Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide prepare to limit access to highly toxic agents, ensure greater protections of food and water supplies, and more closely monitor toxic substances in industrial plants and in transport. Access to toxic agents must be stringently monitored and limited, both those with rapid onset and those that are delayed in onset of toxicity. Improving our public health and medical response/care system is critical to prevent sickness and save lives. December 2008 Version 2.0 Page 356
Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Module Seven Radiation Emergencies - Administration Page The concept of terrorists using radiation as a weapon is extremely concerning. Ionizing or “nuclear” radiation has the clear potential to “terrify” the public as it is associated in the public mind with the destructive force of nuclear weapons, it is invisible and acutely undetectable to the senses, and is associated with the “dread of cancer”; with other effects not well understood by general public. Clinicians can play a vital role in minimizing fear and panic. Several potential scenarios involving the use of radiation by terrorists include the surreptitious placement of a radiation source, the stealth dispersal of radioactive material, an explosive radiation dispersal device (“dirty bomb”), a deliberate attack on a nuclear power plant, or the detonation of a nuclear weapon. Medical personnel may be called upon to care for patients who have been exposed to high levels of radiation or who have been contaminated with radioactive materials. Some of these patients may be gravely ill with radiation sickness or may have radiation burns, while others may have no radiological medical problems other than minor skin contamination. It is essential that medical personnel be able to recognize radiation injury and provide appropriate treatment. It is also essential that medical personnel understand that patients who are merely contaminated may be treated without risk of radiation injury to the medical staff, although contamination control measures may be prudent if the medical condition permits. Acute radiation syndrome is a constellation of signs and symptoms that develop after total body irradiation. The initial signs and symptoms of radiation illness are nonspecific, and could be misdiagnosed as a viral syndrome, or gastroenteritis. It is important in triage to attempt to ascertain the time interval between a person’s acute radiation exposure and the onset of gastrointestinal signs and symptoms. Individuals who become symptomatic in less than 4 hours, and certainly in less than 2 hours after exposure are likely to have absorbed a lethal dose of radiation and cannot be saved. In a mass casualty incident, they might have to be triaged to palliative care rather than intensive supportive care. Duration 45 minutes Scope Statement This module presents the major potential scenarios involving the release of radiation by terrorists and reviews the basic fundamentals of radiation biology and concepts of exposure, contamination and containment. Decontamination and treatment strategies are presented for managing victims of radiation exposure. Terminal Learning Objective (TLO) • Understand the concepts of radiation poisoning to assess and provide clinical care to patients who have been exposed to or contaminated with radioactive material. December 2008 Version 2.0 Page 357
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Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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