CBRN Subway Attack with Cyanogen Chloride Exposure and Respiratory Failure

Learning Objectives

1. Recognizes potential hazardous material exposure and calls for appropriate supplies for decontamination.
2. Appropriately mitigates exposure risk to minimize exposure and contamination.
a. Dons appropriate PPE, including an appropriate mask, and gloves.
b. Identifies environmental threats including vapor hazard, liquid, confined space and low oxygen environments.
c. Moves the casualty away from the threat or agent, using the principles of fresh air, upwind, uphill, upstream, time, distance, and shielding.
3. Assesses casualty to determine agent of concern, conducting triage and recognizing symptoms.
a. C – Consciousness
b. R – Respirations; Are they present, labored, or absent
c. E – Eyes; pupil size
d. S – Secretions; Are they increased or absent
e. S – Skin; Is there diaphoresis, cyanosis, is it dry and hot
4. Evaluates the casualty at the point of injury for life threats and performs immediate interventions if indicated.
5. Performs a secondary assessment and efficient decontamination at the Dirty CCP.
a. Evaluates circulation.
b. Prevents hypothermia and evaluates for potential head injury.
c. Prepares for extraction.
6. Performs a visual contamination check before crossing the cold line.
7. Identifies cyanide toxicity and gives appropriate antidotes.