups of people displaying unusual behaviour, signs and symptoms or unexplained illness

• fog or could have unusual odour

• abandoned devices and packages

• unexplained pools of fluid

• dead animals

• an explosion

biological attack indicators

• groups of people with flu or food poisoning like symptoms

• unscheduled spraying in an area

• abandoned spraying devices

radiological attack indicators

• localized burns with no apparent cause

• groups with nausea, vomiting, abnormal blood counts, no noted disease cause

atropine

blocks nerve agents overstimulation of the body

mechanical dissemination

• no external source for dissemination

• contain a solid, liquid or gas product

• left alone to disseminate or thrown into a path of victim

• most effective in warm temperatures with air exchange

pneumatic dissemination

• uses high pressure to disseminate

• consists of an agent and pressurized gas

explosive dissemination

• uses explosives

• explosion releases agent without destroying it

cross contamination

• can occur through direct contact with contaminated clothes, skin, hair, or personal belongings

• can come from direct contact, airborne droplets, microscopic dust particles, or contact with bodily fluids

universal/routine precautions

• designed to protect workers from exposure to disease spread by blood and bodily fluids

• all patients should be assumed to be infectious for blood-borne diseases

CRBNE contamination avoidance techniques

• approach uphill and upwind

• reserve resources

• limit casualties

• do not enter without proper PPE

• avoid cross contamination

• after decontamination ensure use of routine PPE

scene size CRBNE

• stop and proceed carefully

• minimal resources used and exposure to contaminant

• determine number of victims and severity of symptoms

• wear PPE, time, distance, shielding

• take note of weather and terrain

• consider type and quality of agent

• dissemination methods

minimum inner perimeter for enclosed source

100 metres

minimum inner perimeter for outside source

900 metres

outer security perimeter

• restrict public access

• working area for responders

• should be established at a greater distance

hot zone

• contaminant is deemed to be sufficient enough to cause death or injury

• should have designated exit with pre-decontamination area

warm zone

• decontamination zone

• control points

• staging area for equipment

cold zone

• designated clean area

• command centre

• other key support

control of contaminated casualties

• never go within 5 metres without PPE

• tell casualties not to come closer

• remain upwind when facing casualties

• separate casualties by closest to site and farther away

• speak loudly and firmly

• direct casualties to proper gathering point for decontamination

emergency washdown

• deal with casualties using resources on hand until support shows up

• prioritize casualties with sever signs or symptoms of contamination

• remove all clothing

• place belongings in double plastic bags if possible

• wash from top down

• remain in temporary shelters that should be provided for casualties

• do not wipe face with hands

decontamination process

• equipment requirements

• location (always in the warm zone)

• pre-decontamination (footbath with decontamination solution)

• decontamination line

• decontamination facility (shelter such as a tent, building, etc.)

mass casualty triage

treat the greatest number for the greatest good

pre entry assessment of responders

• vitals

• body weight

• general health

• hydration

• personal fitness

• environment

• PPE

• duration of entry

green tag

• minor injuries

• walking wounded

• assemble near you unit

• may assist other patients if able

red tag

• immediate life threatening

• respiratory rate greater than 30pm

• absent radial pulse or capillary refill over 2 seconds

• unable to follow simple commands

yellow tag

• delayed

• serious but non-life threatening injuries

• also can be orange

black tag

• deceased

• death expected

• no pulse, no breathing

directed first aid

• wash with soap and water

• flush eyes with water

• basic first aid

bull horn first aid

when transporting CBRN patients

• ideally only transport decontaminated patients

• if emergency decontaminated, risk vs reward situation

MCI has how much more psychological victims than physical victims

4-20 times as many