EMS World

JUL 2018

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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By Mike Rubin 32 JULY 2018 | EMSWORLD.com ISSUE FOCUS: MCI & DISASTER RESPONSE T he idea of responding to an act of nuclear terrorism can be daunting. Some may assume everyone will be dead, so why bother? Others may picture devastation so widespread they won't be able to respond. Finally, people in rural areas often believe that since a nuclear detonation (nucdet) would likely only occur in an urban area, they have no need for preparations. All of these assumptions are, to varying degrees, incorrect. During the Cold War, American fears centered on the prospect of nuclear war and the promised Arma- geddon that would result. As that threat ebbed following the dissolution of the Soviet Union, civil defense preparations and resources that had been established to protect Americans from the effects of a nucdet were reduced to near-dormancy. However, concerns about a nucdet have made a recent resurgence on two fronts: conventional nuclear weapons (CNWs) and nuclear terrorism (i.e., the use of an impro- vised nuclear device, or IND). Following the collapse of the Soviet Union, most Americans didn't think much about the prospect of a nucdet; however, recent tension with North Korea and the false nuclear weapon alert in Hawaii have caused a reemergence of fears of use of a CNW. More importantly, terrorism experts have never discounted the possibility—no matter how remote—of an IND attack. The IND Threat Landscape The U.S. Department of Homeland Secu- rity has developed 16 catastrophic planning scenarios. National Planning Scenario #1 involves a terrorist acquiring nuclear mate- rial and fashioning it into a 10-kiloton IND that is employed in an urban area, which has the explosive yield approximately 4,500 times greater than the Oklahoma City bomb. Although considered a remote possibility because of safeguards in place in our cities and ports, an IND event could cause hun- dreds of thousands of deaths and injuries. However, potential devastation on this scale does not mean EMS personnel should throw their hands in the air and write off planning as futile. Rather, responders should understand the predicted impacts and be able to separate the mythology of nuclear consequences from the reality. Eff ects of Nuclear Weapons Nuclear weapons affect living beings, infra- structure, and the environment. A nucdet will produce a massive and instantaneous release of pressure, heat, and radiation— each creating devastating impact of its own. A nucdet produces a blast wave that emanates out in all directions from the point of detonation (ground zero). Peak overpressure—the pressure beyond atmo- spheric pressure caused by a shock wave— can reach 200 pounds per square inch and be accompanied by hurricane-force winds. Such pressures are enough to destroy struc- tures and kill people and animals through internal blunt trauma. Winds can pick peo- ple up and throw them against hard objects. Winds can also make shrapnel and projec- tiles out of glass, wood, and other objects. RESPONDING TO NUCLEAR TERRORISM: WHAT EMS PROVIDERS NEED TO KNOW Your assumptions may be wrong— the time to get them right is now By Erik Gaull, NRP, CEM, CPP, MEP

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