Lt William Finegan, from the Philadelphia Fire Department, on CBRNE mass casualty- problem solved?
Decon doctor on patrol!
“All companies responding to municipal stadium be advised: we have a report of multiple explosions and the use of weaponised toxic industrial chemicals. The incident commander is declaring a level 1 mass casualty incident (MCI) and is requesting six additional alarms. Command has ordered all companies on the first alarm, all hands in service to perform rescue and to decontaminate patients. Operations divisions are North Parking Lot and Broad Street Entrance. Staging is Bus Terminal Parking Lot…” Current operational assumptions for
a mass casualty CBRNE event will pose enormous challenges for first responders. Decon procedures, which are labour intensive and time consuming, will be applied to everyone, including first responders. These operational protocols will result in grave blowback from the tactical misallocation of resources. This begs the question: How will people receive decon in a timely manner? Based on the Tokyo sarin attacks in March 1995, a CBRN incident would result in easily tenfold more unexposed people presenting for treatment than actual exposed victims. Decontaminating this number would require a massive effort. Attempting to decon patients prior to treating them will result in unnecessary delays in treatment of those actually sick and injured. The inescapable truth is that decon must be done first and for that reason, paramedics have never been given the opportunity to solve this tactical problem. If an incident occurred and people,
believing they had been exposed, were made to wait for more than an hour to be decontaminated, the consequences for security at the scene would be dire.
People would likely leave the scene and present in local hospitals only to spread the chaos and contamination even further [the counter argument to this has been presented by Holly Carter in CBRNe World Feb 2014. Ed.]. The hazmistake problem has
been unsolvable because hazmat begins with the assumption that the unidentified material could be one of millions of possible chemicals. This flawed assumptions leads to the paralysis of analysis. A proper threat assessment to identify the credible threats, followed by a quantified risk analysis solves this problem. The solutions re-orders the tactical priorities and expedites the ending of the event. The military teaches us that for
a threat to be credible three things must exist; vulnerability, intention, and capability. If any of these is lacking, there is no threat. The threat assessment process eliminates what can’t happen. Once we have eliminated the background noise, we can do risk analysis on
the credible threats. Risk analysis determines the probability
of possible bad outcomes by using the known to determine the knowable. This will lead to reasonable and achievable strategy and tactics. Applied to the CBRNE threat it looks
like this: forget about the agent/chemical for a minute because it is an unknowable unknown. What do we know? Local weather impacts the
CBRNe Convergence, Indianapolis Motor Speedway, Indiana, USA, 6 - 8 Nov 2017
www.cbrneworld.com/convergence2017 54 CBRNe WORLD June 2017
www.cbrneworld.com
CBRNeWORLD
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