Every emergency response agency, including fire, EMS, hazmat, law enforcement and others, must have a minimum level of basic terrorist incident response training to ensure safety and survival of personnel. The intent of this training is much like awareness-level training for responding to a hazmat incident. Emergency responders must be able to recognize when a hazardous materials incident has occurred.
Photo by Robert Burke Hazardous materials team members may require Level A protection when rescuing non-ambulatory victims.
Recognition is the most important aspect of initial hazmat response. Terrorism incident response is really another type of hazmat response with special circumstances. Therefore, recognition is also the most important aspect of initial response to terrorist incidents. However, all of the recognition and identification tools used for hazmat are not necessarily going to be useful during response to terrorist incidents. There will be no placards, labels, or other marking or identification systems to tell us what, if any, agents were used in an incident. Quantities will likely be small, so don't expect to see tanker trucks, railroad cars or large containers. There also may not be vapor clouds or other typical hazmat warning signs. Of course, terrorists will not be handing out Material Safety Data Sheets (MSDS) for the agents used before leaving the scene. There will be no shipping papers or driver/conductor to interview on the incident scene. So, other tools will be required to recognize when a terrorist incident may have occurred.
Responders need a thorough knowledge of the tools necessary for recognition of a terrorist incident. Otherwise, if response personnel are unable to recognize that a hazmat or terrorist incident has occurred, nothing else really matters at that point, because the incident response is already headed down the road to trouble or disaster.
Scene Approach
Dispatchers and 911 operators should obtain as much information about potential hazmat and terrorist incidents as possible from the caller. They should be trained with some basic hazmat and terrorist response principles and procedures to help them better understand what information to seek from the caller. Checklists should be established for bomb and other threat incidents as well as hazardous materials and terrorist agents. Dispatchers and 911 operators will not receive these types of calls on a regular basis, and the checklists will help them remember what information to ask for. Dispatch and 911 centers as well as emergency operations centers should be provided with security.
Just as with hazardous materials, terrorist incident scenes should be approached from upwind and uphill, if possible. Terrorists may be watching your usual response procedures during the planning stage of a terrorist attack. If you believe a terrorist attack has occurred, you need to alter your usual response to foil any secondary device placement or other booby traps that may have been planted. Become unpredictable, don't do things like you always do if you suspect terrorism. Don't play into the plan of the terrorists. There is no hurry to get into the incident scene.
Photo by Robert Burke The terrorist incident is a crime scene and evidence should be preserved to assist in potential prosecution.
There are two major identification or recognition tools for response to terrorist incidents. First, identify places and events that might be a terrorist target. Terrorists will likely be looking for targets that will have an impact on large numbers of people, the infrastructure, governments (local, state and federal), and important monuments and shrines. When there are reports of explosions, unusual odors or other suspicious event at these types of facilities, responders should immediately add potential terrorist attack as one of the things they think about in terms of size-up of the incident.
If an explosion has been reported and the location is a potential terrorist target, care should be taken when approaching the scene. Park apparatus at least 1,000 feet from the scene and notify the nearest bomb squad to clear the area of unexploded ordnance or secondary devices before other responders enter the area. Bombs may not look anything like what you would expect them to look like. They can be built into almost anything, so having the bomb squad clear the area is most important for responder safety.
Second, terrorists will likely target locations or events where large numbers of people gather. It is highly unusual to respond to an incident where there are multiple non-trauma victims. Terrorist attacks will likely become mass-casualty incidents. Numbers of victims may be larger than any responders have ever encountered or planned for.
Incident Clues
Casualties that occur as a result of a terrorist attack will be significant clues to responders concerning what may have occurred. Symptoms presented by victims or the number of victims can be clues. Responders must also be familiar with symptoms of terrorist agent exposures. For example, chemical agent exposures other than mustard agent will likely present with symptoms very quickly. Mustard exposure may take from four to 24 hours. Biological agents in general would not show symptoms for several hours to days. All responders should be able to recognize the signs and symptoms of agent exposure and the types of locations and events that may be terrorist targets.
In addition to the major identification points mentioned above, some other signs may be helpful during a response if the responder is highly vigilant. Nerve agents are closely related to pesticides, so if the response occurs in summer in parts of the country where insects are expected to be found, but none are present, personnel should take heed. Other hints could be clues of a hazmat release or a terrorist incident. If there is an unusual amount of road kill or domestic animals have died, this could also be a clue to a chemical release. Although some chemical agents are odorless, unusual odors should not be overlooked as a hint to some kind of chemical release. Responders should also be on the lookout for anything else that is unusual or out of place.
Photo by Robert Burke Hospitals should be notified if contaminated victims may be expected to arrive at emergency departments so they can make the necessary preparations.
When responding to potential acts of terrorism, it is highly unlikely that dispatch information will confirm an act of terrorism has occurred. Response personnel will need the tools previously discussed to make that determination. Establish command, do a thorough job of size-up, identification of hazards and risk/ benefit analysis before sending personnel into harm's way. Only the minimum number of personnel necessary to do a job should ever be sent into the scene.
Isolation zones should be established as well as perimeters. Isolation distances can be found for terrorist chemical agents like nerve and mustard and for other chemicals, in the 2000 Emergency Response Guide Book (ERG). They are listed by chemical name, such as sarin, soman and VX. Biological agents also have listings in the ERG. Perimeters and all other operational sites must be secured with armed law enforcement personnel to protect the other responders and the scene, which is also a crime scene.
The Crime Scene
Terrorist incident scenes are crime scenes. For that reason, emergency response personnel must protect any evidence that may be present as a result of an attack. Generally, firefighters and EMS personnel are not accustomed to dealing with armed security or evidence preservation at incident scenes. They may not know what constitutes evidence. Responders would do well to invite law enforcement evidence experts to a company meeting to go over details and expectations and to answer responder questions.
Evidence may be on victims, even those who have expired. If evidence must be moved for patient care, locations should be documented and diagramed, even photographed, if possible. If there is no fire or there are no victims, fire and EMS personnel may have no reason to be within the crime scene area and should not be there because they may damage evidence. If evidence is picked up to be secured because of operational issues, the chain of custody must be maintained and the evidence turned over to law enforcement as soon as possible.
Protective Clothing
Just as with hazmat responses, emergency personnel must identify the hazards present at a terrorist incident scene in order to know what protective clothing should be used to protect personnel and what methods will be necessary to protect the public. Firefighter turnouts with positive pressure self-contained breathing apparatus (SCBA) usually will not provide much protection against the hazards of chemicals, other than respiratory protection. However, tests conducted at Aberdeen Proving Ground in Maryland challenging firefighter turnouts with nerve agents provided interesting results. Test findings are located in the publication Guidelines for Incident Commander's Use of Firefighter Protective Ensemble with Self-Contained Breathing Apparatus For Rescue Operations During A Terrorist Chemical Agent Incident, commonly known as the "3/30 Rule." This information is designed to assist incident commanders in protecting responders during a rescue attempt of viable victims located in a contaminated environment where chemical agents have been released. (It is not for general operations within the incident scene or "hot zone.")
Test results indicate that standard turnout gear using SCBA would provide users with adequate protection against nerve agent vapor hazards inside the hot zone or downwind areas for 30 minutes provided there is not an immediately dangerous to life and health (IDLH) atmosphere. It is reported that SCBA alone provides 10,000 times more protection than is available to an unprotected person. Standard turnout gear in which the openings have been taped will provide adequate protection in an unknown nerve agent atmosphere for a three-minute entry into the hot zone for rapid reconnaissance or to search for viable victims. Keep in mind that this means avoiding any contact with visible liquid because many chemical agents, particularly nerve and mustard, are skin-contact as well as inhalation hazards. Nomex and PBI were both tested against nerve agent vapor. It is always preferable to use monitoring instruments and appropriate chemical personal protective equipment (PPE) when entering any atmosphere where hazardous materials or terrorist agents may be present. The entire report should be read and evaluated by incident commanders and standard operating procedures (SOPs) developed for local protocols.
Firefighter turnouts and SCBA will provide significant protection against biological agents because all are inhalation hazards and most are not skin-contact hazards for intact skin. However, because of the characteristics of biological agents, responders may not be present at the dissemination event. It may take several days for the symptoms of biological materials to appear. The first indication that a biological incident has occurred may be when victims show up at hospital emergency rooms, doctors' offices or clinics, or call for ambulances. The biological incident may become a public health emergency. Because some field tests are not always reliable, any field testing done for biological agents should be followed up with laboratory tests for confirmation. Unless symptomatic, administration of antidotes or prophylactics should not begin until laboratory results confirm an agent present.
Most of the same protocols used for protective equipment for hazmat responses hold true for terrorist responses. When a confirmed chemical release has occurred, only those in the proper protective equipment should enter the hot zone for mitigation or removal of non-ambulatory victims. Responders in full firefighter turnouts and SCBA may use the 3/30 Rule, but it is not without risk. If proper protective clothing is available, it should be utilized in conjunction with monitoring instruments.
Public Protection Options
Protecting the public is the next priority after emergency responder protection has been established. There are two basic options: protection in place and evacuation. Both methods will require actions to notify the public of the procedures they are to follow.
Protection or sheltering in place requires instructions to those doing the sheltering. Sheltering in place is effective for only short periods. If an evacuation is required, evacuation centers should be different than those usually used for other types of evacuations such as floods, hurricanes, and other. Terrorists could obtain information about the usual evacuation center locations and plan a secondary attack. Security needs to be in place to protect evacuation centers.
Some victims may bypass the emergency response system and take themselves to hospitals. Emergency responders should notify hospitals as soon as possible to make them aware of a possible chemical or biological incident so they can prepare to decontaminate victims going directly to the medical centers. Security should also be provided at medical centers in the event that the terrorist decides to make them secondary targets.
There are two general types of decontamination, emergency and technical. Technical decontamination is that typically used by a hazmat team following entry into the hot zone and for victims of chemical exposures. Hazmat teams and thus technical decontamination are not always immediately available. Any time a person has a chemical on his or her body, the substance must be removed as quickly as possible to reduce the damage and exposure to the victim.
Emergency Decon
Any engine company has the resources to conduct emergency decontamination. Nozzles can be attached to the discharge ports of the pump panel and placed on wide fog. Two engines side by side can provide a spray toward the center through which ambulatory victims can proceed to remove contaminants. Hoselines from engine companies on wide-angle fog can also be used to wash down victims. When more resources become available, ladder pipes and other equipment can be used for overhead and victim decontamination.
Privacy of victims should be protected during both emergency and technical decontamination. Outer clothing should first be removed as 80% or more of the contamination may be on the clothing. It is not recommended for hazmat or terrorist agents that bleach or other chemical solutions be used for decontamination. Disinfection of biological materials with bleach requires contact between the bleach and the biological material for a period of time to kill the organisms. Just flushing with bleach does not always kill biological agents. Bleach and other chemicals can damage the skin and cause blindness if it gets into the eyes.
When biological materials are thought to be in decontamination runoff or collected water, placing bleach in the water for an extended period, will kill the biological agents there. The U.S. Centers for Disease Control and Prevention (CDC) in Atlanta or the local health department or environmental protection agency should be contacted for guidance.
There is little if anything that emergency responders can do to prevent acts of terrorism. However, they can keep the incident from becoming worse by insuring that they have the proper training and an effective response plan that has been tested through periodic exercises.
Robert Burke, a Firehouse® contributing editor, is the fire marshal for the University of Maryland. He is a Certified Fire Protection Specialist (CFSP), Fire Inspector II, Fire Inspector III, Fire Investigator and Hazardous Materials Specialist, and has served on state and county hazardous materials response teams. Burke is a veteran of 24 years in fire and emergency services, with experience in career and volunteer departments. He has attained the rank of lieutenant, assistant chief and deputy state fire marshal. Burke is an adjunct instructor at the National Fire Academy and the Community College of Baltimore, Catonsville Campus, and the author of the textbooks Hazardous Materials Chemistry for Emergency Responders and Counter-Terrorism for Emergency Responders. He can be reached on the Internet at [email protected].
