Terrorist incidents levels

Overall, there is a general agreement that local preparedness of medical professionals for chemical terrorist incidences, as well as the levels of organization and systemic preparedness required and available are nominal. Although there are some highly trained personnel available and excellent capabilities in many consequence management organizations to respond to a domestic chemical disaster, chemical response personnel and equipment are everywhere limited compared to the potential threat, and there is still much room for improvement. 

For purposes of this report, we differentiate four levels of medical intervention, primarily on the basis of proximity to the precipitating event or initial victims. Response to a distinct, immediately recognizable terrorist incident (as opposed to a covert release of an agent whose effects would not be apparent for hours or days) would, in most instances, be initiated by law enforcement or fire and rescue personnel, followed at some point by a hazardous materials (Hazmat) team and emergency medical technicians. This is the group referred to in Table 1-1 as "Local Responders." In the same table, "Initial Treatment Facilities" refers to the fixed-site medical facilities to which victims might initially be transported (or transport themselves) or that might initially be called upon for assistance by victims or personnel on the scene. Under "State" in the table, we... 

The response of the NHS, emergency services and any individual responders or groups (such as local BASICS practitioners) is covered in Chapter 2. This chapter covers the response to a terrorist incident at a national level when this is necessary, bearing in mind that the majority of incidents will be handled by local agencies. 

In most cases, the coordination of the response to a terrorist incident will remain with local agencies. Described below is the guide to the structure of responses at regional level. 

The widespread dissemination of accurate and timely information is a key part of the effective response to a terrorist incident (Box 1.15). Because of its widespread availability, on any level other than the purely local, the most important agent for informing the public will be the BBC. The BBC has systems in place to ensure a coordinated and effective response to any incident that might occur (www.bbc. co.uk/connectinginacrisis). This service uses BBC local radio as its key charmel of information and the system is accessed via the managing editor of the local radio service. 

There may be positive effects of a terrorist incident not just at an individual level but also for society as a whole. Moreover, the extent to which terrorist incidents strengthen a community should not be underestimated, as typified in Britain by the BUtz mentality (although some authorities would only use this term when there is clear evidence of shared values). 

This incident was the first chemical terrorist attack in a large city. There were few first responders who could even have conceived of such an attack and would have been prepared to rapidly evacuate victims from the subway station premises. Many passengers who had difficulty walking rushed out of the trains and onto the subway platform and fell down, which in effect would have increased their exposure to sarin in the subway station. In addition, the site to which many of the victims were finally evacuated at ground level where they could lie down was in close proximity to an air exhaust vent from the subway below. 

Mycotoxin contaminated feedstuffs could be purchased and used as a terrorist tactic in manufacture of a completed feed. For example, horse or swine feeds could be formulated to contain a high level of screenings which are known to contain mycotoxins. Field incidences of mycotoxicoses not finked to terrorist activities fiave been reported from the use of fumonisin contaminated screenings in formulating horse and swine feeds (Wilson et al, 1990 Osweiler et al, 1992). 

In the case of the military, the population of interest is primarily one of healthy young males, while the civilian community includes an equal mix of genders, the very young, the very old, and the sick. In addition, acceptable levels of exposure for military personnel operating in a CWA environment differ significantly from those for the general civilian population that may be involved in a terrorist CWA incident. Furthermore, in most instances some level of physical protection would be available to a prepared military force, while civilian populations would be unprotected. 

Moore and Alexander describe the organization and capabilities of the national response apparatus to a domestic or international terrorist use of a weapon of mass destrnction. This apparatus involves many federal agencies that snpport and complement local and state response systems which respond to snch incidents. The review also discusses the implications of low-level toxicity of chemical warfare agents for the crisis and consequence management phases of the federal response. Finally, the anthors provide a brief summary of how several federally funded research and development programs may enhance future response capabilities. 

The potential physical and cyber-related consequences of any incident, including terrorist attacks and natnral or hnman-made disasters, are the first factors to be considered in risk assessment. In the context of the NIPP Base Plan, consequence is measured as the range of loss or damage that can be expected. The consequences that are considered for the national-level comparative risk assessment are based on the criteria set forth in Homeland Security Presidential Directive No. 7 of 2003 (HSPD-7). These criteria can be divided into four main categories (NIPP, 2011) ... 

A detailed study of incidents with CWs linked to A1 Qaeda shows that cyanides, ricin, and TICs have been the main choices of jihadist terrorists (Pita, 2007). Nerve agents also seem to be of interest, especially because of their toxicological and physico-chemical properties, which make them ideal for tactical use in terrorist attacks. However—and as previously mentioned—the synthesis process requires some level of expertise and is far more complex than the recipes featured in jihadist manuals. 

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