Chemical, biological, radiological, nuclear and explosive

Describe general signs and symptoms of exposure to selected chemical, biological, radiological, nuclear, and explosive agents (CBRNE). 

The need for effective terrorism preparedness, encompassing chemical, biological, radiological, nuclear, and explosive (CBRNE) agents, has placed new demands on the PHN. To continue in the tradition of assessment, assurance, and policy development, new skills must be developed relating to CBRNE events. 

All toxic effects of chemical, biological, radiological, nuclear, and explosive agents (CBRNE) are dose dependent. The dose for respiratory exposure is the concentration of the agent multiplied by time of exposure. Physiological factors, such as rate and depth of respiration during the exposure period, will also determine the final pathophysiological outcome of the patient. 

Society for Countermeasures Against Chemical, Biological, Radiological, Nuclear and Explosive Terrorism, 2008. Nuclear, Biological and Chemical Terrorism Countermeasure Handbook. Shindan To Chiryo Sha, Tokyo, Japan. 

Military support to civil authorities is the final tier in the nation s disaster response system. Federal resources that may be implemented in the event of a major biochemical or radiation disaster are the U.S. Army Special Medical Augmentation Response Teams. The mission of the SMART teams is to provide short-duration medical liaison to local, state, federal, and DOD agencies responding to disasters, civil-military cooperative actions, humanitarian assistance missions, weapons of mass destruction incidents, or chemical, biological, radiological, nuclear, or explosive incidents. There are 37 SMART teams, including two burn SMART teams operated by the U.S. Army Institute of Surgical... 

Typical assaults on military and police personnel involve knives, firearms with both handgun and rifle bullets, and explosive devices that produce blast, fragmentation and heat. Additional attacks may come from chemical, biological, radiological and nuclear weapons or enviromnental hazards such as collisions in road traffic accidents and falling masomy. Knives, bullets, fragmentation and blast will be used here as examples. 

In the 1970s, the NBC classification was changed by both military and civil formations to include radioactive substances, separate from those produced by a nuclear explosion. This resulted in the CBRN (chemical, biological, radiological and nuclear) classification still in use today. Why the term radiological was chosen to describe the hazards firom substances that are radioactive is not clear. The term in English had always been used to describe the medical speciality of imaging by X-rays. However the term has remained unaltered and by convention will be used in this chapter to mean a radioactive substance. 

Based on the history of terrorist attacks, which have mostly involved hijacking and bombing of aircraft, current threat-detection measures have concentrated on detecting weapons or explosives. In the future, terrorist attacks could also involve the use of toxic chemicals, chemical and biological warfare agents, or even radiological and nuclear materials.1 2... 

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