Post on 20-Jan-2016
Technician Module 2 Unit 6 Slide 1
MODULE 2UNIT 6
CBRNE
Technician Module 2 Unit 6 Slide 2
Unit 6 Learning Objective
At the completion of this unit the student will be able to give specific considerations to rescue, evacuation and mitigation when
dealing with WMD releases.
Technician Module 2 Unit 6 Slide 3
Student Performance Objectives• Be able to recognize types of WMD agents or materials. Know
how to use and read • results from diagnostic and sampling equipment and reading
instruments. Understand the limitations of the detection or diagnostic instruments and devices provided by the department.
• Know how to use and read results from diagnostic and sampling equipment and reading instruments.
• Understand the limitations of the detection or diagnostic instruments and devices provided by the department.
• Know how to use and read results from medical diagnostic and sampling equipment and reading instruments.
• Be able to recognize the types of hazardous materials or WMD agents that may be present on victims.
Technician Module 2 Unit 6 Slide 4
Student Performance Objectives• Recognize the dangers and aspects inherent in hazardous materials or
WMD events.
• Know the methods, limitations, and operating procedures for sampling equipment use to collect solids (including particulate materials), liquids, and gases for detection, identification, classification, and verification of hazardous materials and WMD agents.
• Have training and experience in emergency medical basic life support treatment, rescue of contaminated victims and responders, selection of appropriate procedures for decontamination of persons and equipment, and in protection of personnel involved in transporting victims exposed to WMD agents. Assist the emergency medical group that is on the scene and the incident commander in coordinating this support.
Technician Module 2 Unit 6 Slide 5
Student Performance Objectives• Have the training and experience to assist the incident
commander in establishing safety procedures for performing specialized tasks to lower the level of hazard from the potential WMD agent or hazardous materials.
• Follow procedures for operating sampling equipment. Understand limitations for collecting solids (including particulate materials), liquids, and gases for detection, identification, and classification of potential WMD agents and materials and for verification of such materials if needed. Use technical reference materials as needed in performing these tasks.
Technician Module 2 Unit 6 Slide 6
WMD Recognition
• Occupancy & Locations
• Type of Event
• Timing of Event
• On Scene Warning Signs
Technician Module 2 Unit 6 Slide 7
CAUTION
ALWAYS BE ALERT FOR SECONDARY DEVICES !
Technician Module 2 Unit 6 Slide 8
Chemical (CBRNE)
Industrial Chemicals
Chemical Agents
Technician Module 2 Unit 6 Slide 9
Chemical Use
It has been shown in Iraq that a chlorine laden commercial vehicle makes an
incredible WMD.
In the recent past there have been increasing attacks utilizing chlorine
tankers with explosives used to release the poisonous gas.
Technician Module 2 Unit 6 Slide 11
Biological (CBRNE)
Bacteria
Rickettsiae
Viruses
Toxins
AGENT DETECTION TREATMENT
Anthrax I: 1–6 d. FLS. Possible widened mediastinum. Gram stain (gram-positive rod) of blood and blood culture (late).
TBI: treatment may be delayed 24 h. until cultures from incident site available.
PEP (only if instructed by govt. officials): ciprofloxacin or doxycycline po x 8 wks.
Severe cases: ciprofloxacin, doxycycline, or penicillin IV.
Cholera I: 4 h–5 d. Severe gastroenteritis with "rice water" diarrhea.
Oral rehydration with WHO solution or IV hydration.Tetracycline, doxycycline (dosage as below or 300 mg one
time) po for 3 d. Ciprofloxacin or norfloxacin po for 3 d. if resistant strains.
Plague I: 2-3 d. FLS.CXR: patchy infiltrates or consolidation.Gram stain of lymph node aspirate, sputum, or CSF
(gram negative, non-spore forming rods).
Isolation.PEP: doxycycline or ciprofloxacin for 7 daysSymptomatic: gentamicin or doxycycline IV for 10–14 days.Meningitis: chloramphenicol.
Tularemia I: 2-10 d. FLS. Gentamicin for 10–14 d.
Q Fever I: 10-40 d. FLS. Most cases self-limited.Tetracycline or doxycycline po for 5–7 d.
Smallpox I: 7-17 (avg. 12) d. FLS. Later erythematous rash that progresses to pustular vesicles.
Electron or light microscopy of pustular scrapings. PCR.
Isolation.PEP: vaccinia vaccine scarification and vaccinia immune
globulin IM.
Viral Encephalitides I: 1-6 d. FLS.Immunoassay.
Supportive.
Viral Hemorrhagic Fevers I: 4-21 d. FLS. Easy bleeding and petechiae.Enzyme immunoassay.
Isolation. Supportive care.Some respond to ribavirin.
Botulism I: 1-5 d. Descending bulbar, muscular and respiratory weakness.
Supportive.PEP: toxoid.Symptomatic: anti-toxin.
StaphylococcusEnterotoxin B I: 3-12 h. FLS. Supportive.
Ricin I: 18-24 h. FLS, pulmonary edema, and severe respiratory distress.
Supportive.
T-2 Mycotoxins I: 2-4 h. Skin, respiratory and GI symptoms. Supportive.
Abbreviations: CSF: cerebro-spinal fluid. CXR: chest x-ray. d: days. h: hours. FLS: flu-like symptoms. GI: gastro-intestinal. I: incubation period.PCR: polymerase chain reaction. PEP: post-exposure prophylaxis. TBI: threatened biologic incident. WHO: World Health Organization.Dosages: Chloramphenicol: 50-75 mg/kg/d, divided q 6 hrs. Ciprofloxacin: po: 500 mg q 12 h.; IV: 400 mg q 8-12 h. Doxycycline: po: 100 mg q 12 hrs; IV: 200 mg initially
then 100 mg q 12 h. Erythromycin: po: 500 mg q 6 h. Gentamicin: 3-5 mg/kg/d. Norfloxacin: po: 400 mg. Penicillin: IV: 2 million units q 2 h. Tetracycline: po: 500 mg q 6 h. Streptomycin: IM: 15 mg/kg, BID. Vaccinia immune globulin: IM: 0.6 mL/kg.
WHO solution: 3.5 g NaCl, 2.5 g NaHCO3, 1.5 g KCl and 20 g of glucose per liter of water.
Technician Module 2 Unit 6 Slide 13
AgentType
Name of Agent Rate of ActionEffective
DosageSymptoms/Effects
Bacteria
Bacillus anthracis Causes anthrax
Incubation: 1 to 6 days
Length of illness:1 to 2 days
Extremely high mortality rate
8,000 to 50,000 spores
Fever and fatigue; often followed by a slight improvement, then abrupt onset of severe respiratory problems; shock; pneumonia and death within 2 to 3 days
Yersinia pestis Causes plague
Incubation:2 to 10 days
Length of illness:1 to 2 days
Variable mortality rate
100 to 500 organisms
Malaise, high fever, tender lymph nodes, skin lesions, possible hemorrhages, circulatory failure, and eventual death
Brucella suis Causes brucellosis
Incubation:5 to 60 days
2% mortality rate
100 to 1,000 organisms
Flu-like symptoms, including fever and chills, headache, appetite loss, mental depression, extreme fatigue, aching joints, sweating, and possibly gastrointestinal symptoms.
Pasturella tularensis Causes tularemia Also known as
rabbit fever and deer fly fever
Incubation:1 to 10 days
Length of illness:1 to 3 weeks
30% mortality rate
10 to 50 organismsFever, headache, malaise, general discomfort,
irritating cough, weight loss
RickettsiaeCoxiella burnetti Causes Q-fever
Incubation:2 to 14 days
Length of illness:2 to 14 days
1% mortality rate
10 organisms Cough, aches, fever, chest pain, pneumonia
Technician Module 2 Unit 6 Slide 14
AgentType
Name of Agent Rate of ActionEffective
DosageSymptoms/Effects
Viruses
Variola virus Causes
smallpox
Incubation:average 12 days
Length of illness:several weeks
35% mortality rate in un-vaccinated individuals
10 to 100 organisms
Malaise, fever, vomiting, headache appear first, followed 2 to 3 days later by lesions
Highly infectious
Venezuelan equine encephalitis virus
Incubation:1 to 5 days
Length of illness:1 to 2 weeks
Low mortality rate
10 to 100 organisms
Sudden onset of fever, severe headache, and muscle pain
Nausea, vomiting, cough, sore throat and diarrhea can follow
Yellow fever virus
Incubation:3 to 6 days
Length of illness:1 to 2 weeks
5% mortality rate
1 to 10 organisms
Severe fever, headache, cough, nausea, vomiting, vascular complications (including easy bleeding, low blood pressure)
Toxins
Saxitoxin Produced by
blue-green algae commonly ingested by shellfish, mussels in particular
Time to effect:minutes to hours
Length of illness:Fatal after inhalation of lethal dose
10 micrograms per kilogram of body weight
Dizziness, paralysis of respiratory system, and death within minutes
Technician Module 2 Unit 6 Slide 15
AgentType
Name of Agent
Rate of ActionEffective
DosageSymptoms/Effects
Toxins
Botulinum toxin Causes
botulism Produced by
Clostridium botulinum bacterium
Time to effect: 24 to 36 hours
Length of illness:24 to 72 hours
65% mortality rate
.001 microgram per kilogram of body weight
Weakness, dizziness, dry throat and mouth, blurred vision, progressive weakness of muscles
Interruption of neurotransmission leading to paralysis
Abrupt respiratory failure may result in death
Ricin Derived from
castor beans
Time to effect:few hours
Length of illness:3 days
High mortality rate
3 to 5 micrograms per kilogram of body weight
Rapid onset of weakness, fever, cough, fluid build-up in lungs, respiratory distress
Staphylococcal enterotoxin B (SEB)
Produced by Staphylococcus aureus
Time to effect:3 to 12 hours
Length of illness:Up to 4 weeks
30 nanograms per person
Fever, chills, headache, nausea, cough, diarrhea, and vomiting
Technician Module 2 Unit 6 Slide 16
Radiological & Nuclear (CBRNE)
The nuclei of certain naturally occurring isotopes, and of others produced
artificially, contain excess energy, i.e., they are unstable. To attain stability, nuclei with excess energy emit that
energy in the form of nuclear, ionizing radiation and, in that process, frequently
change into different elements.
Technician Module 2 Unit 6 Slide 17
Radiation Stability
• Radioactive Decay - Radioactive decay is the process by which radionuclides decay, emitting ionizing radiation.
• Half-Life - is defined as the time required for half of the atoms of a given sample of radioisotope to decay.
Technician Module 2 Unit 6 Slide 18
Types of Radiation
• Alpha
• Beta
• Gamma
• Neutron
Technician Module 2 Unit 6 Slide 19
Explosive (CBRNE)
Explosives are classified as low or high explosives according to their rates of decomposition. Low explosives burn
rapidly (or deflagrate). High explosives ordinarily detonate.
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Low Explosive
• Black Powder
• Safety Fuse
• Photoflash Powder
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High Explosive
These are normally employed in warheads. They undergo detonation at rates of 3,300 to 28,500 feet per second. High explosives are conventionally subdivided into two classes
and differentiated by sensitivity:
Primary
Secondary
Technician Module 2 Unit 6 Slide 22
Monitoring / Detection
Ion Mobility SpectrometryPhoto Ionization Detectors (PID)Flame Ionization Detectors (FID)
Flame Spectrophotometer Detector (FPD)Surface Acoustic Wave / Gas
Chromatograph (SAAW/GC)
Technician Module 2 Unit 6 Slide 23
Ion Spectrometry
An ion mobility spectrometer (IMS) is a spectrometer capable of detecting and identifying very low concentrations of chemicals based upon the differential migration of gas phase ions through a
homogeneous electric field.
Technician Module 2 Unit 6 Slide 24
Photo Ionization Detectors
A photo ionization detector or PID uses an ultraviolet (UV) lightsource to break molecules to positively charged ions
that can easily be counted with a detector.
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Flame Ionization Detectors
An FID is an ion detector which uses an air-hydrogen flame to produce ions. As
components elute from the GC's column they pass through the flame and are
burned, producing ions.
Technician Module 2 Unit 6 Slide 26
Flame Spectrophotometer Detector (FPD)
The flame spectrophotometer detector is a relatively new technology that shows great promise to detect and quantify all associated IDLH issues for emergency
responders that have to perform an initial assessment during a WMD event.
Technician Module 2 Unit 6 Slide 27
Surface Acoustic Wave / Gas Chromatograph (SAAW/GC)
SAW/GC meters are another of the new and emerging technologies to show great potential in the detection
and identification of TICs and chemical warfare materials.
The acoustic values of the crystals can be applied in conjunction with engineered principles of operation found in gas chromatograph systems for an very
accurate reading of a possibly toxic environment to the emergency responder.
Technician Module 2 Unit 6 Slide 28
Medical Monitoring
The WMD Tech should have a working knowledge of how to read results from
medical diagnostic and sampling equipment and reading instruments.
Technician Module 2 Unit 6 Slide 29
Unit 6 Quiz
Technician Module 2 Unit 6 Slide 30
Questions