Chapter 8

By what mechanisms do explosives cause damage to the human body?

1. Blast pressure wave causes compression/decompression injury as it passes through lungs, ears, other hollow, air-filled organs. 2. Debris thrown by blast produces penetrating or blunt injuries. 3. Combustion induces burn injury. 4. Structural collapse causes blunt and crushing injuries.

Weapons of Mass Destruction include what type of weapons?

1. Chemical 2. Biological 3. Radiological 4. Explosives

What are the types of extreme damage that a nuclear detonation can cause?

1. Concentric circles of total destruction and mortality. 2. Severe destruction; very high mortality. 3. Heavy destruction; moderate mortality. 4. Light destruction; limited mortality.

How do nerve agents have their effects on the body?

1. Damage nervous impulse conduction. 2. Inhibit degradation of neurotransmitters; quickly cause nervous system overload. 3. Causing muscle twitching and spasms, convulsions, unconsciousness, respiratory failure.

Name three agents that are considered contagious?

1. Ebola 2. Plague 3. Smallpox

Name associated dangers that you may encounter after an explosion.

1. Fire 2. Electrical Hazard 3. Structural Collapse 4. Combustible or toxic hazards

How should you care for injured during the first hour post-ignition?

1. Move injured into structures that will protect them from fallout. 2. Emergency responders organize, determine direction of fallout movement, begin to extricate walking wounded and seriously injured from outer perimeter of explosion. 3. Evacuation of those in anticipated path of fallout occurs.

What are four examples of incendiary agents?

1. Napalm 2. Gasoline 3. White phosphorus 4. Magnesium

What are common symptoms seen with radiation exposure?

1. Nausea 2. Fatigue 3. Malaise

What are the classifications for chemical weapons?

1. Nerve agents 2. Vesicants 3. Pulmonary agents 4. Biotoxins 5. Incapacitating agents 6. Other hazardous chemicals

Give three examples of pulmonary agents:

1. Phosgene 2. Chlorine 3. Hydrogen sulfide

What are some examples of Biotoxins?

1. Ricin 2. Staphylococcal enterotoxin B (SEB) 3. Botulinum toxin 4. Trichothecene mycotoxins (T2)

What does SLUDGE stand for?

1. Salivation 2. Lacrimation 3. Urination 4. Diarrhea 5. Gastrointestinal distress 6. Emesis.

Name three examples of nerve agents?

1. Sarin (GB) 2. Soman (GD) 3. Tabun (GA)

What are the effects of a nuclear detonation?

1. Unleashed energy tremendous; creates explosion of immense proportion. 2. Radiant heat likely to incinerate everything in vicinity of blast. 3. Serious burn injury to skin even at great distances from blast epicenter. 4. Burn injuries likely to be most lethal and debilitating injuries.

The prognosis is good for patients who have been exposed to nerve agents with what two steps of treatment?

1. aggressive artificial ventilation 2. quick administration of antidote.

What are two noncontagious biological agents?

1. anthrax 2. biotoxins

What are three biological agents that are contagious and capable of spreading from human to human?

1. smallpox 2. ebola 3. plague

What are some dangers to consider when dealing with an explosion?

1. structural collapse, 2. fire, 3. electrical hazard, 4. combustible or toxic gas hazards.

Incendiary Agents

A subset of explosives with less explosive power and greater heat and burn potential.

Name an agent that is not considered contagious?

Anthrax

What are the prototype anticholinergic agents for military use?

BZ and QNB

What is Produced by living organisms but are themselves not alive?

Biotoxins

What type of agents are Vesicants

Blistering Agents

What is one of the most toxic agents known to man?

Botulinum

Why is the use of Botulisms limited for WMDs?

Botulism toxin very unstable

_______ are likely to be the most lethal and debilitating injuries associated with a nuclear detonation.

Burn Injuries

What are the most common life-threatening injuries from a nuclear incident?

Burns

What are the late signs of T2 exposure if left untreated?

CNS signs, hypotension, death.

What is the process for treating the wounded form a nuclear incident?

Care for victims: decontamination, treatment for conventional explosion, treatment for thermal burns.

What type of effects do vesicants cause?

Cause damage to skin, eyes, respiratory tract, lungs; induce generalized illness.

CBRNE

Chemical, Biological, radiological, explosives

_______ is a common disease in underdeveloped countries and is frequiently linked to poor sanitation.

Cholera

Specific Gravity

Density or weight of vapor or gas as compared with air.

What is the guide to most common hazardous material published by the DOT?

Department of Transportation's Emergency Response Guidebook (ERG)

What effects can a nuclear detonation have on EMS services?

Disrupts access to scene and limits ability of EMS system to identify, reach, and care for seriously injured.

What are some of the signs and symptoms associated with incapacitating agent exposure?

Dry mucous beds, dilated pupils, slurred speech, disorientation, blurred vision, inhibition of sweating reflex, elevated body temperature, facial flushing.

What are some of the signs and symptoms seen with nerve agent exposure?

Dyspnea, fasciculations, rhinorrhea, blurry vision, miosis, nausea, sweating. May become unconscious, seize, stop breathing, die.

When are the best times to use chemical agents and why?

Early morning and before sunset best for agent release; because winds are at lowest velocity this will cause the most damage.

What are more advanced treatments for someone who may have been exposed to a pulmonary agent?

Endotracheal intubation and ventilation

How should rescue personnel enter the scene after a nuclear incident?

Entry into scene made from upwind and laterally to upper air movement to limit radioactive fallout exposure to rescuers.

How far should you evacuate the population during a daytime chemical release incident?

Evacuate population for radius of 700 to 2,000 feet and 1.5 miles downwind during day.

______ are the most common method by which terrorists strike?

Explosives

What are two types of chemical agents?

Gasses and aerosols

What is a problem with identifying a biological event?

Identification of release is difficult; often there is no noticeable cloud of gas or noticeable odor.

How do you know if someone has received high radiation exposure from a nuclear incident?

If symptoms the symptoms occur earlier than 6 hours after detonation.

What are the two routs that botulinum can enter the body?

Inhalation and Ingestion

What type of danger do vapors, gases, aerosols present?

Inhalation danger

How does Botulinum cause effects on the body?

It attacks the nervous system; causing weakness, paralysis, death by respiratory failure.

How does the radiation from a nuclear detonation cause damage to the body?

It damages cells of body as it passes through them.

Geiger counter

Measures passage of radioactive particles or rays through receiving chamber.

Where is most emergency medical care provided after a nuclear incident?

Medical care provided at treatment sectors remote from seriously damaged areas.

Are most chemical weapons gas or liquid?

Most chemical weapons are liquids that are moderately volatile.

What type of gas is an example of vescicants?

Mustard Gas

What is Botulinum often a result of?

Often a Result of improper canning technique.

What do nuclear reactions generate?

Particles of debris and dust that give off nuclear radiation.

Dosimeter

Pen-like device used to record your total radiation exposure.

How do potassium iodide (KI) tablets have their effects?

Reduce uptake of radioactive iodine by thyroid; reduce risk of thyroid injury or cancer.

Nuclear Detonation

Release of energy generated when heavy nuclei split (fission) or light nuclei combine (fusion) to form new elements.

What is the first step to relieve exposure of Incapacitating agents?

Relieved by removal from source, exposure to fresh air, administration of oxygen.

What is the immediate treatment for someone who has been exposed to pulmonary agents?

Removal from environment; exposure to fresh air, high-concentration oxygen; rest.

How does Ricin cause it's effects on the body?

Ricin inhibits the body's ability to synthesize proteins.

What agent is commonly responsible for food poisoning?

Staphylococcal Enterotoxin

How may the effects of explosives be increased?

Surround explosive charge with: Old auto batteries, Scrap metal, nails, screws; act as shrapnel. Nails coated with rat poison.

What effects does trichothecene mycotoxins have on the body?

T2 acts very quickly, causing skin irritation, respiratory irritation, eye irritation, gastrointestinal symptoms.

Volatility

The ease with which chemical changes from liquid to a gas.

How do pulmonary agents affect the lungs?

The produce inflammation and pulmonary edema, resulting in dyspnea and hypoxia.

Lewsite

The term for the inhalation danger that vapors, gases, aerosols present?

How does exposure to chemical agents have their effects on the body?

They are absorbed through skin or inhaled and absorbed through respiratory system.

What is the objective of both domestic and foreign terrorist?

To incite terror in the public

What does T2 stand for?

Trichothecene Mycotoxins

Outbreaks of naturally occurring disease may be more likely and more severe than terrorist's use of biological weapon (T or F).

True

True or False. Nuclear radiation cannot be felt, seen, or detected by any of our senses.

True

What PPE will be needed during a chemical attack?

Use personal protective equipment (PPE): HEPA filter mask, nitrile gloves, Tyvek® disposable suit.

What are tell tell signs of a possible chemical agent release incident?

You may notice clusters of patients with chemical exposure symptoms or injured, incapacitated, or dead insects, birds, or animals.

Mark I Kit

a Two-part autoinjector set of atropine and pralidoxime.

What is the most effective route of administration for T2?

absorption through the skin

When do the signs and symptoms of disease occur after release of a biological weapon?

at end of incubation period, often days or weeks after initial contact.

What two drugs are used to treat nerve agent exposure?

atropine and then pralidoxime chloride.

What produces Stphylococcal Enterotoxin?

bacterium

What is a common why that botulinum causes dealth

by respiratory failure

What are two types of chemicals with high specific gravity?

chlorine and phosgene.

What is the weapon of choice used by terrorist groups?

conventional explosives

Emergency care for the patient exposed to a vesicant is immediate _______________.

decontamination

What is the preferred method of distribution for incapacitating agents?

detonation of mixture of explosive and agent.

How far should you evacuate the population during a night time chemical release incident?

evacuate a 2,000-foot radius and 6 to 7 miles downwind.

What is known to produce Trichothecene mycotoxins?

fungus molds.

What are the symptoms caused by Ricin when it is ingested?

gastric symptoms

What is the best emergency care provided to those exposed to vescicants and why?

immediate decontamination; exposure can result in permanent injury.

What do the signs and symptoms of biological weapon exposure resemble?

influenza or other common illnesses.

What step should you take before providing care to someone who has been exposed to a chemical agent?

make sure they are properly decontaminated

What is an example of a Chemical that remains liquid said to be persistent and poses contact or absorption threat?

mustard gas

What is the smell associated with phosgene?

newly mown grass

Chemical that remains liquid said to be _______.

persistent

If there is a serious risk of fallout and continuing radiation exposure, paramedics may be asked to help distribute ____ tablets.

potassium Iodide

What are the symptoms caused when Ricin is inhaled?

pulmonary edema

What is the smell associated with hydrogen sulfide?

rotten eggs

Why is administration of diazepam given quickly after administration of the Mark I Kit?

to reduce seizure activity.

fission

when heavy nuclei split

fusion

when light nuclei combine to form new elements