In the first responders capacity to take the situation and control it from the start. It is the most crucial step in the crime scene investigation, it starts at securing evidence and witnesses to making sure all people are safe and cared for. With a biological attack it makes the situation more difficult for the first responders, especially if they don’t know what has happened. If they do know it may take special training on part of the first responders in a terrorist attack regardless of what kind. In a biological attack we know that it takes special suits and knowledge of the chemical, not to mention how to care for the victims and possibly find the assailants.
When dealing with any potential terrorist attack, past experience has taught that the first necessary task is to secure the area and ascertain the nature and severity of the threat. Particularly in the past few years, several instances have been reported when a secondary device has been targeted at emergency responders, or armed secondary assault has been perpetrated by offenders, in an attempt to harm or kill rescuers and disrupt emergency operations.
In most cases, both a primary and secondary secured perimeter must be established. A thorough search of these perimeters must be a priority at the onset of the incident. In the event of a biological or chemical release, a large downwind area may also need to be rapidly secured and evacuated in order to minimize civilian casualties.
The primary functions that must be performed at any toxic release remain fairly consistent. The top twenty actions that must be taken will generally involve:
1. Incident "Size-up" and assessment
2. Scene Control/establishment of perimeter(s)
3. Product Identification/information gathering
4. Pre-entry examination and determination/donning of appropriate protective clothing & equipment
5. Establishment of a decontamination area
6. Entry planning/preparation of equipment
7. Entry into a contaminated area and rescue of victims (as needed)
8. Containment of spill/release
9. Neutralization of spill/release
10. Decontamination of victims/patients/rescuers
11. Triage of ill/injured
12. BLS Care
13. Hospital/expert consultation
14. ALS care/specific antidotes
15. Transport of patients to appropriate hospital
16. Post-Entry evaluation examination of rescuers/equipment
17. Complete stabilization of the incident/collection of evidence
18. Delegation of final clean up to responsible party
19. Record-keeping/after-action reporting
20. Complete analysis of actions/recommendations to action plan
TOXICOLOGY UNDERSTANDING
In order to effectively perform their duties at a chemical/biological release, EMS/medical/management personnel must understand some basic toxicology principals. They include (but are not limited too):
A. Acute and Delayed toxicity
B. Routes of Exposure
1. Inhalation
2. Absorption
3. Ingestion
4. Through open wound/Injection
C. Local and systemic effects of exposure
D. Dose Response as it relates to risk assessment
E. Synergistic effects of combined substances
F. Assessment and use of toxicology information services/treatment modalities
G. Relationship of proper decontamination to higher mortality and morbidity
H. Alteration of triage principals as they relate to toxically exposed patients.
I. Levels of personal protective clothing and equipment needed
The Fire Chief should oversee all operations; he will be the incident commander. The next logical step would be to place the Police Chief as the section chief and alongside him would be the Sheriff to overlook operations. The command staff would consist of the Sheriff Deputies and Firemen (women) and finally the local police, including explorers, would overlook operations. The logistics would oversee protective suits, food, and medical supplies. The Planning department would take care of emergency operation procedures. The administrative staff would be the public information officer and they would involve the state and federal departments.
The most important phase will be containing the individuals that have come in contact with the Ricin, providing all responders with protective suits, then cordoning off the area for at least six blocks. Then setting up a decontamination shower, one shower for every 10 people, so approximately 50, and triage areas set up to accommodate 1 for every 20 people, so approximately 25. The people who have been decontaminated and checked by the triage should be watched for at minimum 2 hours to make sure there are no further symptoms.
The crime scene should be preserved by the first responder by:
1. Setting a perimeter that is indicative to the size and type of terrorist attack. Example; if it is an explosion or a biological attack it would differ for each.
2. All first responders should be aware of any footprints that need to be documented and other weather related evidence if the incident occurs outdoors.
3. Asking all the victims who come in for decontamination or otherwise (triage) for any help in the case can lead to preserving the crime scene.
4. All pieces of evidence should be individually packaged and labeled.
The crime scene preservation in a terrorist attack should be no different than a typical crime scene when it comes to preserving evidence. The difference in the crime scenes are scale (both size and population), it may require more diligence on the part of the first responders.