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Medical Disaster Preparedness and Nuclear, Biological, and Chemical (NBC) Operations (Chapter 23)
On October 23, 1983, the terrorist bombing of the Marine barracks in Beirut took the lives of 241 U.S. military personnel and wounded 112 others. This terrorist action severely stressed the peacetime military health care system in Europe and directed worldwide attention to the ability of our armed forces to respond to a wartime medical contingency. A major emergency
affecting a large number of people may occur anytime and anywhere. Whether a peacetime disaster or an enemy attack, lives can be saved if one is prepared for either contingency. To do this requires one to be ready by planning and preparing for just such an event. Planning requires an awareness of: the range of disasters which can occur, possible preventive measures, types of injuries, measures to prevent further casualties, and special problems and requirements. The principles of disaster management may be summarized as follows: a. Prevent the occurrence, b. Minimize the number of casualties, c. Prevent further casualties, d. Rescue, e. Provide first aid, f. Evacuate the injured, g. Provide definitive care, h. Facilitate reconstruction-recovery. The intent of this chapter is to provide the field flight surgeon an updated information resource on the planning, operations, and readiness of disaster preparedness within the Air Force. It will cover primarily operations involving nuclear, biological, and chemical (NBC) weapons. The flight surgeon will know where to find specific information from Air Force regulations, manuals, pamphlets, and technical orders. Additionally, certain Army publications will be included. Another chapter will cover specific personnel, equipment, and planning issues in remote environments and should be used in conjunction with this chapter.
United States. Department of Defense
Tedesco, Mark J.
2001
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Chemical and Biological Systems Technology
This section addresses technologies for: Bioprocessing; Chemical Manufacturing; Chemical and Biological Defense Systems; Detection, Warning and Identification; Battlefield Environment; and Human Factors. The technology areas identified in the above box contain militarily critical technologies. The other technology areas do not currently include technologies that are militarily critical. The Chemical and Biological Defense Systems section includes technologies that are designed to protect forces when contamination cannot be avoided and provide
prophylaxis and therapy from threat agents to any affected forces. These
Chemical and Biological Defense Systems technologies also cover
decontamination to ensure rapid force reconstitution. Detection, Warning
and Identification technologies covered in this section can provide real-time capability to detect, identify, locate, and quantify chemical and biological threats.
Sensors must be integrated with an information processing system to analyze the threat, identify potentially affected units, and pass on alarms and warnings to implement protective measures. Both detection and protection apply to personnel operating on the ground, at sea, in the air, and in shelters and large
enclosures. Although many sensor and defense technologies have commercial
applications, military requirements are much more stringent. Selected toxic chemicals and biological agents which are of concern for defense and detection are presented in tabular form. Toxic chemicals are extracted from the Chemical Weapons Convention. Biological agents are extracted from the Australia Group list.
United States. Department of Defense
2001
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Vesicants (USAMRICD Presentation)
The objectives in this presentation on vesicants are to: know the mechanism of action (pathophysiology); identify signs and symptoms for all routes of exposure and the clinical time course; know specific pre and post exposure treatment regimens; understand the specific pharmacology of each treatment regimen; and to understand the prognosis and triage for mild, moderate, and severe exposure. Mustard phosgene and lewisite are outlined in detail along with a history.
United States. Department of Defense
2001
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Report of the Commission to Assess United States National Security Space Management and Organization
This report provides the Commission's assessment of the organization and management of space activities in support of U.S. national security. Members of the Commission were appointed by the chairmen and ranking minority members of the House and Senate Armed Services Committees and by the Secretary of Defense in consultation with the Director of Central Intelligence. The Commission has unanimously concluded that organizational and management changes are needed for the following reasons. First, the present extent of U.S. dependence on space, the rapid pace at which this dependence is increasing and the vulnerabilities it creates, all demand that U.S. national security space interests be recognized as a top national security priority. Second, the U.S. Government--in particular, the Department of Defense and the Intelligence Community--is not yet arranged or
focused to meet the national security space needs of the 21st century. Third, U.S. national security space programs are vital to peace and stability, and the two officials primarily responsible and accountable for those programs are the Secretary of Defense and the Director of Central Intelligence. Fourth, we know from history that every medium--air, land and sea--has seen conflict. Reality indicates that space will be no different. Finally, investment in science and technology resources--not just facilities, but people--is essential if the U.S. is to remain the world's leading space-faring nation.
United States. Department of Defense
2001-01-11
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On Missile Defense, Remarks by Deputy Secretary of Defense Paul Wolfowitz, Frontiers of Freedom, Dirksen Senate Office Building, Washington, DC, Thursday, October 24, 2002
Remarks by Deputy Secretary of Defense Paul Wolfowitz , Frontiers of Freedom, Dirksen Senate Office Building, Washington, DC, Thursday, October 24, 2002.
United States. Department of Defense
2002-10-24
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Industrial Chemicals and Terrorism: Human Health Threats Analysis
Terrorists, warring factions, and saboteurs use chemicals commonly found in communities in industrialized nations to create improvised explosives, incendiaries, and chemical agents. Common chemicals may be used because standard military chemical agents may be difficult or dangerous to manufacture, access, or disperse. The Agency for Toxic Substances and Disease Registry (ATSDR) developed a 10-step procedure to analyze, mitigate, and prevent public health hazards resulting from terrorism involving industrial chemicals. Results of applying the 10-step procedure to two communities are discussed.
United States. Agency for Toxic Substances and Disease Registry
Hughart, Joseph L.
1999-04-06
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Generation IV Roadmap: Fuel Cycles
This document is from a presentation on November 13, 2001 to the American Nuclear Society. The purpose: Examine fuel resource inputs and waste outputs for the range of potential Generation IV fuel cycles, consistent with projected energy demand scenarios. Responsibilities include: Define energy demand projections, Project ore resource base, Survey of cycle types: Identify technology gaps & Recommend R&D, Determine range of energy supply achievable by Gen IV concepts within ore availability & waste arising constraint (Scenarios), Recommend fuel cycle parameters for all GenIV activities. The span of fuel cycles will include currently deployed and proposed fuel cycles based on uranium and/or thorium. Long-term sustainability will determine the choice of fuel cycles. Economics do not strongly constrain the choice of the fuel cycle--other factors may impact choices. Included are graphs and charts as supporting documentation.
United States. Department of Energy
2001-11-13
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Development of an Evaluation Methodology to Support the Generation IV Nuclear Energy Systems Technology Roadmap
The purpose of this document is to develop a process for the systematic evaluation of the comparative performance of proposed Generation IV concepts against established Generation IV Goals. A simple methodology has been developed for an initial screening of concepts for their potential to meet the goals. Methodology allows for a qualitative assessment of concepts for their potential to meet Generation IV Goals; assessment is based on a comparison to a Generation III
reference. A refined methodology for Final Screening is in development to allow for comparison and finer discrimination among concepts also for relative ranking of concepts to support selection.
United States. Department of Energy
2001-11-13
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Generation IV Nuclear Energy Systems Initiative
At the end of 2001, 438 nuclear power reactors were in operation in 31 countries around the world, generating
electricity for nearly 1 billion people. They account for approximately 17 percent of worldwide installed base capacity for electricity generation and provide half or more of the electricity in a number of countries. As a whole, these reactors have an excellent operating record and are generating electricity in a reliable, environmentally safe, and affordable manner without emitting noxious gases into the atmosphere. Concerns over energy resource availability, climate change, air quality, and energy security suggest an important role for nuclear power in future energy
supplies. While the current Generation II and III nuclear power plant designs provide an economically,
technically, and publicly acceptable electricity supply in many markets, further advances in nuclear energy
system design can broaden the opportunities for the use of nuclear energy. To explore these opportunities, the U.S. Department of Energy's Office of Nuclear Energy, Science and Technology has engaged
governments, industry, and the research community worldwide in a wide-ranging discussion on the
development of next-generation nuclear energy systems known as "Generation IV". Generation IV nuclear energy systems will: Provide sustainable energy generation that meets clean air objectives and promotes long-term availability of systems and effective fuel utilization
for worldwide energy production.
Minimize and manage their nuclear waste and notably reduce the long term stewardship burden in the future, thereby improving protection for the public health and the environment. Increase the assurance that they are a very unattractive and least desirable route for diversion or
theft of weapons-usable materials.
Excel in safety and reliability.
Have a very low likelihood and degree of reactor core damage. Eliminate the need for offsite emergency response.
Have a clear life-cycle cost advantage over other energy sources.
Have a level of financial risk comparable to other energy projects.
United States. Department of Energy
2002-03
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Technology Goals for Generation IV Nuclear Energy Systems
Technology Goals have been developed by the Generation IV Roadmap NERAC Subcommittee (GRNS) and endorsed by the Generation IV International Forum (GIF). Close interaction was provided with the Roadmap Integration Team (Bennett) and the DOE Office of Nuclear Energy, Science & Technology (Magwood). Generation IV is all about' reaching for challenging goals with innovative systems.
United States. Department of Energy
2001-11-13
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Army Field Manual: Health Service Support in a Nuclear, Biological and Chemical Environment
The purpose of this manual is to provide doctrine and tactics, techniques, and procedures for
medical units and personnel operating in a nuclear, biological, and chemical (NBC) environment. This manual is intended for all echelons of health service support (HSS). It
discusses the operational aspects of the following HSS activities: Medical treatment, medical evacuation, health service logistics, combat stress control, and preventive medicine,
veterinary, dental, and medical laboratory services.
United States. Department of Defense
1996-11-26
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Army Field Manual: Chemical and Biological Contamination Avoidance
This manual is one of five that explains the fundamentals of NBC defense: FM 3-3, Chemical and Biological Contamination Avoidance; FM 3-3-1, Nuclear Contamination Avoidance; FM 3-4, NBC Protection; FM 3-5, NBC Decontamination; FM 3-7, NBC Handbook. A general overview of these fundamentals is given in FM 3-100, NBC Operations. This manual, FM 3-3, defines and clarifies the entire process of CB contamination avoidance.
Another manual, FM 3-3-1, outlines contamination avoidance procedures for nuclear operations. FM 3-3 details the NBC Warning and Reporting System, how to locate and identify CB
contamination, and how to operate in and around NBC contamination. This manual is designed and intended to be an easy-to-read, step-by-step manual depicting the manual method of calculating CB contamination avoidance procedures for chemical officers and NCOs. However, subject matter discussed in Chapters 1 and 2 and Appendices A and C are of general use for all branches and MOS.
United States. Department of Defense
1994-09-29
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Various CDC Bioterrorism Articles
This is a collection of different articles from the publication 'Emerging Infectious Diseases', ranging from Volume 3, Number 2 in April 1997 to Volume 4, Number 3 in July of 1998. Included are the following articles about bioterrorism, biological weapons, germs, and germ warfare: "The Economic Impact of a Bioterrorist Attack: Are Prevention and Postattack Intervention Programs Justifiable?", "Biologic Terrorism -- Responding to the Threat", and "Bioterrorism as a Public Health Threat". Anthrax and smallpox are both subjects in these articles.
Centers for Disease Control and Prevention (U.S.)
1998
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HHS Fact Sheet: HHS Initiative Prepares for Possible Bioterrorism Threat
While the exact risks are unknown, the use of biological weapons by terrorists potentially could result in life-threatening illness on a large scale. Even a lone terrorist could cause a major disease outbreak in the population - and, in the case of communicable disease, the outbreak could spread in successive waves of infection. Unlike explosions or chemical releases, a bioterrorist attack could be surreptitious and thus difficult and time-consuming to detect. Symptoms might not occur among victims for days or weeks, and those initially presenting themselves to physicians and clinics might
be geographically dispersed. A strong public health network would be needed to piece together early reports and quickly determine what had happened. Once detected, the situation could overwhelm local health systems that are faced not only with the tasks of
caring for mass casualties but also with the demands of even larger numbers of people requiring preventive care. In fiscal year 2001, HHS will invest $297 million in anti-bioterrorism efforts. HHS efforts
are focused on five areas: improving the nation's public health surveillance network, to quickly detect and identify the biological agent that has been released; strengthening the capacities for medical response, especially at the local level; expanding the stockpile of pharmaceuticals for use if needed; expanding research on the disease agents that might be released, rapid methods for identifying biological agents, and improved treatments and vaccines; and preventing bioterrorism by regulation of the shipment of hazardous biological agents or toxins.
United States. Department of Health and Human Services
2001-08-16
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CDC Pharmaceutical and Alert Network
This is a collection of different Center for Disease Control and Prevention publications about bioterrorism. Included are a commentary on "Biologic Terrorism-Responding to the Threat", "Health Alert Network", "Laboratory Response to Chemical Terrorism", "National Pharmaceutical Stockpile Program", "Nuclear Blindness: An Overview of the Biological Weapons Programs of the Former Soviet Union and Iraq", "Historical Trends Related to Bioterrorism: An Empirical Analysis", "Chemical Terrorism", and "Public Health Response to Terrorism". Each of these articles deals with the issue of biologic weapons, the consequences of using these weapons, and prevention and reaction programs.
Centers for Disease Control and Prevention (U.S.)
2000
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Foreign Missile Developements and the Ballistic Missile Threat Through 2015: Unclassified Summary of a National Intelligence Estimate
"The Senate Select Committee on Intelligence requested that the Intelligence Community (IC) produce annual reports containing the latest intelligence on ballistic missile developments and threats and a discussion of nonmissile threat options. This paper is an unclassified summary of the National Intelligence Estimate (NIE) that is the fourth annual report. The NIE describes new missile developments and our projections of possible and likely ballistic missile threats to the United States, US interests overseas, and military forces or allies through 2015; updates assessments of theater ballistic missile forces worldwide; discusses the evolving proliferation environment; and provides a summary of forward-based threats and cruise missiles."
National Intelligence Council (U.S.)
2001-12
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Unclassified Report to Congress on the Acquisition of Technology Relating to Weapons of Mass Destruction and Advanced Conventional Munitions, 1 July Through 31 December 2001
As directed by Congress, this report, submitted by the Director of the Central Intelligence, outlines the acquisition by foreign countries during the preceding 6 months of dual-use and other technology useful for the development or production of weapons of mass destruction (including nuclear weapons, chemical weapons, and biological weapons) and advanced conventional munitions. As stated, this report is submitted to Congress every six months.
United States. Central Intelligence Agency
2001-09-07
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Annual Report to Congress on the Safety and Security of Russian Nuclear Facilities and Military Forces [February 2002]
Congress directed the Director of Central Intelligence (DCI) to submit to the Congressional leadership and intelligence committees an annual, unclassified report assessing the safety and security of the nuclear facilities and military forces in Russia. Congress further asked that each report include a discussion of the following: 1) The ability of the Russian Government to maintain its nuclear military forces; 2)The security arrangements at Russia's civilian and military nuclear facilities; 3)The reliability of controls and safety systems at Russia's civilian nuclear facilities; 4)The reliability of command and control systems and procedures of the nuclear military forces in Russia. This annual report is the third responding to this Congressional request. The report addresses facilities and forces of the Russian Ministry of Defense, the Ministry of Atomic Energy, and other Russian institutes. It updates the September 2000 report to Congress.
National Intelligence Council (U.S.)
2002-02
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Testimony of Department of Health and Social Services Secretary, Tommy G. Thompson
Bioterrorism presents unique challenges since it differs dramatically from other forms of terrorism and national emergencies. While explosions or chemical attacks cause immediate and visible casualties, an intentional release of a biological weapon would unfold
over the course of days or weeks, culminating potentially in a major epidemic. Until sufficient numbers of people arrive in emergency rooms, doctors' offices and health clinics with similar illnesses, there may be no sign that a bioterrorist attack has taken place. Individuals with symptoms may be at considerable distance from the site of initial exposure, both in terms of onset of disease and geographic location. Moreover, the bioweapons most likely to be used are pathogens not routinely seen by health care providers. Medical providers generally are not familiar with the diagnosis and treatment of these disorders and may even fail initially to recognize symptoms. These scenarios underscore the importance of preparing for the possibility of bioterrorism. Our efforts include preparing the medical and public health response to mass casualty events, working to improve our infectious disease surveillance capabilities, managing and securing the National Pharmaceutical Stockpile and investing in necessary research and development to improve our capability to respond to an emergency. Because of the potential for widespread damage a bioterrorist attack could bring, I will focus on what I consider HHS's main priorities
as the coordinator of medical assistance and the surveillance efforts CDC would undertake to identify the pathogen used.
United States. Department of Health and Human Services
2001
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Testimony of Robert G. Joseph Before the House Armed Services Committee
There is substantial agreement on the emerging threat to the United States from long-range ballistic missiles. This is reflected in the unanimity of views in the Rumsfeld Commission and in the subsequent reassessment by the intelligence community last fall. The overwhelming majorities in both Houses of Congress that passed the National Missile Defense Act -- making it U.S. policy and law to deploy a national missile defense "as soon as is technologically possible" -- is further evidence of the growing consensus on the threat, both to U.S. forces and allies abroad, as well as to the American homeland. Long-range missiles become particularly valuable to states such as North Korea as instruments of coercion to hold American and allied cities hostage, and thereby deter us from intervention. They need only hold a handful of our cities at risk. This is not irrational. In fact, it is very well thought out. If you cannot compete conventionally and you have territorial or political or religious goals that require the use of force, you must find a means of keeping the United States out of the fight.
Any comprehensive approach to meeting the missile proliferation threat must reconcile these inconsistencies. In doing so, we will better protect against the growing threat and establish a more stable basis for our relations with Russia and others.
National Defense University. Center for Counterproliferation Research
2000-06-28
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Radiological Emergency Management
This independent study course is intended to provide members of the general public with an overview
of several types of radiological emergencies: radiological transportation accidents, nuclear power plant accidents, nuclear terrorism threat, and other radiological hazards. This overview introduces the nature, degree of hazard, and general emergency response strategies associated with each type of emergency. Specific emergency response guidance, such as how to operate radiation detection equipment or how to respond to a radiation incident, is presented in other courses. For optimal results, study this course carefully at your own pace. Learning from these materials is different than learning from a traditional textbook. The course is self-instructional and contains all of the information you need to increase your knowledge of radiological hazards. The course contains a pretest, five units, a final examination and a glossary. You should take the pretest to test your knowledge before you begin studying. You can score the pretest yourself, using the pretest answer key (located after the pretest questions), to determine units requiring additional emphasis. The glossary, located before the final exam, contains definitions of terms related to radiological hazards. The glossary may be consulted while you are reading the units or may be read separately.
United States. Federal Emergency Management Agency
2001
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Environmental Protection Agency: Radiological Emergency Response Plan
The 1999 EPA Radiological Emergency Response Plan (EPA-RERP) is published to replace the 1986, EPA Radiological Emergency Response Plan. The EPA-RERP has been developed to reflect changes in EPA's programmatic and operational concepts for responding to radiological incidents and emergencies. The EPA-RERP is to be used as a guide for planning and maintaining readiness to respond to
those releases in accordance with EPA's mission to protect human health, welfare, and the environment. Furthermore, this Plan distinguishes between EPA's role as a Lead Federal Agency for response coordination under the FRERP, and its role as a lead agency for directing and managing an emergency response pursuant to the NCP. It also accents the EPA-OSC's role in managing/directing the emergency response actions as prescribed in the NCP.
United States. Environmental Protection Agency
2000-01-10
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Radiation Emergency Assistance Center/Training Site (REAC/TS)
The Radiation Emergency Assistance Center/Training Site (REAC/TS) is one of the emergency response resources, or assets, administered by DOE. REAC/TS focuses on providing rapid medical attention to people involved in radiation accidents. REAC/TS is on call 24 hours a day to provide direct or consultative help with medical and health physics problems from local,
national, and international incidents.
REAC/TS also provides medical support to other DOE emergency response assets. REAC/TS' mission is to maintain an around the clock response center to provide direct support, including deployable equipment and personnel trained and experienced
in the treatment of radiation exposure, to assist Federal, state, Tribal and local organizations, and DOE Radiological Emergency Response Assets. REAC/TS provides medical advice, specialized training, and the unique capability of onsite
assistance for the treatment of all types of radiation exposure accidents.
United States. Department of Energy
2001
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FEMA Fact Sheet: Radiological Accidents
This fact sheet discusses radiological accidents in terms of definition, prevention, reaction, and preparation. Radiological accidents can occur wherever radioactive materials are used, stored, or transported. In addition to nuclear power plants, hospitals, universities, research laboratories, industries, major highways, railroads, or shipping yards could
be the site of a radiological accident. Distance, shielding, and time are the three ways to minimize exposure to your body.
United States. Federal Emergency Management Agency
1993-09
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FEMA Fact Sheet: Nuclear Power Plant Emergency
Although construction and operation of nuclear power plants are closely monitored and regulated by the Nuclear Regulatory Commission, accidents, though unlikely, are possible. The most immediate danger from an accident at a nuclear power plant is exposure to high levels of radiation. Distance, shielding and time are the three ways to minimize risk of exposure. This fact sheet discusses planning and identifies terms to be familiar with in the event of an emergency.
United States. Federal Emergency Management Agency
2001
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Medical NBC (Nuclear, Biological, Chemical) Battlebook (U.S.Army)
The purpose of this battlebook is to address operational health concerns in environments where Nuclear, Biological, and Chemical (NBC) threats exist. Potential NBC threats range from weapons of mass destruction to contamination of the battlefield by hazardous material. Medical personnel, in conjunction with chemical personnel, must be able to advise commanders on a wide
range of issues including the health effects of NBC threats, protective clothing and measures, and management of NBC casualties. This manual is not an emergency response book or treatment guide. It is intended to provide a quick reference for decision making as to whether to request expert consultation in a given area. Except in extreme emergency, the contents should not be construed as definitive.
United States. Department of Defense
2001-09-30
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Chemical Weapons Improved Response Program (CWIRP) Playbook: Guidelines for Responding to and Managing a Chemical Weapons of Mass Destruction Terrorist Event
This Playbook, one of several products of the Chemical Weapons Improved Response Program (CWIRP) process, serves to identify the key issues that the program studied and provides basic recommendations and guidelines for enhancing response and management of a chemical incident. This document, along with the referenced material in Part VII, provides a comprehensive collection of knowledge of the CWIRP. The Playbook and other referenced documents are designed to build upon the DPP WMD training program awareness and operations training. The issues covered in the Playbook are intended to be applicable to the majority of jurisdictions across the country (large, small, metropolitan, rural). Jurisdictions and agencies using the Playbook to assist in preparation of plans, policies, and procedures for response to a chemical WMD incident are expected to adapt these recommendations to fit their current level of preparedness and staffing.
U.S. Army Chemical and Biological Defense Command
2001
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Reference Document 230A: Short-Term Chemical Exposure Guidelines for Deployed Military Personnel
Reference Document (RD) 230A provides details of the scientific rationale and decision making behind the U.S. Army Center for Health Promotion and Preventive Medicine (USACHPP) Technical Guide (TG) 230A - Short-Term Exposure Guidelines for Deployed Military Personnel. Specifically, TG 230A presents a number of chemical concentration level exposures which cause a range of health effects. This RD presents the notes and sources from which these concentration guidelines were derived. The scope, audience, application, and specific guidelines are detailed in TG 230A.
United States. Department of Defense
1999-07
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DoD Strategy to Address Low-Level Exposures to Chemical Warfare Agents (CWAs)
This report responds to the Strom Thurmond National Defense Authorization Act for Fiscal Year 1999 (H. Rpt. 105-736, Sec 247: Chemical Warfare Defense, Public Law 105-261, 17 October 1998, p. 39 and p. 591), and provides our review of the policies and doctrines of the Department of Defense (DoD) on chemical warfare defense. Based on this review, DoD recommends no modifications to policies and doctrine to achieve the objectives set forth in the public law. This report also provides a plan to establish a research program for determining the effects of chronic and low-dose exposures to chemical warfare agents, as requested. Two reviews indicate that an extensive number of doctrinal publications and policies addressing operationally significant concentrations of chemical warfare agents for temporary and short-term exposures and that current operational guidance and doctrine focuses on temporary exposures, with some short-term exposure scenarios addressed.
United States. Department of Defense
1999-05
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Incapacitating Agents: U.S. Army Medical Research Institute of Chemical Defense: Chemical Casualty Care Division
The U.S. Army Medical Research Institute of Chemical Defense (USAMRICD) presentation of incapacitating agents describes the history and definition of incapacitating agents. The series of slides cover representative compounds and glycolate anticholinergics, namely, BZ and Agent 15; moreover, it details its history, physiochemical properties, pharmacokinetics (ADBE), mechanism of action (pharmacodynamics), clinical presentation of casualties and treatment. The term 'incapacitating' is ambiguous. Three definitions are offered here, one of which is specifically applicable. CW agents designed not to injure or kill but to induce disorientation or other temporary effects leading to impaired performance is the definition given for incapacitating agents.
United States. Department of Defense
2001
