WEAPONS OF MASS DESTRUCTION
to make political statements and show power by terrorist organizations. Healthcare Consideration : Many terrorists will set off secondary explosions when first responders have arrived. These secondary explosions are bombs used to victimize the first responders and hamper the emergency response (USDL: OSHA, n.d.a.). Healthcare providers must be on the alert for possible devices that could be used to set off explosions or be explosive devices and be prepared to care for new victims. treatment directed at specific presenting signs and symptoms before the confirmation of the agent. While the medical consequences of each type of event vary, a brief discussion follows with more information to be found above under each specific type of event. The effect of chemical weapons dispersed as aerosolized agents or exploding dispersal devices, such as chlorine gas to nerve agents, can exhibit within the respiratory route, through the skin, or by ingestion. The healthcare provider would see individuals disoriented, with bloody noses, uncontrollable twitching, production of bloody and frothy sputum, and difficulty breathing caused by fluid in the lungs. Agents such as mustard gas result in ophthalmological manifestations from severe tearing, blurred vision, and pain where the patient may declare they are blind; burns and skin lesions that grow rapidly to a yellowish gelatinous material; respiratory problems with upper airway involvement displayed as choking, coughing, and complaints of burning in the throat to the lower airway involvement indicated with shortness of breath and a severe and continuous productive cough; gastrointestinal symptoms such as nausea and vomiting; hematological complications; and infection (CDC, 2018e). The effect of biological agents dispersed by a WMD through food or the air, such as anthrax, botulism, or the plague, yields victims who exhibit symptoms through the respiratory, skin, and/or gastrointestinal systems. The healthcare provider would see individuals with complaints of weakness, flu-like symptoms, cough, fever, congestion, itching skin ulceration and dead patches of tissue on wounds, abdominal pain, nausea, and vomiting. Agents such as septicemic plague result in fever and chills, prostration, abdominal pain, nausea, and vomiting, and progress to include purpura, hypotension, and shock (CDC, 2018h). The effect of radioactive and nuclear weapons dispersed on an object, or a person can also be released into the environment in the form of dust, powder, or liquid, either externally via skin, hair, and clothing, or internally through the respiratory, gastrointestinal, or integumentary system. The healthcare provider would see individuals with complaints of nausea, vomiting, and diarrhea followed by complaints specific to the areas of the body affected by radiation exposure. WMDs such as a dirty bomb result in burns and/or blast injuries produced by the blast wave, thermal component, shrapnel, or a combination of these (CDC, 2018e). Healthcare Consideration : WMDs are designed to cause mass casualties and create destruction and chaos to advance an agenda. Healthcare providers must be aware that, when responding to WMDs, they will need to change how they routinely practice addressing the weapon used by the terrorist. In addition to actual victims, some individuals will believe they were affected even though they weren’t, creating an overload within the healthcare facilities responding to the event. To complicate care further, victims of explosive events may be blind or unable to hear and require constant attention. Additional care demands may include injured first responders and management of families, volunteers, and media personnel.
Weapons of mass destruction are any weapons designed to injure or kill significant numbers of bystanders, emergency responders, military personnel, or other victims. These can take the form of biochemical, radiologic, or explosive devices (Horowitz & Narang, 2013). They may also include individuals with guns, ammunition, or homemade explosive devices attacking a group of people from a military situation to a local sporting event or concert. These weapons may do less physical than psychological damage, as they are usually designed All forms of terrorism are WMD The National Consortium for the Study of Terrorism and Responses to Terrorism (START) collects and maintains the recording of articles describing terrorist attacks within the Global Terrorism Database (GTD), which defined terrorism as “the threatened or actual use of illegal force and violence to achieve a political, social, religious, or economic goal through fear, coercion, or intimidation” (Miller, 2014). The definition of terrorism under the US Code is “the unlawful use of force and violence against persons or property to intimidate or coerce a government, the civilian population, or any segment thereof, in furtherance of political or social objectives" (28 C.F.R. Section 0.85, 2017). The Las Vegas shooting that occurred on October 1, 2017 is an example of individual terrorism. The intent of killing and injuring multiple individuals via automatic gunfire (The New York Times, 2017) defines this as a terrorist attack. Though this shooting was not an example of chemical or bioterrorism, it revealed the purpose to destroy and create psychological fear, confusion, or uncertainty, all hallmarks of WMD and all-powerful psychological elements, capitalizing and intensifying upon a population’s vulnerabilities, creating anxiety in society. WMD can also be used as secondary explosive devices, such as bombs that explode after a primary explosion to target responders, causing injury and or death. These secondary explosive devices can be camouflaged in ordinary objects such as garbage cans, backpacks, and vehicles. The U.S. Fire Administration provides the following guidelines that healthcare providers should follow when participating in any response to an emergency, disaster, or terrorist attack: ● Anticipate the presence of a secondary device at any suspicious incident. ● Search for a secondary device before moving into the incident area. ● Avoid touching or moving anything that may conceal an explosive device. ● Effectively manage the scene with boundaries, exclusion zones, triage areas, etc. ● Evacuate victims and non-essential personnel as quickly as possible. ● Preserve the scene as much as possible for evidence collection and crime investigation (USDL: OSHA, n.d.a.). Self-Assessment Quiz Question #6 A weapon of mass destruction is designed to: a. Cause first responders to panic from secondary damage. b. Destroy farmland. c. Cause massive physical damage d. Create psychological damage through fear and panic. Medical consequences Chemical, biological, radioactive, and nuclear events are life- threatening, each presenting different challenges necessitating decontamination and treatment with survival determined within the first few minutes of onset. The role of the healthcare provider is to minimize traumatic injury and death. Triage, decontamination, and protection methods are employed with
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