Basic Level Pre-Course Reading

Chapter 6
Casualty Management
Thinking Question
What are the medical monitoring protocols for first responders practiced by
Emergency Medical Services in your community?
6.3 Psychosocial Response
6.3.1 Potential Impact of the Public’s Reaction on Emergency
Services
The first casualties of a terrorist attack will likely result from direct exposure to the
CBRN agent and/or from trauma-related injuries. The impact on those potentially
exposed or not exposed, however, may be almost as traumatic because of the
uncertainty and anxiety associated with a CBRN incident. Both exposed and
non-exposed individuals may exhibit similar symptoms. Experience with past
events indicates that there may be 4 to 20 psychological casualties for every
physical casualty in a mass casualty situation. For example, of the 5510 people
who sought medical treatment in the 1995 Tokyo sarin gas attack:
• 12 died,
• 17 were critically injured,
• 1370 had mild to moderate injuries, and
• 4000 + had no or minimal injuries.
Immediately after learning of a CBRN attack, the whole community will be
affected. People trying to get away from the disaster area could cause traffic
jams and accidents. Medical facilities could easily become overwhelmed with
physical and psychological casualties. Stress, fear, worry, and grief will add to
existing medical and psychological problems in the community. Increased stress
on the response system can be caused by the reactions to the incident rather
than by the incident itself. Two distinct health care challenges must be addressed
when training for a CBRN terrorist attack: managing the deaths and injuries
caused directly by the attack and dealing with the fears, health concerns, and
psychosocial reactions that will arise.
CBRN First Responder Training Program
59
Basic Level Course