1. Weapons of Mass Destruction

2. 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

3. 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.

4. 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

5. Common Biological Agents
Anthrax
Botulism Toxin
Plague
Small pox
Tularemia
Viral Hemorrhagic fevers
Ricin

6. Treatment of Biologicals
In general the prehospital treatment for any of these biological agents will include supportive measures for ABC’s
(airway, breathing, circulation)
Because of the potential for infection appropriate protective equipment should be used

7. 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

8. Classification of Chemical Weapons- By Human Effects
Blister Agents
Choking Agents
Blood Agents
Nerve Agents

9. Blister Agents Intended to cause incapacitation rather than death
Used extensively during WWI
Tactic: Overload a region’s medical facilities
Examples: Lewisite, Mustard Gas

10. Blistering Agents Mustard Gas Mustard Lewisite Nitrogen Mustard
Burning and blistering of the eyes and skin
Coughing and respiratory distress

11. Blistering Agents Treatment Protective clothing / gas mask
Avoid vapor clouds
Begin the decontamination process
Support the patients ABC’s
Dress large blisters

12. Choking Agents
Most common during WWI but have lost much of their usefulness since the advent of the nerve agents.
Intended to cause death
Easily obtained
Example: Phosgene (CG as designated by the military) is a common industrial chemical with a moderate lethal dose

13. Choking Agents Chlorine Diphosgene Phosgene
Cause eye and airway irritation
Respiratory irritation; coughing, hoarseness, dyspnea, chest tightness, and pulmonary edema

14. Choking Agents Treatment Protective clothing Immediate evacuation
Support patients ABC’s

15. Blood Agents
Cyanide based compounds are the main components of the blood agents
Rapid rate of evaporation
Tactic: assassination of an individual since these agents aren’t well suited for use on a large number of people
Example: Hydrogen Cyanide (AC)

16. Blood Agents Cyanogens chloride Hydrogen chloride Seizures
Respiratory Arrest / Cardiac Arrest

17. Blood Agents Treatment Protective suits / masks
Decontamination procedures
Support patients ABC’s
Cyanide Antidote Kits-- not approved for EMS

18. Nerve Agents Newest trend in chemical weapons
Original nerve agents were developed by German scientists during the 1930’s as insecticides and were developed into chemical weapons by the Nazi military later that decade.
Sarin, Tabun, Soman and other agents have been the main toxins stockpiled as chemical weapons

19. Nerve Agents
Nerve agents are hundreds to thousands times more lethal than blister, choking or blood agents
Most useful to terrorists because only a minute quantity is necessary to cause a substantial amount of casualties
In their most effective form, most nerve agents are more difficult to obtain
VX and Sarin, the most toxic of the nerve agents, can be synthesized by a moderately competent organic chemist.

20. 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

21. Nerve Agents Treatment Protective suits / gas masks
Mark I Antidote Kit (2 Pam)
Two auto injectors
Atropine 2 mgs
Pralidoxime Chloride 600 mg

22. For Comparison…United States Stockpiles of CW (June, 2000)

23. 2013

25. The 1925 Geneva Protocol banned the use of chemical weapons in warfare
The 1925 Geneva Protocol banned the use of chemical weapons in warfare. By 1993 the Chemical Weapons Convention asked signatory nations to destroy their existing chemical weapons stockpiles and stop producing new ones.
Of the signatories, the United States and Russia are the two countries with the largest chemical weapon stockpiles. Currently, they are in the process of destroying them. Among the signatory states that have not yet ratified the Convention we find Israel and Myanmar. States that have not signed the Convention include Angola, Egypt, North Korea, South Sudan, and Syria.

26. Additional Weapons Nuclear Weapons Incendiary Devices Dirty Bombs
A small incendiary device used to disperse radioactive material

27. 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 minutes to arrive

28. 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

29. Nuclear Attack Treatment Protective equipment
Radioactive decontamination
procedures
Support patients ABC’s

30. 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