You Are the Emergency Medical Responder

Emergency Medical Response

You Are the Emergency Medical Responder

You are an EMR dispatched to the scene of an explosion. On arrival you are staged with other emergency vehicles one block away. You are told that police suspect that a building was targeted by an extremist group and it is uncertain if there were injuries from the blast.

Lesson 46: Disasters, Terrorism and Weapons of Mass Destruction


Terrorism

The unlawful use of force and violence against persons or property to intimidate or coerce government, the civilian population or any segment thereof, in furtherance of political or social objectives.


Preparation for Disasters and Terrorism

Federal Emergency Management Agency (FEMA) National Response Framework (NRF) National Disaster Medical System (NDMS)


National Incident Management System

Comprehensive national framework for managing incidents

Outline of structures for response activities for command and management

Provision of consistent, nationwide response at all levels


Areas of NIMS

Incident command systems (ICS) Multiagency coordination system (MACS) Unified command, training, identification and

management of resources Mutual aid and assistance Situational awareness Qualifications and certification Collection, tracking and reporting of incident

information Crisis action planning Exercises


Emergency Support Functions

1. Transportation2. Communications3. Public works and engineering4. Firefighting5. Emergency management6. Mass care, emergency assistance, housing and

human services7. Logistics management and resource support


Emergency Support Functions (cont’d)

8. Public health and medical services9. Search and rescue10. Oil and hazardous materials response11. Agriculture and natural resources12. Energy13. Public safety and security14. Long-term community recovery15. External affairs


Three Main Categories of Disasters Natural

Human-caused (terrorist attacks, HAZMAT incidents and MCIs)

Biological


The EMR’s Role

Leadership if first responder on the scene If you are not the first responder on the scene—

• Assist the leader.• Assume other roles.o Triage patientso Provide medical careo Provide patient reception at staging facilitieso Prepare patients for evacuation


Weapons of Mass Destruction

Known by the acronym CBRNE: Chemical Biological Radiological/Nuclear Explosives


Chemical Agents

Nerve agents Blister agents Blood agents Pulmonary agents Incapacitating agents


Biological Weapons

Class A weapons Class B weapons Class C weapons


Radiological/Nuclear Agents

Damage due to the following:• Air blast• Heat• Ionizing radiation• Ground shock• Secondary radiation


Explosives and Incendiary Weapons

High-order explosives: supersonic over-pressurization shock wave

Low-order explosives: subsonic explosion


Response to CBRNE/WMD Incident Preparation

• Medical direction• Personal preparation• Equipment• Transportation and communication

Equipment and supplies Arrival on the scene Scene safety Providing care


Nerve Agent Poisoning

Initial effects dependent on dose and route• Inhalation via gas• Absorption through skin • Ingestion from liquids or food

Dose and amount of exposure leads to varying effects


Care for Nerve Agent Poisoning

Ventilation Antidotes

• Atropine• Pralidoxime chloride

Decontamination Continued monitoring and transport (if ingested) Nerve agent auto-injector kit (for self- or peer-

administration of nerve agent antidote)


Activity

You and several other EMRs are providing care to patients at the scene involving exposure to a nerve agent. You observe a fellow EMR begin to sweat excessively and cough. He starts complaining of headache and nausea. You also notice a runny nose, watery eyes and pinpoint pupils. You suspect that he is exhibiting signs of nerve agent poisoning.


You Are the Emergency Medical Responder

There is some question about the cause of the explosion but police strongly suspect that is was a terrorist attack using a WMD, most likely a high-order explosive. While in the staging area you observe a large trash bag near a dumpster in close proximity to staged apparatus.


Pandemic Flu Three pillars:

• Preparedness and communication• Surveillance and detection• Response and containment

Phases:• Early detection• Treatment with antiviral medications• Infection control measures• Vaccination


Personal Preparedness

Get a kit Make a plan Be informed

Documents

You Are the Emergency Medical Responder