Technical Emergency Response Training

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					“In Those Days…”
 Mat 24:6 "You will be hearing of wars and rumors of wars. See that you are not
frightened, for {those things} must take place, but {that} is not yet the end.

For nation will rise against nation, and kingdom against kingdom, and in various
places there will be famines and earthquakes.

But all these things are {merely} the beginning of birth pangs.

Then they will deliver you to tribulation, and will kill you, and you will be hated by all
nations because of My name.

At that time many will fall away and will betray one another and hate one another.

Many false prophets will arise and will mislead many.

Because lawlessness is increased, most people's love will grow cold.

But the one who endures to the end, he will be saved.

This gospel of the kingdom shall be preached in the whole world as a testimony to
all the nations, and then the end will come. - NASB
     The Urban Legend
• The Government
• Homeland Security
• The United Nations
• The Russians
• The Chinese
• “They”

Are going to capture us all and put us all in slave
labor camps or gas chambers!
 What to expect “In Those Days”

1. Terrorism (CBRNE)
  Chemical – Biological – Radiological – Nuclear - Explosive

2. Disease - Pandemic
  Natural or Man-Made (Terror Related)

3. Natural Disasters
  Fires, Floods, Earthquakes, Storms

4. Persecution


Domestic Targeting of United States

FBI definition of terrorism:

Activities that involve acts dangerous to human life that appear
to be intended to intimidate or coerce a civilian population; to
influence the policy of a government by mass destruction,
assassination, or kidnapping (United States Congress, par. 3)

Reasons Terrorists might use
(Chemical Biological Radiological Nuclear Explosive)

Low Cost

High Availability


Hard to Detect

Maximum Benefit

Critical Infrastructure Sectors
Agriculture and Food      Energy

Water                     Transportation

Public Health             Banking and Finance

Emergency Services        Chemical Industry and Hazardous
Defense Industrial base
                          Postal and Shipping

Nature of Possible Attacks
Disruption or arrest of the functions of critical infrastructure

Cascading disruption and financial consequences for
government, society, and economy through public and private
sector reactions

Exploitation of particular infrastructure for disruption or
destruction of another

Methods of Possible Attack
CBRNE (Chemical, Biological, Radiological, Nuclear,


Cyber Attacks (computer and electronic networks)

Indicators of Biological Attack
Indicators at the scene
  • Verbal or written threats
  • Abandoned spray device
  • Biohazard, culture, or culture medium labels
Indicators for Medical Sector
  • Numerous calls to 911 asking for assistance and reporting
    similar signs and symptoms
  • Sudden rush of people showing up at urgent care facilities
    or emergency rooms showing similar signs and symptoms

Indicators of Biological Attack

Mist or fog sprayed by slow-moving aircraft

Aerial bombs that pop, rather than explode

Sighting of insects not normally found in the region

Unusual concentrations of insects not normally found in region

Indicators of Biological Attack

Disease that is unusual or does not occur naturally in area

Large numbers of casualties

Massive point-source outbreak

Dead animals of multiple species

Absence of natural vectors in area of outbreak

The targets of biological agent attacks vary. Individual targets
could be selected for revenge, for political reasons, for religious
purposes, or to create fear:

  • Elected officials

  • Members of the media

  • Corporate officers

  • Christian, Jewish or Zionist sympathizers

  • Many others

Fall 2001: letters containing anthrax bacteria
mailed to several news media offices and two
U.S. Senators

October 2003: letter containing ricin addressed
to D.O.T. found at postal-handling facility in

                                                   Letter sent to Sen.
                                                  Daschle in Fall 2001

Incidents (continued)
November 2003: letter addressed to White House intercepted
after it was found to contain ricin

February 2004: ricin found on mail sorter in mailroom serving
Sen. Bill Frist

Biological Agents and Characteristics

Types                Signs and symptoms

Dissemination        Mortality

Availability         Basic Treatment

Routes of entry

Incubation periods

Types of Biological Agents
Bacteria (Bacillus anthracis, Yersinia pestis)

Viruses (Variola major, Viral Hemorrhagic Fevers)

Toxins (Ricin, Botulinum Toxin Type A)

Spraying devices

Direct deposit devices

Exploding devices

                         Hand-held pesticide
                           sprayer with tank

Advantages of Using Biological
Agents as WMD
Availability     Tie up resources

Hard to detect   Psychological impact

Used covertly    Difficult to prepare for

Easily spread

Mass Casualty-Generating Potential
of Biological Warfare Agents
This is a hypothetical dissemination by airplane of 50kg of drug agent along a 2-
km line upwind of a population center of 500,000 people in a developing country.
Agent                      Downwind Reach (km)        Dead     Incapacitated
Rift Valley Fever                   1                   400       35,000
Tick-borne Encephalitis             1                 9,500       35,000
Typhus                              5                19,000       85,000
Brucellosis                         10                  500      100,000
Q Fever                           >20                   150      125,000
Tularemia                         >20                30,000      125,000
Anthrax                           >20                95,000      125,000

Radiological Dispersal Device (RDD)
The Department of Defense (DOD) defines an RDD as—

     "any device, including any weapon or
     equipment, other than a nuclear explosive
     device, specifically designed to employ
     radioactive material by disseminating it to
     cause destruction, damage, or injury by
     means of the radiation produced by the
     decay of such material"

Common Radiation Exposures
Chest x-ray                                        10-30 mrem

Cigarette Smoking (1.5 packs daily over a year)    1300 mrem

Mild radiation sickness                           200,000 mrem

Lethal dose                                       450,000 mrem

Max. annual routine dose                           5,000 mrem

Max. emergency dose (property)                     10,000 mrem

Max emergency dose (lifesaving)                    25,000 mrem

Health Hazards
Internal Hazard—Damage to the body caused by the
inhalation, ingestion or intake of radioactive materials
through open wounds. Radioactive materials inside the
body can be taken up and made a part of body tissues

External Hazard—Damage to the body caused by
prolonged exposure to external radiation. The radiation
may be particulate or in the form of rays that penetrate the

Health Risks
Dose is the total amount of radiation received. Dose rate is the
length of time of exposure. Health risks depend on the amount
of radiation received and the length of time of exposure

Acute Exposure—large exposure over a short time. Symptoms
such as skin burns, vomiting and indigestion appear more

Chronic Exposure—small doses over a long time. Symptoms,
such as tumors, are delayed

Exposure Versus Contamination

External Exposure   External        Internal
                    Contamination   Contamination
Radiological Terrorism
                   Release of radioactive material by
                   means other than explosives

                   Large-scale conventional
                   explosives near radioactive

                   Release and dispersal by
                   conventional explosive devices

Visible Indicators
Unusual metal debris or containers

Radiation symbols or placards

Heat emitting material

Glowing material/particles

Victims with burns, skin reddening, vomiting





Radiation can be detected and identified only with instrumentation.

         No                                        Yes


                                               Radiation Detectors           


   Source                                  Dose
                                         25 mrem

  100 mrem per hour x 15 min (.25 hour) = 25 mrem






Radiological Decontamination

     Decontamination             Decontamination       

 What Can We Expect To Happen In
   A WMD Event In Our Area?
Depending on the type of event, you and your family will
experience some form of decontamination.
The general public will be put through a rapid Triage type of
decontamination based on their exposure.
Those of you who have taken the time and pains to protect
yourselves will experience a much more detailed “Technical

Mass Decontamination
Time constrained

Low-pressure, high-volume

Saves lives by reducing
agent from skin of victims

Also known as emergency,     Mass Decontamination
gross, hasty, immediate

Mass Decontamination (continued)
Decontamination System

  • Creates a longer
    decon corridor

  • Allows for
    decontamination of
    larger number of

                         Ladder-Pipe Decontamination

Emergency Decontamination
Can occur at any time
during a response operation

Copious amounts of water

Wash victim from top down

Speed is crucial: conduct
rapid decontamination
followed by response to the
                              Emergency Decontamination

Technical Decontamination
                                   Not time constrained

                                   Complete decontamination of
                                   the residual hazard

                                     • Usually for responders,
                                       their PPE, equipment,
                                       and facilities

                                   Also known as thorough,
                                   deliberate, detailed,
Indoor Technical Decontamination   responder, definitive

Secondary Decontamination
Following mass

As needed basis

Still symptomatic

More thorough than mass

                          Secondary Decontamination

Ambulatory Victims
Walk and assist in

Have minor injuries and
minimum exposure

Processed by triage

                          Ambulatory Victim Decontamination

Nonambulatory Victims
Victims cannot assist
in decontamination

  • Keep clothing
    away from the
    victim’s face

  • Cut clothing from
    head to toe

                        Nonambulatory Victim Decontamination

Decontaminate Nonambulatory
Speed and efficiency are

Minimize exposure

Use care when handling
victims during cut-out

Monitor responders for
                           Decontaminate Nonambulatory Victims


A flu pandemic is an outbreak caused by
   a new human flu virus that spreads
           around the world.

 Because the pandemic virus will be a
new strain, many people could get very
  sick or could die before an effective
          vaccine is available.
It’s not a matter of IF, but WHEN!
Three flu pandemics happened in the 1900s.
Near the end of World War I, the 1918 Flu
Pandemic was the most severe flu pandemic
              of the century.

It killed about 675,000 people in the United
States and between 20 to 50 million people
             around the world.

   In the current H1N1 Pandemic, CDC
     estimates 12 million cases, 53,000
     hospitalizations, and 2900 deaths.
   We have learned from past flu
pandemics that during a pandemic,
limiting contact among people helps
 to slow the spread of the virus and
          helps to save lives.
Until a vaccine can be made, limiting
  contact among people will be our
main tool for helping to contain the
 disease and to prevent others from
              getting it.
 A new pandemic flu virus will spread
 easily from person to person, mostly
   through coughing and sneezing.

 When a sick person coughs or sneezes
near you (less than 3 feet away), you can
 breathe in droplets that have the virus.

The droplets also could land on surfaces
   you may touch with your hands.
  During a flu pandemic, health
  officials may ask you and your
community to take actions to help
   limit contact among people.

Your daily routines could change
      for several months.
Make plans now to be able to stay
home for at least 10 days if you are
     sick with pandemic flu.

  Make a plan for who will take
care of you and your household if
           you get sick.
In severe flu pandemics, people may
be asked to limit contact with others
 in the community and workplace.

 Places where people gather, such as
stores, schools, theaters and places of
       worship, may be closed.
Get in the habit of washing your
hands often and covering your
      coughs and sneezes.

These actions can help you stay
healthy now. They will also help
  protect you and your family
     during a flu pandemic.
  Teach your family the importance of
  these habits and practice them now:

   Wash your hands often with soap and water. If
 there is no soap and water, use an alcohol-based
hand gel. Wash your hands before eating, drinking,
               or touching your face.

    Cover your mouth and nose when you cough or
sneeze. Throw used tissues away in a trash can, and
wash your hands. If you do not have a tissue, cough
 or sneeze into your sleeve and not into your hands.
Level III Pandemic PPE Kit,
(1) Full-length Impervious Coverall w/Hood, Elastic Wrists & Ankles
(1) NIOSH approved, N95 Cone-shaped Respirator w/valve
(1) Pair Fog-Free, Indirect-Vented Goggles
(1) Pair Nitrile Gloves, 6 mil.
(1) Pair Heavy-Duty Green Nitrile Gloves, 15 mil
(2) Germicidal Surface Disinfectant Wipes
(1) 4 oz. Bottle of Hand Sanitizer Gel
  Personal Protective Equipment Guidelines for
           response to Anthrax Threat

Suspicious package or letter no visible product:
             Latex Medical Gloves
            Particulate Mask (P95+)
           Safety glasses or goggles

Suspicious package or letter w/ product spilled or
              Latex Medical Gloves
             Particulate Mask (P95+)
            Safety glasses or goggles
        Tyvek or comparable protective suit
Personal Protective Equipment Guidelines for
      response to Radioactive Fallout
detonation of Radiological Dispersion Device

            Latex Medical Gloves
           Particulate Mask (P95+)
          Safety glasses or goggles
      Tyvek or comparable protective suit

Rev 8:10 The third
angel sounded, and
a great star fell from
heaven, burning like
a torch, and it fell on
a third of the rivers
and on the springs
of waters.
End of Session
         The Saddlebag Project
Mat 24:17- 18 "Whoever is on the housetop must
not go down to get the things out that are in his
house. Whoever is in the field must not turn back to
get his cloak.” NASB
         What does
  “The Saddlebag Project”
       plan to teach?
In order to be truly “Free” where you live right now,
you should evaluate everything you own and do.
When you have developed the plan, mindset, and
skills to get free of the materialistic culture that
grips our world today, you should, be able to literally
walk away from everything and start over.
When you have placed your full dependence on God,
you will find the freedom that He intended for His
people since the Creation.
        Who do you owe?

Our debt to others is the greatest destroyer
of Freedom (and families)!
Proverbs 22:7 “The rich rules over the
poor, And the borrower is the slave of the
What material thing do
you have that you are
 no longer interested
What material thing do
you have that you are
 no longer interested

But are still paying for?
What material thing do
you have that you are
 no longer interested

But are still paying for?
        Sell It!
    From this point on,
 if you cannot pay cash
for something you need
        or want…
    From this point on,
 if you cannot pay cash
for something you need
        or want…

    Don’t buy it!
  As you pay off your
debts, set aside 10% for
   yourself, in cash.

    Store it in a safe
 fireproof place where
    you can get to it
Begin to develop your
 skills to be able to
    “go it alone”
should you and your
   family need to.
Develop a skill or hobby that you can
use to earn money if you lost your

Learn to grow, raise, or hunt for
enough food to feed your family for a
year or longer if necessary.

Begin to minimize your dependence
on “Stuff” that can capture your time.
 When was the last time
 you went camping?
Lev 23:34 "Speak to the sons of Israel,
saying, 'On the fifteenth of this seventh
month is the Feast of Booths for seven
days to the LORD.” NASB
  When was the last time
  you went camping?
Lev 23:34 "Speak to the sons of Israel,
saying, 'On the fifteenth of this seventh
month is the Feast of Booths for seven
days to the LORD.” NASB
God gave this commandment to His people so
that they would remember their trek in the
wilderness. What if it was also to prepare them for
Jesus’ instructions in Matt. 24?
What do you need in
 your saddlebag?
 What do you need in
  your saddlebag?

Let’s do some “Brainstorming.”

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