weapons of mass destruction. definition: any weapon, nuclear device, biological agent, or chemical...
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Weapons of Mass Destruction
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Weapons of Mass Destruction
• Definition: Any weapon, nuclear device, biological agent, or chemical that can kill a large number of people.– Three types of delivery systems usually are
considered for WMD, ballistic missiles, cruise missiles, and combat aircraft
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Guided Rocket
• A guided rocket powered delivery vehicle for use against ground targets. A large portion of its flight is in a ballistic trajectory. It’s the optimum delivery system for WMD.
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Cruise Missile
• A cruise missile is a guided missile that flies at a moderate speed and at low altitude, following the terrain beneath it. The Tomahawk is a cruise missile
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Common Biological Agents
• Anthrax
• Botulism Toxin
• Plague
• Small pox
• Tularemia
• Viral Hemorrhagic fevers
• Ricin
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Anthrax
• Primarily a disease of large hoofed animals
• Gram positive bacillus spore
• Human contact– Inhalation: pulmonary anthrax– Ingestion: gastrointestinal anthrax– Skin: cutaneous anthrax
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Anthrax
• Signs and Symptoms– Inhalation: common cold like symptoms, after
several days patient begins to have severe difficulty breathing
– Cutaneous: Raised itchy bump, 1-2 days painless ulcer with a black necrotic center
– Intestinal: Acute inflammation of the gastrointestinal tract, N/V, fever, abdominal pain, hemoptosis, severe diarrhea
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Botulism
• Clostridium botulinum, gram positive anaerobic bacillus which form endospores
• When spores enter an anaerobic environment such as cans and jars it germinates producing a nerve toxin
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Botulism
• Signs and Symptoms– Develop within hours to day of ingesting the
contaminated food– Blurred vision, slurred speech, difficulty
swallowing and chewing, labored breathing– Toxin affects the nerves by inhibiting the
neurotransmitter acetylcholine into the junctions of nerve and muscle
– Ultimately causes respiratory paralysis
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Plague
• Transmitted by fleas from infected rodents to humans– Bubonic– Septicemic– Pnuemonic (bioterrorism)
• Aerosol for dissemination
• After infection can be transmitted from infected individual via cough or sneeze
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Tularemia
• Non spore forming bacterium
• Contact with diseased rodents, rabbits, ticks, mosquitoes, or deer flies
• Aerosol form of the bacterium most likely administration by bioterrorists
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Tularemia
• Signs and Symptoms– Very non specific often patients are treated for
strep throat, rickettsail, lymphoid cancer or cat-scratch fever
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Smallpox
• Extremely cantagious disease.
• Person to person transmission
• Contact with bodily fluids
• Exposure through aerosol
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Smallpox
• Signs and Symptoms– High fever and malaise– Pink to red spots (macules) starting on face
then progressing to trunk of body– Progress to looking like pink pimples (vesicles)
filled with fluid– Finally progress to a deep pustule which emits
pus
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Hemorrhagic Fever
• The hemorrhagic fever viruses (HFVs) are a diverse group of viruses capable of causing a “viral hemorrhagic fever syndrome”. Each virus belongs to one of four distinct families:
Filoviridae: Ebola and Marburg viruses
Arenaviridae: Lassa fever virus and New World arenaviruses
Bunyaviridae: Crimean Congo hemorrhagic fever virus, Rift Valley fever virus, and a group of related viruses referred to as “agents of hemorrhagic fever with renal syndrome”
Flaviviridae: Dengue, Yellow fever, Omsk hemorrhagic fever, and Kyasanur Forest disease virus
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Hemorrhagic Fevers
• Depending on the specific virus, illness may develop within 2 to 21 days after exposure to a hemorrhagic fever virus; however, specific disease manifestations may vary according to virus.
• The classic VHF syndrome is characterized by fever, fatigue, body aches, rashes, malaise, nausea, abdominal pain, and headaches.
• Progression of disease results in hemorrhagic manifestations that may include bleeding under the skin, in internal organs, or from body orifices. In severe cases, death results 1 to 2 weeks after the onset of symptoms, often caused by kidney failure, multiorgan system failure, or shock. Not all patients develop the classic VHF syndrome
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Ricin
• Ricin is a poison that can be made from the waste left over from processing castor beans.
• It can be in the form of a powder, a mist, or a pellet, or it can be dissolved in water or weak acid.
• It is a stable substance. For example, it is not affected much by extreme conditions such as very hot or very cold temperatures
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Ricin
• Ricin works by getting inside the cells of a person’s body and preventing the cells from making the proteins they need. Without the proteins, cells die. Eventually this is harmful to the whole body, and death may occur.
• Effects of ricin poisoning depend on whether
ricin was inhaled, ingested, or injected.
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Ricin
• Signs and Symptoms• Inhalation: Within a few hours of inhaling
significant amounts of ricin, the likely symptoms would be respiratory distress (difficulty breathing), fever, cough, nausea, and tightness in the chest.
• Heavy sweating may follow as well as fluid building up in the lungs (pulmonary edema).
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Ricin
• Ingestion: Vomiting and diarrhea that may become bloody. Severe dehydration may be the result, followed by low blood pressure.
• Other signs or symptoms may include hallucinations, seizures, and blood in the urine.
• Within several days, the person’s liver, spleen, and kidneys might stop working, and the person could die.
• Skin and eye exposure: Ricin in the powder or mist form can cause redness and pain of the skin and the eyes.
• Death from ricin poisoning could take place within 36 to 72 hours of exposure, depending on the route of exposure (inhalation, ingestion, or injection) and the dose received. If death has not occurred in 3 to 5 days, the victim usually recovers.
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Treatment of Biologicals
• In general the prehospital treatment for any of these biological agents will include supportive measures for ABC’s
• Because of the potential for infection appropriate protective equipment should be used
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Chemical Agents
• Multiple forms of chemical and or nerve agents that could be used for a WMD
• Classified by the symptoms they cause– Blistering agents– Blood agents– Nerve agents
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Blistering Agents
• Mustard Gas
• Mustard Lewisite
• Nitrogen Mustard– Burning and blistering of the eyes and skin – Coughing and respiratory distress
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Blood Agents
• Cyanogens chloride
• Hydrogen chloride– Seizures– Respiratory Arrest / Cardiac Arrest
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Choking Agents
• Chlorine
• Diphosgene
• Phosgene– Cause eye and airway irritation– Respiratory irritation; coughing, hoarseness,
dyspnea, chest tightness, and pulmonary edema
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Nerve Agents
• Tabun
• Sarin
• Soman
• VX– These agents act on all parts of the nervous
system– Pinpointed pupils, runny noses ,difficulty
breathing, seizures, and convulsions
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Blistering Agents
• Treatment– Protective clothing / gas mask– Avoid vapor clouds– Begin the decontamination process– Support the patients ABC’s – Dress large blisters
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Blood Agents
• Treatment– Protective suits / masks– Decontamination procedures– Support patients ABC’s
• Cyanide Antidote Kits-- not approved for EMS
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Choking Agents
• Treatment– Protective clothing– Immediate evacuation– Support patients ABC’s
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Nerve Agents
• Treatment– Protective suits / gas masks– Mark I Antidote Kit (2 Pam)
• Two auto injectors– Atropine 2 mgs
– Pralidoxime Chloride 600 mg
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Additional Weapons
• Nuclear Weapons
• Incendiary Devices
• Dirty Bombs– A small incendiary device used to disperse
radioactive material
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Nuclear Attack
• Evacuation of residents around the targeted area
• If a nuclear blast occurs, seek cover preferably underground. You can take cover behind anything, lie flat on the ground and cover head.
• Fallout will take 15-20 minutes to arrive
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Nuclear Attack
• Signs and Symptoms– Blast type injuries and burns– Radiation exposure
• Vomiting
• Headache
• Fatigue
• Weakness
• Thermal burn like effects
• Secondary infections
• Bleeding and hair loss
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Nuclear Attack
• Treatment– Protective equipment– Radioactive decontamination procedures– Support patients ABC’s
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Conventional Incendiary Devices
• Terrorist organizations are prone to wipe out the rescuers through secondary blast devices
• Scene safety should be of paramount concern– Burns and blast injuries – Utilize standard MCI protocols