By Mary Wade Triplett
While this sounds alarming, so far, it’s just a scenario, one of many presented during a training attended by Jamie Moore, manager of Monongalia County Health Department’s Threat Preparedness program. Moore also heads up the six-county Preparedness Action Coalition Team (PACT) threat prep region that includes Monongalia, Preston, Marion, Harrison, Doddridge and Taylor counties.
Moore just returned from attending a course called “Hospital Management for Chemical, Biological, Radiological/Nuclear and Explosives,” held at the U.S. Army Medical Research Institute of Chemical Defense at Aberdeen Proving Grounds in Aberdeen, Md.
It was a week filled with lectures but also a variety of practical exercises, including a HAZMAT tent displaying treatment options for casualties of chemical and biological situations. There also was a show and tell in which the organizers “set up equipment so you can walk through and see how different treatments worked,” Moore said. Demonstrations on how to administer injection drugs were performed thanks to expired medication and mannequins.
The primary focus of the training was to illustrate how hospitals and other medical responders deal with CBRNE events—those that involve chemical, biological, radiological/nuclear or explosive situations—whether they happen by accident or are due to the actions of people.
“We learned a greater understanding with how to interact with a CBRNE event in conjunction with hospital operations,” Moore said.
Noted Dr. Lee B. Smith, MCHD executive director and county health officer: “Threat Preparedness is not intuitive and is a topic that continues to increase in its expanse and complexity.
“In addition, public health is being asked to participate at higher levels than ever before and our six counties now function as threat prep region. I look at these educational opportunities as investments in the future of MCHD and as a means of placing us in a leadership role moving forward.”
A variety of issues came up during the training, such as the major chemicals used via chemical warfare. These include nerve agents, such as sarin, tabun and soman; vesicants, which cause blistering; cyanide, which is highly toxic; and pulmonary, which disrupt normal breathing.
Keeping current on the latest chemicals that can be used against humans is important, Moore noted. “The current treatments for nerve agent exposure won’t work on the next generation nerve agents,” he said. “They are designed to resist the counteragents currently being used.”
Of course, not all exposures to dangerous CBENE agents are on purpose. In today’s world, people can be endangered because of an accidental leak or spill at a chemical or nuclear plant, or through products such as bulk pesticides or radioactive waste being transported by train or truck that could be involved in a crash.
“The response is not that different if it was caused accidentally or if it was a military attack or a terrorist attack,” Moore said.
Trainees also considered topics such as how to deal with the “worried well”—those people who express concern about exposure after an event but have no symptoms, as well as pet d-con.
The latter one is because often when situations happen and people gather for decontamination, they bring their pets with them. “People leave their pets, so they need to be d-conned as well,” Moore said. “So, you have teams that just deal with pets.”
The process of decontaminating animals already has been a factor, such as when a military dog encounters a chemical while on duty.
CBERNE events and how to react to them is not a pleasant topic, but it’s one that area first responders and health officials need to study and practice. Now that Moore has returned from training, he can begin sharing what he learned with local responders as well as other members of the six-county PACT region.
“These are facts in our community, and it doesn’t matter if something happens because of evil or accidents or if it’s inadvertent,” Moore said. “They are things we need to know about and be able to respond to.”
As Dr. Smith noted, “Jamie Moore has graciously stepped up in a leadership role as the regional threat preparedness manager and it is our obligation to provide him with the proper tools and education to function at the highest levels in that position.
“It is unfortunate that in today’s world we have to think about terrorism and its many facets. However, forewarned is forearmed and we are fortunate to have such trainings made available from the military and subject matter experts.”