cbrne training academy relating the exotic to the mundane
TRANSCRIPT
CBRNE Training Academy
CBRNE Training Academy
Relating the Exotic to the Relating the Exotic to the MundaneMundane
Relating the Exotic to the Relating the Exotic to the MundaneMundane
ObjectivesObjectives
• Integrate Awareness, Hazard Recognition and SIN
• Illustrate the “All Hazards” approach
• Personal empowerment
• Integrate Awareness, Hazard Recognition and SIN
• Illustrate the “All Hazards” approach
• Personal empowerment
Scenario #1Scenario #1
• You are a security guard• You work at the large county
hospital• You control flow into the
emergency department
• You are a security guard• You work at the large county
hospital• You control flow into the
emergency department
Here’s what you see . . .Here’s what you see . . .
• Patient presents with a cough• Fifth patient in last hour with
cough• They all also have fever• They are all from the same place
• What do you do now?
• Patient presents with a cough• Fifth patient in last hour with
cough• They all also have fever• They are all from the same place
• What do you do now?
ApproachApproach
• Awareness– Abnormal for time of year, hospital
• Hazard Recognition– Cough and fever is infectious
• S-I-N– Protect yourself (mask, isolate)– Protect others (isolate, masks, etc.)– Notify the triage nurse or supervisor
• Awareness– Abnormal for time of year, hospital
• Hazard Recognition– Cough and fever is infectious
• S-I-N– Protect yourself (mask, isolate)– Protect others (isolate, masks, etc.)– Notify the triage nurse or supervisor
Gather informationGather information
• They are all from the same shelter / prison
• They are all from the same apartment building / office
• They are all from the same day care / nursing home
• They are all from Hong Kong• They are all from the same train
• They are all from the same shelter / prison
• They are all from the same apartment building / office
• They are all from the same day care / nursing home
• They are all from Hong Kong• They are all from the same train
What is this?What is this?
• “A cold?”• Influenza?• Tuberculosis?• Atypical pneumonia (Legionella)?• SARS?• Anthrax?
• More importantly, does it matter?
• “A cold?”• Influenza?• Tuberculosis?• Atypical pneumonia (Legionella)?• SARS?• Anthrax?
• More importantly, does it matter?
Common groundCommon ground
• This is an infectious disease problem– The organism defines the menace– The intent defines the malice
• A biological terrorism event is an “Infectious Disease Outbreak”– Initial approach is the same– Subsequent is modified by what you
learn
Anyone can sound the alarm
• This is an infectious disease problem– The organism defines the menace– The intent defines the malice
• A biological terrorism event is an “Infectious Disease Outbreak”– Initial approach is the same– Subsequent is modified by what you
learn
Anyone can sound the alarm
Scenario #2Scenario #2
• You work at the gift shop in the hospital lobby
• It is a popular place for employees• They get discounts on medicine,
food and drink• It is a slow day because of the
blizzard
• You work at the gift shop in the hospital lobby
• It is a popular place for employees• They get discounts on medicine,
food and drink• It is a slow day because of the
blizzard
Here’s what you see. . .Here’s what you see. . .
• An employee has tearing, and difficulty breathing
• Third employee in last hour with similar problem
• They all smell funny• You start to feel the same
symptoms
• What do you do now?
• An employee has tearing, and difficulty breathing
• Third employee in last hour with similar problem
• They all smell funny• You start to feel the same
symptoms
• What do you do now?
ApproachApproach
• Awareness– This is not normal; you are healthy
• Hazard Recognition– Something is causing irritation– This is being brought by the employees
• S-I-N– Close up shop, find clean air– Remove contaminated clothing, seek
care– Notify your supervisor, security, the ER,
etc.
• Awareness– This is not normal; you are healthy
• Hazard Recognition– Something is causing irritation– This is being brought by the employees
• S-I-N– Close up shop, find clean air– Remove contaminated clothing, seek
care– Notify your supervisor, security, the ER,
etc.
Gather informationGather information
• They all work in the kitchen• They all work as groundskeepers• They all work in environmental
services• They all work in the same lab• They all work in security• They all work in the mailroom
• They all work in the kitchen• They all work as groundskeepers• They all work in environmental
services• They all work in the same lab• They all work in security• They all work in the mailroom
What is this?What is this?
• Environmental allergy?• Pesticide?• Chlorine gas?• Tear gas?• Nerve agent?
• More importantly, does it matter?
• Environmental allergy?• Pesticide?• Chlorine gas?• Tear gas?• Nerve agent?
• More importantly, does it matter?
Common groundCommon ground
• This is an chemical exposure problem– The chemical defines the menace– The intent defines the malice
• A chemical terrorism event is a “Hazardous Materials Incident”– Initial approach is the same– Subsequent is modified by what you learn
Anyone can sound the alarm
• This is an chemical exposure problem– The chemical defines the menace– The intent defines the malice
• A chemical terrorism event is a “Hazardous Materials Incident”– Initial approach is the same– Subsequent is modified by what you learn
Anyone can sound the alarm
Scenario #3Scenario #3
• You are an emergency physician• You are responsible for medical
command of the local EMS units• It is three o’clock in the morning
• You are an emergency physician• You are responsible for medical
command of the local EMS units• It is three o’clock in the morning
Here’s what happens . . .Here’s what happens . . .
• EMS calls• There was an explosion• They are bringing five critical
patients• They are all coming from the same
place
• What do you do now?
• EMS calls• There was an explosion• They are bringing five critical
patients• They are all coming from the same
place
• What do you do now?
ApproachApproach
• Awareness– Know resources, staff and community
• Hazard Recognition– Know what exists near the hospital– Know your EMS units and paramedics
• S-I-N– Prepare– Activate trauma team, plan; get info– Let people know (administration, etc.)
• Awareness– Know resources, staff and community
• Hazard Recognition– Know what exists near the hospital– Know your EMS units and paramedics
• S-I-N– Prepare– Activate trauma team, plan; get info– Let people know (administration, etc.)
What you learnWhat you learn
• Construction site• Fireworks factory• Chemical production plant• Nuclear power plant• Subway car / Train station• Church / Synagogue• FBI building
• Construction site• Fireworks factory• Chemical production plant• Nuclear power plant• Subway car / Train station• Church / Synagogue• FBI building
What is this?What is this?
• Explosive + Thermal?• Explosive + Thermal + Chemical?• Explosive + Thermal +
Radiological?
• More importantly, does it matter?
• Explosive + Thermal?• Explosive + Thermal + Chemical?• Explosive + Thermal +
Radiological?
• More importantly, does it matter?
Common groundCommon ground
• This is an fire / explosive problem– The blast defines the menace– The intent defines the malice
• A fire / explosion terrorism event is a “Mass Casualty-Trauma/Burn Incident”– Initial approach is the same– Subsequent modified by what you learn
Anyone can sound the alarm
• This is an fire / explosive problem– The blast defines the menace– The intent defines the malice
• A fire / explosion terrorism event is a “Mass Casualty-Trauma/Burn Incident”– Initial approach is the same– Subsequent modified by what you learn
Anyone can sound the alarm
SummarySummary
• Be calm• Be aware• Recognize hazards• Remember to S-I-N and count to T-
E-N• Healthcare focuses on the menace• Consistent, common approach• Anyone can sound the alarm
• Be calm• Be aware• Recognize hazards• Remember to S-I-N and count to T-
E-N• Healthcare focuses on the menace• Consistent, common approach• Anyone can sound the alarm
Questions?Questions?