Correlate the different weapons of mass destruction (WMD) to their medical consequences. Describe the signs and symptoms of exposure to and emergency treatment for victims exposed to weapons of mass destruction.
Develop a disaster preparedness response for personal and professional terrorist response. Determine when the public’s legal rights take precedence over individuals’ rights in a disaster.
INTRODUCTION
of trauma inflicted or agent used and what specific treatment is needed and prevent further casualties. The reality is that all healthcare providers will have to deal with the aftermath of a disaster at some point. Understanding how to respond to a disaster or terrorist attack has become more critical as terrorists seek to damage countries’ infrastructures. Local, homegrown disasters have always been present, but there has been an increase in these events with copycat incidents of terrorism; religious and political ideologies leading individuals to terrorist attacks; and the increased use of social media allowing individuals with extreme points of view to spread their influence faster than ever before. Chemical, biological, radiological, nuclear, and explosive (CBRNE) disasters and terrorist events are broadly classified as five different forms of terrorism. This continuing education course will identify the different types of terrorism and the medical consequences of each type. to deal with the numbers requiring treatment and asked Beth to remain there to help receive casualties. Beth asked Rachel if she thought this involved any chemical or biological agents. Rachel replied she did not know. Trying to determine what she could do to help; Beth knew she and her small hospital were unprepared to help. She saw a poster on the wall that was developed by The Nevada Threat Analysis Center (NTAC). She had not paid much attention to the poster in the past or thought much about any possibilities of a terrorist attack before, but it now seemed to her that this could be a real possibility.
Terrorism has become a reality of the 21st Century for Americans in a way never imagined before. For most Americans, homegrown terrorism became a painful reality with the attacks on children and concertgoers, and the pipe bombs mailed out recently. Healthcare providers have learned that terrorism takes on many forms, including weapons of mass destruction. To understand the implications for healthcare providers who may become involved in caring for victims of terrorism and any disaster, understanding the differences between emergencies, disasters, terrorism, and response levels is necessary in being prepared to deal with these occurrences. Responding to a disaster or terrorist attack is a situation no one wishes to be part of but is a possibility all healthcare providers must accept they will face at some point. The care provided depends on the type of disaster or terrorist attack. Still, the primary goal in all responses is to triage properly, identify those who can be saved without the normal CPR attempts, provide immediate care for life-threatening injuries, and then to understand the general type Case study The sound of the emergency klaxon startled Beth as she was preparing to close her office for the day at the 50-bed hospital in the unincorporated town of Selby, Nevada. She knew the sound meant a major emergency had occurred at the Lucky Lady Mine and wondered what had happened. Rachel, her good friend, was an occupational health nurse for the mine, and Beth called to see if she needed help. Rachel answered, immediately telling Beth that several miners had reported with strange respiratory symptoms, and more were coming out of the mine coughing and choking. She told Beth that she would not be able
DEFINING THE TERMS
There are various layers involved in understanding the types of emergencies a healthcare provider may deal with in responding to these incidents, both within the type of incidence and the type of responses they will generate. The overarching term, emergency , refers to any event that occurs unexpectedly. Disasters Disasters can occur at any level, from the local community to the county, town, state, national, or international level. Using a fictitious example of a Nevada mine suffering a serious fire that the mining company could not handle, county and city emergency medical services (EMS) would be called in to supplement the company's fire and medical teams. If these EMS could not supply the needed response, they may ask the governor of Nevada to send in support services that could range from the Nevada National Guard to state EMS responders. Should the disaster exceed the response capabilities of Nevada, the governor may ask the president of the United States for a national response to help support the state's services. While the need has not yet existed, the president can ask the United Nations for EMS help. Some countries have done this, such as western African countries that needed assistance to deal with Ebola outbreaks (Adelman & Wood, 2018; Office of Press Relations, 2021). This scenario could occur in any city or county in the United States. Terrorism Terrorism is the purposeful use of violence to cause panic and fear in a population. Terrorism can take on many forms, from trying to cause psychological responses that can cripple a particular population, to causing financial or physical loss to a population or entity, such as the attack and destruction of the World Trade Center. It is typically focused on civilians
Normally, emergency response teams can handle the incident without backup support. When an emergency reaches the level of a disaster, the normal emergency response systems are overwhelmed and support from outside the local area is needed.
Disasters can be manmade or natural. Natural disasters include any event that occurs without the direct intervention of a person or persons such as tornadoes, hurricanes, volcanic eruptions, and floods. Natural disasters also include earthquakes, severe seasonal storms, heat waves, and hurricanes. Manmade disasters can be intentional terrorist attacks, such as an attack by a religious group on a facility or city. However, the intent of terrorist attacks is to cause terror, not to take control over a city. Individual attacks occur as well, with more than 20 in late 2017 and the first few months of 2018 when an individual attacked a public school and killed and wounded scores of children, teachers, and police responders (U.S. Department of Homeland Security [USDHS], 2020). Manmade disasters may also include mine explosions, bridge collapses, and plane crashes, whether intentional or not; the distinction is that there is human involvement in the resulting incident.
and in peaceful settings for maximum impact. For example, a homegrown terrorist might wish to cause economic damage to the residents of Springfield, Illinois, for some imagined slight, and plant a bomb in the Abraham Lincoln Homestead. The results could lead to decreased tourism in the city and financially impact many of the city's businesses (Cinar, 2017).
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