CBRNE Training Academy

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CBRNE Training Academy

• Relating the Exotic to the Mundane

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Objectives

• Integrate Awareness, Hazard Recognition and SIN
• Illustrate the All Hazards approach
• Personal empowerment

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Scenario 1

• You are a security guard
• You work at the large county hospital
• You control flow into the emergency department

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Heres 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?

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Approach

• 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

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Gather 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

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What is this?

• A cold?
• Influenza?
• Tuberculosis?
• Atypical pneumonia (Legionella)?
• SARS?
• Anthrax?
• More importantly, does it matter?

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Common 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

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Scenario 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

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Heres 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?

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Approach

• 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.

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Gather 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

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What is this?

• Environmental allergy?
• Pesticide?
• Chlorine gas?
• Tear gas?
• Nerve agent?
• More importantly, does it matter?

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Common 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

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Scenario 3

• You are an emergency physician
• You are responsible for medical command of the
  local EMS units
• It is three oclock in the morning

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Heres 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?

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Approach

• 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.)

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What you learn

• Construction site
• Fireworks factory
• Chemical production plant
• Nuclear power plant
• Subway car / Train station
• Church / Synagogue
• FBI building

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What is this?

• Explosive Thermal?
• Explosive Thermal Chemical?
• Explosive Thermal Radiological?
• More importantly, does it matter?

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Common 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

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Summary

• 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

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Questions?