NORTH COUNTY FIRE AUTHORITY POLICY & PROCEDURE MANUAL OPERATIONS

Transcription

1 PURPOSE: To provide Fire Department Personnel with information on the limitations of the use of Weapons of Mass Destruction (WMD) and Nuclear, Biological, Chemical (NBC) agents related to terrorist incidents. GENERAL: All First Responders shall be familiar with the contents of this instruction and be aware of the actions that need to be taken to protect life. POLICY: Limitations of the use of Weapons of Mass Destruction (WMD) and Nuclear, Biological, Chemical (NBC) agents. 1. Even with their advantages, WMD/NBC agents have their drawbacks for the terrorists and it is important to mention. a. Chemical Weapons (CW) require many gallons of a particular agent to have a massive effect, which can be detected and can produce handling and preparation problems. During the manufacturing process the agent may kill the producer. b. Biological agents are less attractive because of their delayed effect (no immediate political or media attention). Much of the political benefits are lost when it becomes difficult to determine whether an outbreak of disease was the result of natural causes or a terrorist incident. Additionally, once released, a biological agent is hard to control and the terrorist can t anticipate the impact. The biological agent has a high potential of infecting the grower. c. Radiation materials are difficult to shield and thus the container will be very heavy and difficult to transport without detection. If the terrorist reduces the shielding to improve the ease of transportation and reduce detection, he increases his potential of exposure. DATE DATE PAGE 1 of 12 PPO 3-52

2 2. The Incident Commander should consult with the appropriate San Mateo County HazMat Technical Specialist for more detailed information about each of the following. a. An Incendiary Device is any mechanical, electrical, or chemical device used intentionally to initiate combustion and start a fire in other materials or structures. These elements may be used alone or in combination, simple or elaborate, and come in all shapes and sizes. (1) Each device consists of three basic components: an igniter or fuse, a container or body, and an incendiary material or filler. (2) Only trained personnel should handle incendiary devices discovered prior to ignition. Handling of such devices by inexperienced individuals can result in ignition and possible injury or death. In addition, proper handling is critical for crime scene preservation. b. An Explosive Device is a substance or article designed to function by explosion (i.e., an extremely rapid release of gas and heat), or a substance, which, by chemical reaction within itself, can function in a similar manner even if not designed to function by explosion. (1) It is apparent that bombs are the current weapon of choice among terrorist groups. It is estimated that 70% of all terrorist attacks worldwide involve explosives (2) The FBI also noted three other interesting facts: When public safety agencies know of the presence of a device, they have only a 20% chance of finding it. Hundreds more hoax bomb threats are reported each year. Residential properties are the most common targets for bombers. DATE DATE PAGE 2 of 12 PPO 3-52

3 c. Nuclear or radiological materials can pose both acute and long-term hazards to humans. In many ways they behave like some of the chemical agents in that they cause cell damage. A major difference is that radiological agents do not necessarily have to be inhaled or come in contact with the skin to cause damage. Some radiation can penetrate significant layers of protective materials. Despite what we see in the media, producing a functional nuclear device is highly improbable and considered to be the least likely of the terrorist threats. Even medical grade radioactive materials, which are relatively easy to come by, would be very unlikely to be used due to the amount required to be placed in an area where people can be exposed long enough to produce an effect. The terrorists main benefit from using radioactive materials would be psychological rather than physical casualties. (1) Radiation can be classified as: Alpha particles: limited range and penetrating power. Beta particles: more range and penetrating power than Alpha. Gamma radiation: not a particle but a ray with long range and deep penetrating power. (2) Radiation is measured in millirems and rems (1000 millirems). For example, a chest X-ray will expose you to millirems (mrem) of radiation. Exposure to 200 rems will cause mild radiation sickness and 450 rems are considered a lethal dose. (3) Fire Personnel s degree of risk depends on the amount of radiation received (dose) and the duration of the exposure. DATE DATE PAGE 3 of 12 PPO 3-52

4 The three types of exposure are: whole body exposure, inhalation, and ingestion of contaminated materials. (4) Alpha and Beta particles are primarily an inhalation and ingestion risk involving dust and contaminated food and water. Gamma radiation is difficult to protect against and the First Responders need to use time, distance, and shielding to limit their exposure. (5) Decon consists of: (d) Wetting down to reduce the risk of contaminated materials becoming airborne and ingested. Stripping contaminated clothing. Flushing any contamination from exposed skin and hair with large amounts of water. Covering up to protect exposure. (6) Protection against radiation exposure consists of time, distance, and shielding. PPE requirements for rescue are dependent upon the type of radiation emitted as follows: Alpha particles: First responders wearing SCBA and turnouts are sufficient. Beta particles: SCBA and Level A PPE are for this hazard. Quick in-and-out may be the only viable rescue option. Gamma radiation: Limiting the duration of exposure is the only viable precaution. (7) Most HazMat teams already have detection devices. These detection devices should be used routinely on any incident where the presence of radiation is suspected. DATE DATE PAGE 4 of 12 PPO 3-52

5 (8) The key elements for Fire Personnel to remember when radioactive materials are found are to back out, use full protective clothing, SCBAs, time, distance, and shielding. d. Biological agents are living germs that will cause disease in people. Some of these are deadly to animals as well, though they are not usually the primary targets. Toxins are poisonous byproducts made by living organisms and are also categorized as biological agents. Biological agents have no color, taste, or smell. All biological agents have a delayed effect or incubation period, which is the time it takes for the organism or toxin to overpower the body s natural immune system. The incubation period can range from several hours to days, and in some cases weeks. So unlike most of the other terrorist weapons, Fire Personnel may never get called to an actual incident where the weapon was released. In fact, the first indication that a biological agent has been used in your community will most likely be through EMS responders and hospital emergency rooms seeing numerous patients with similar symptoms. Nevertheless, as a First Responder you should know something about these agents and how to protect yourself if you do encounter one. Most biological agents need to be inhaled or ingested to be harmful. Just as with any other germ, your skin provides a good barrier for protection. Biological agents will be disseminated as a solid, aerosol or liquid. Since most of these agents are living organisms, the environment (i.e., heat, cold, moisture, and sunlight) adversely affects them. If released, they usually live for only a few hours or days. Because they are somewhat frail, they will most likely be used in enclosed areas. (1) Some of the diseases that have been suggested as potential agents are: DATE DATE PAGE 5 of 12 PPO 3-52

6 Anthrax bacteria incubation 1-7 days; mortality can reach 90%; flu-like symptoms and swelling lymph nodes. Plague bacteria incubation 2-3 days; untreated mortality can reach 100%; flu-like symptoms, spitting up blood and shortness of breath. Q-Fever rickettsia (bacteria/virus) incubation 2-10 days; mortality under 1%; flu-like symptoms. (d) (e) Smallpox virus incubation days; mortality can reach 30%; flu-like symptoms, rigors, backaches. Ebola virus incubation 3-21 days; mortality can reach 90% flu-like symptoms, blotches on the skin from subcutaneous bleeding. (f) Venezuelan Equine Encephalitis (VVE) virus incubation 1-5 days mortality under 1%; flu-like symptoms. (2) Treatments for these agents include antibiotics and supportive therapy. Toxins are faster acting and may include: Staphylococcus Enterotoxin B (Cytotoxin) incubation 4-6 hours; recovery is spontaneous after 6-8 hours; symptoms of food poisoning including vomiting, abdominal cramps, explosive diarrhea. Botulinum (neurotoxin) incubation hours; mortality can reach 60%; symptoms include weakness, dizziness, dry mouth and throat, and blurred vision. Ricin incubation hours; untreated, mortality can be high. Symptoms include vomiting, bloody diarrhea, abdominal cramps, and difficulty breathing. Ricin is DATE DATE PAGE 6 of 12 PPO 3-52

7 made from the castor bean plant, is readily available, and is 2-3 times more toxic than the most deadly nerve agent VX. (3) Treatment includes antitoxins and supportive measures. (4) Decon consists of: Wetting down the clothing and exposed skin with copious amounts of water to reduce the airborne hazard. Removing all contaminated clothing. Flushing with water, soap, or best would be 0.5% bleach solution (one quart of household bleach to 2 ½ gallons of water). (d) Covering to prevent exposure to the elements. (5) After responding to an incident, Fire Personnel should watch for flu-like symptoms and seek immediate medical attention upon the first signs. This would include the administration of one Mark I auto-injector set of atropine and 2 PAM Chloride if the agent is unknown. e. Chemical agents are supertoxic chemicals used for the purpose of poisoning victims. They are similar to hazardous industrial chemicals, but hundreds of time more toxic. Most chemical agents are heavier than air and may be persistent or non-persistent. Persistent agents (vapor, liquid or dust) remain in the affected area for hours, day, or weeks. Non-persistent agents (primarily vapors) remain a hazard in the affected area for a shorter time period, usually minutes or hours. DATE DATE PAGE 7 of 12 PPO 3-52

8 (1) Being extremely toxic means the downwind hazard could be a much greater risk than the typical hazmat incident. Some factors regarding chemical agents are as follows: Usually liquid when in a container and become gaseous when released. Usually disseminated as vapors or as a gas and will dissipate with time. Influenced by weather conditions such as temperature, wind, and humidity. (d) Can be protected against, treated, and decontaminated. (2) Chemical agents are classified according to how they affect you. Choking Agents Phosgene (CG) Smells like newly mown hay Chlorine (CI) Smells like a swimming pool (1) Both become a gas when released from their containers and will dissipate rapidly in the open air. When the agent comes into contact with body fluids, it produces Hydrochloric Acid that burns the tissue. Once inhaled, it is very irritating to the throat and lungs. Coughing or choking will appear immediately, but serious symptoms involving oxygen starvation and suffocation may occur 2-3 hours later. DATE DATE PAGE 8 of 12 PPO 3-52

9 There is no absorption through the skin; however, it will produce burns and should be flushed off immediately. Both agents can be decontaminated by flushing with water. Blood Agent Hydrogen Cyanide (AC) Cyanogen Chloride (CK) (1) Both are commercially available and used in manufacturing processes and easily obtained by terrorists. Both turn to gas at room temperature and have the smell of bitter almonds. Both are inhalation threats and attack the body by blocking the transfer of oxygen from the blood stream to the individual body cell. Victims will have reddish skin and lips (blue in dark-skinned people), gasping for air, frothing or vomiting, then unconsciousness and death. These symptoms occur very rapidly. There is no absorption through the skin. Antidotes are available and once removed from the chemical, no decon is necessary. Blister Agents: Mustard (H) Lewisite (L) Phosgene Oxime (CX) DATE DATE PAGE 9 of 12 PPO 3-52

10 (1) Out of these three, mustard agents are the most likely to be used because they are the easiest to make. These agents are normally disseminated as liquids at normal temperatures and are, therefore, persistent (will not evaporate rapidly). Mustard freezes at 58 F so it will most likely not be used outside during colder periods. Mustard has a definite odor of garlic and appears as an oily liquid. It is intended to be used as a liquid for skin contact that causes blistering. The vapors are extremely irritating to the eyes, throat, and lungs. Blister agents affect both the respiratory tract and the skin so full protection is required. Treatment involves removal of the victim from the contaminated area, getting the agent off the victim s skin as soon as possible, and then flushing with water. All of the blister agents can be decontaminated using water. f. Nerve Agents: Nerve agents should be our biggest fear. These agents are not as easy to obtain as most of the other chemical agents; however, they are more toxic. (1) There are four Nerve agents: Tabun (GA) Sarin (GB) Soman (GD) DATE DATE PAGE 10 of 12 PPO 3-52

11 VX All four are heavier than air and extremely fast acting. The G agents are generally a vapor, so they are not persistent and act as an inhalation and skin contact threat. On the other hand, VX is a liquid hazard, is persistent (days or months), and has a consistency and evaporation rate similar to motor oil. VS-series agents are generally considered as a skin contact hazard; or when used as an aerosol, they can also be an inhalation hazard. In their more pure state, G agents are both colorless and odorless or may have a slight fruity odor. VX may have a slight yellowish color and smell of sulfur. Nerve agents act by blocking the body s normal electrical impulses to the muscles causing them to be in a constant state of contraction. They also over-stimulate smooth muscle tissue causing pinpoint pupils, airway narrowing, and hyperactivity of the gastrointestinal tract. Death usually occurs from cardiopulmonary failure. Symptoms from exposure to all four nerve agents include: runny nose, tightness of the chest, dimness of vision, pinpoint pupils, difficulty breathing, drooling, excessive sweating, muscle twitching, involuntary urination and defecation, nausea, vomiting, cramps, staggering, confusion, drowsiness, coma, convulsions, and death. A lethal dose received through skin contact (percutaneous) can cause death within two hours. A respiratory lethal dose can cause death in one to ten minutes. Nerve agents are a respiratory and skin contact threat and First Responders cannot make entry with their regular turnout gear. Entry into a hot (exclusion) zone can only be made with Level A suits. Additionally, contaminated clothing will DATE DATE PAGE 11 of 12 PPO 3-52

12 continue to off gas and full Level A protection is required throughout the decon process. Decon can be accomplished by flushing with diluted bleach and must be done as soon as possible. Treatment requires administration of atropine, pralidoxime chloride (2-PAMCL), and diazepam in varying dosages depending on the amount of exposure to the agent. (2) Members of the North County Fire Authority have been instructed on the use of the Mark I Auto-Injector Set for self-aid in the event of an exposure to a nerve agent. DATE DATE PAGE 12 of 12 PPO 3-52