CASE EXERCISE OVERVIEW                                                                                 

Title: Chlorine: A Chemical Release in Northern NJ
Author: Frank Kemp
Author Contact Info : UMDNJ-NJMS, MSB Rm 506, Newark NJ 07101-1709; (973) 972-4404; kemp@umdnj.edu
Date: November 2008
Target Audience: Physicians
Time Required: 3 hrs
Format: Tabletop
Copyrighted Original Case: NO
Link To Copyright Statement:
Publisher/Source: NJ-PTC
Attribution:

CATEGORY
  • Chemical

NATIONAL PLANNING SCENARIO
  • Chem attack: chlorine tank explosion

CORE COMPETENCIES
  • Recognize and assess the level of threat in the immediate environment.
  • Institute action to contain and mitigate the threat.
  • Meet acute patient care needs in the event of a BCRNE or other traumatic event.
  • Identify the proper procedures for notification of law enforcement and public health authorities.
  • Describe the chain of command in an emergency situation.
  • Know the limits of his/her authority and ability and refer to appropriate specialists when necessary.
  • Undertake his/her functional role in a community or other local coordinated response plan.
  • Identify and procure appropriate supplies and equipment to enable protection of self and subordinates, treatment of patients and mitigation of the threat.
  • Communicate with local or community non-health officials (e.g. school boards, mayors, town councils, etc.).
  • Communicate with appropriate government authorities (including public health, legal, law enforcement, etc.) to report events and execute the directed response as part of a coordinated preparedness and response plan.

LEARNING OBJECTIVES
  • Describe the possible routes of exposure (inhalation, gastrointestinal, dermal, etc) for CBRNE agents.
  • Identify situations, exposures, and health outcomes of a possible CBRNE event.
  • Describe the role of PPE in self-protection.
  • Describe one's professional roles, functions and responsibilities in CBRNE and other public health situations (i.e. one's personal role in this system/NIMS/NRP).
  • Define the Incident Command System (ICS) and National Incident Management System (NIMS), National Response Plan (NRP) and describe their general structure and components. (ICS 100 or equivalent)
  • Explain the roles and responsibilities of local, state and federal public health planning and response agencies (e.g.: state health and homeland security departments, CDC, NIH, FEMA, etc).
  • List examples of appropriate decontamination methods and how they differ depending on chemical, biological and radiological agent and route of exposure.
  • Suspect or consider the possibility of a WMD attack (e.g. "situational awareness," "being a medical detective").
  • List the different categories of chemical agents (i.e. blistering agents, nerve agents, etc) and provide appropriate examples (i.e. mustard gas, sarin, etc).
  • Define medical triage and discuss situations where its use is appropriate.
  • Describe the key components of the public health and emergency response system (NJ e.g.: SNS, LINCS, Medical Coordination Center, Community Mental Health Agency, PODS, MRC, Citizen Corps).
  • Describe one's role in the local, community and statewide public health emergency response system.
  • Discuss the professional and legal rights, responsibilities and protections in a public health emergency.
  • Identify reliable, trustworthy and credible information sources for use during an emergency (i.e. CDC, OEMS, NJDHSS, hospitals) and describe methods by which to obtain information from these sources (HAN/NJLINCS, Internet, textbooks, CD-ROM).
  • Describe and analyze ethical conflicts between professional and personal responsibilities.
  • Critique and evaluate components of the response plan, including one's individual role.
  • Describe one's role in the pre-event planning process (Planning, Intervention, Recovery, and Evaluation).
  • Describe and apply a framework for ethical decision making.
  • Discuss the treatment protocols for chemical exposures (e.g. antidote administration, removal of clothing, etc).
  • Act upon intelligence data that indicates a potential/actual CBRNE emergency.
  • Activate appropriate mitigation activities to lessen the impact of a potential/actual emergency.
  • Define the ethics of routine public health practices/interventions in emergency situations and discuss the legal/ethical issues of triage.
  • Defend the framework chosen for ethical decision making.

NIMS/ICS/NRP ELEMENTS
  • NIMS: Accountability
  • NIMS: Flexibility/Adaptability
  • NIMS: Interoperability/Compatibility
  • NIMS: Scalability
  • NIMS: Standardization
  • NIMS: Unification
  • ICS: Command & Management
  • ICS: Common Terminology
  • ICS: Incident Action Planning
  • ICS: Information & Communications Management
  • ICS: Integrated Communications
  • ICS: Manageable Span of Control
  • ICS: Measurable Objectives
  • ICS: Modular Organization
  • ICS: Multi-Agency Coordination
  • ICS: Resource Management
  • NRP: All-Hazards Preparedness
  • NRP: Incident Management at Lowest Possible Level
  • NRP: Mutual Aid Agreements
  • NRP: Preparation
  • NRP: Prevention
  • NRP: Recovery & Mitigation
  • NRP: Response

TARGET CAPABILITIES
  • CBRNE Detection
  • Community Preparedness and Participation
  • Emergency Operations Center Management
  • Emergency Public Information and Warning
  • Environmental Health
  • Epidemiological Surveillance and Investigation
  • Explosive Device Response Operations
  • Isolation and Quarantine
  • Mass Care (Sheltering, Feeding, and Related Services)
  • Mass Prophylaxis
  • Medical Surge
  • Onsite Incident Management
  • Planning
  • Public Health Laboratory Testing
  • Public Safety and Security Response
  • Responder Safety and Health
  • WMD/Hazardous Materials Response and Decontamination