Civil Emergency Planning Plans civils durgence

Project on Minimum Standards and Non-Binding Guidelines for First Responders Regarding Planning, Training, Procedure and Equipment for Chemical, Biological, Radiological and Nuclear (CBRN) Incidents

GUIDELINES FOR FIRST RESPONSE TO A CBRN INCIDENT

NATO Civil Emergency Planning Civil Protection Committee

Civil Emergency Planning Plans civils durgence

Foreword
The consequences of Chemical, Biological, Radiological and Nuclear (CBRN) emergencies may stretch national capabilities to their maximum extent. Responsibility for first response remains with individual nations. It is essential that nations build on their resources to respond and mitigate the consequences of an emergency situation to lives, property and the environment. Due to the nature of CBRN incidents, particularly their trans-national effects, co-operation between Euro-Atlantic Partnership Council (EAPC) nations is necessary. The development and adoption of Non-Binding Guidelines and Minimum Standards facilitates and improves national responses and mutual assistance. The initiative to develop Non-Binding Guidelines and Minimum Standards for First Responders regarding planning, training, procedures and equipment for CBRN incidents, stems from the EAPC Seminar on responses to terrorism which was held in Warsaw in February 2002. It was subsequently included in the Civil Emergency Planning related section of the Weapons of Mass Destruction (WMD) Initiative Stocktaking Report adopted at the Reykjavik Ministerial in May 2002. The purpose of the initiative is to provide general guidelines that EAPC nations may draw upon on a voluntary basis in order to enhance their preparedness to protect their civilian populations against Chemical, Biological, and Radiological and Nuclear (CBRN) risks. Such guidelines seek to improve understanding and interoperability between nations, thereby contributing to greater efficiency in the use and delivery of national and international assistance, ultimately enhancing interoperability. The project fills a void at national and international level for consequence management (CM) planning, training, procedures and functional equipment for first responders. National legal responsibilities may be divided in substantially different ways; there can be no universal solution for CBRNrelated civil emergency planning. Likewise, the mandates of first responders involved in emergency response may be formulated in substantially different ways from one nation to another. These guidelines are therefore generic in nature. They serve to establish a lowest common denominator through best practice and shared lessons learned.

Introduction
The aim of the response guidelines is to establish procedural guidelines for midlevel strategic/tactical planners responsible for CBRN preparedness and response. The response guidelines provide generic advice and guidance on procedures, capabilities and equipment required to implement an effective response. They are designed to improve multi-agency interoperatbility in first response to a CBRN incident and provide guidance on when regional, national or international assistance may be required. The guidelines have been prepared to help planners in EAPC nations determine their own level of capability through self-assessment. They serve as a checklist. Implementation of the guidelines is entirely optional. Rather than aiming for standardisation, the response guidelines focus on developing a common understanding of the actions required during the initial response phase (20mins). In order for a response to be fully integrated it is vitally important that deliberate and effective pre-planning takes place between members of all responding agencies at local, regional, national and, where appropriate, international level. The development of regular training designed to test agreed roles, responsibilities, capabilities and protocols is also an essential component of the pre-planning process and will provide opportunities for all agencies to develop further their combined response to a CBRN emergency. The response guidelines are presented as a matrix divided into four sections. They are generic in nature and relate to procedures, capabilities and equipment 1 required to implement an effective response.

Equipment in this project refers to its functional aspects as opposed to recommending specific items.

1. Information gathering, assessment and dissemination

Recognising that a CBRN has, or may occur is critical. Information may be received and disseminated via a number of routes, including intelligence agencies, the public, emergency service control rooms, pre-determined risk information contained in operational response plans, labelling of hazardous substances and transportation containers, first responder observations of signs and symptoms (victims, animals, plants, the surrounding environment).

4. Additional/specialist support.
Following the immediate operational response, specialist advice should be sought to assist with consequence management. This may include hazard identification or confirmation and establishing levels of contamination, medical support, transport and treatment of casualties and supplementing emergency service resources. Where necessary, regional, national and international resources can also be used to maintain or provide a sufficient level of emergency provision and response. Specialist advice and resources may also be required as part of the recovery management phase, including the provision of long term health monitoring, psychological support, building and environmental decontamination, re-establishing public confidence and supporting a return to normality. For clarity, the term First Responders refers to individuals and teams that are involved in activities which address the immediate and short-term effects of a CBRN emergency. This includes on-scene personnel from the police, fire brigades and health services acting to minimise the consequences of a CBRN-emergency. It also includes personnel in hospitals, crisis management institutions and those involved in detection, verification and warning.

2. Scene management
The scene should be isolated to mitigate consequences. Effective scene management (Hot-zone management) is required to control access to and from the incident scene, control movement of contaminated victims, provide safe working methods for responders and contain the release of any substances.

3. Saving and protecting lives

Saving lives is the top priority of all responding agencies. Contamination of victims/casualties must be considered as part of the initial assessment and effective methods for rescue, decontamination and medical treatment must be provided. The provision of timely warnings and/or evacuation of the public where appropriate, may also contribute to saving lives by reducing the risk of exposure.

1. INFORMATION GATHERING: Gather, assess and disseminate all available information Procedure Capability
Call centres and mobilising centres

Equipment

cognise that a CBRN incident BRN awareness training for e C has or may occur call takers

uestionnaire Q

nformation technology I ather, assess and G ethod of gathering M irect telephone lines D disseminate all available information (public, intelligence adios R information to first responders etc) eographical information G stablish an overview of the E ethod of sharing information M (maps) affected area between responding agencies esponse plans for specific R rovide and obtain regular P re-determined level of P risks updates to and from first response to (suspected/ responders confirmed) CBRN incidents First Responders Approach and arrival at scene pproach scene with caution A and upwind arry out scene assessment C BRN awareness training for C responders eather information W ersonal Protective Equipment P (PPE)

hemical, Biological and C Radiological Detection, stablish Incident Command E nowledge and understanding K Identification and Monitoring (each responding agency) of risk assessment Equipment (for personnel, ecognise signs and indicators nowledge and understanding R K boundary monitoring and of CBRN incidents of response to improvised analysis) explosive devices etermine whether CBRN or D ocket and/or emergency P hazardous material incident nowledge and understanding K response guides of roles, responsibilities and stimate number of casualties/ E nter-operable communications capabilities of each responding I victims equipment (eg. handheld agency stimate resource E radios) ffective inter-agency E requirements ain scheme radios M coordination on-site onsider specialist advice/ C eographical information G ommon command system C resource requirements (maps) and structure

Procedure
rovide situation report to P emergency control rooms etc and request assistance if necessary arry out risk assessment C

Capability
ulti-agency communication M channels nowledge of geographical K area

Equipment
esponse plans for specific R risks

earch capability S ndertake hazard identification nalysis capability U A o not approach or touch D nowledge of facilities and K suspect objects/packages do critical infrastructure not operate radios, mobile rotection of unaffected P phones or other electronic critical infrastructure and key devices within vicinity (safe sites (local, regional, national distance +/-400m) targets) onsider secondary devices/ C targets stablish and agree multiE agency response plan dentify safe areas for I additional first responder vehicles earch for secondary devices S ritical infrastructure C considerations

2. SCENE MANAGEMENT: Isolate scene to mitigate consequences Procedure Capability

Initial: onsider wind direction C stablish multi-agency E command point in safe area (cold zone) stablish inner and outer E cordon (hot/warm/cold zone) ommon command system C and structure

Equipment
ocket and/or emergency P response guide

nowledge and understanding etection, Identification K D of hot/warm/cold zone and Monitoring Equipment (for personnel, boundary monitoring and analysis) ersonal Protective Equipment P (respiratory protection, chemical protection suits) ordon tape and signage C

Containment: ontain contaminant material/ C liquid nowledge and understanding ocket and/or emergency K P of signs, symptoms and effects response guide of substances (chemical, stablish quarantine(holding) E ordon tape, signage, barriers C biologicial and radiological) area for contaminated victims/ etection, Identification D casualties (where necessary) nowledge and understanding K and Monitoring Equipment of Hazmat management stablish decontamination and E (for personnel, boundary triage areas ordon off contaminated areas C nowledge and understanding K monitoring and analysis) of decontamination ersonal Protective Equipment P (emergency, mass, clinical) (respiratory protection, nowledge and understanding K chemical protection suits) of medical triage econtamination equipment D (emergency, mass, clinical) helter for victims/casualties S form adverse weather

Procedure
Additional considerations: dentify and establish multiI agency marshalling area for additional resources stablish traffic cordon E

Capability
dentify sites/locations to I accommodate large numbers of multi-agency vehicles and resources

Equipment
ordon tape, signage and C barriers ecording equipment (Video/ R still cameras) vidence bags E

U reserve scene and maintain se pre-determined sites/ P evidence to the extent possible locations where possible. (criminal investigation) se available/suitable space U with solid foundation arry out co-ordinated C evidence collection

etection, Identification D and Monitoring Equipment (for personnel, boundary nowledge and understanding K monitoring and analysis) of scene preservation for criminal investigation (evidence, forensics) ffective exhibit handling E

3. SAVING AND PROTECTING LIVES: Saving lives, giving warnings or managing evacuation Procedure Capability
etermine immediate actions D and priorities vacuate inner cordon (to E quarantine area) estrict inner cordon access R (protected first responders only) eather information W

Equipment

ersonal Protective Equipment P (respiratory protection, nowledge and understanding K chemical protection suits) of decontamination (emergency, mass, clinical) ecording system for hot zone R personnel nowledge and understanding K of medical triage econtamination equipment D (emergency, mass, clinical) ersonal property bags (for P belongings of decontaminated victims) ost decontamination clothing P for victims etection, Identification D and Monitoring Equipment (for personnel, boundary monitoring and analysis) edical treatment (trauma, M prophylactics etc) ransport (ambulance, bus etc) T ordon tape, signage and C barriers repared documentation P ebsite W

rovide safe working methods ufficient numbers of trained P S for rescuers personnel to provide rescue, decontamination, medical arry out necessary rescues C support and operational scene mplement decontamination as I management appropriate (emergency, mass, afe working methods for hot S clinical) zone personnel (recording onsider decontamination of C entry and duration of exposure) personal property ransportation of contaminated T mplement medical triage and I victims/casualties treatment ethods for communicating M mplement responder/rescuer I timely advice/warnings to the decontamination public onsider requirements and C mergency evacuation plans E provide transport for victims/ ffective links with utility E casualties companies rovide timely warnings P anagement of potential M and advice to the public (immediate vicinity and beyond public order problems as necessary) onsider evacuation C (immediate vicinity and beyond as necessary) onsider utility shutdown C onsider public order C onsider hospital defence (self C presenters)

MS-messages S rovision of survivor reception P se of media (television, radio) U centre

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4. ADDITIONAL/SPECIALIST SUPPORT: Alert specialists, notify appropriate authorities, integrate specialist advice and resources Procedure Capability Equipment
Notification: otify appropriate authorities N at local, regional and national level (governmental and responder agencies) L re-agreed responsibilities for ist of notifications (specialists P etc) for mobilising centres notification

nformation technology I cientific support (chemical, S biological, radiological/nuclear, irect telephone lines D otify specialists (chemical, N medical) eographical information G biological, radiological/nuclear, ocal, regional, national L (maps) medical) response plans esponse plans for specific R onsider international support ethods to request regional, C M risks and conventions (IAEA, WHO, national and international ransport of specialists T OPCW) support rovide situation reports to all ilateral agreements (cross P B notifications border assistance) ethods to transport M specialists to required location Assessment: repare impact assessment P (en-route/on site) stablish effect on population E stablish effect on critical E infrastructure stablish effect on E environment rediction (dispersion P modelling) lan for short, medium and P long term actions and effects nalyse samples A nowledge of critical K infrastructure locations etection, Identification D and Monitoring Equipment (for personnel, boundary monitoring and analysis) eographical information G (maps) esponse plans for specific R risks ritical infrastructure site C locations azard Prediction tools H eteorological equipment M

P arry out incident specific and re-established agreement to C augment resources (private environmental sampling industry, public service, azard prediction H international aid/support) ispersion modelling D adiation monitoring R onsider emergency provision C requirements for immediate

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4. ADDITIONAL/SPECIALIST SUPPORT: (continued) Alert specialists, notify appropriate authorities, integrate specialist advice and resources Procedure Capability Equipment
and wider area ssess resource requirements A (short, medium and long term) Integration of support: pecialist advice and/or S additional resources to be incorporated into incident plan ommon command system C and structure elfare and accommodation W for responders rovision of food and drink, P administration facilities, sleeping accommodation for responders and supporting resources

Substance identification: ubstance confirmation S Victim/casualty support: rovide information to P hospitals rovide clinical P countermeasures P irst aid and treatment centres re-identify potential F accommodation ost incident clinical counter P measures rophylactics etc P nformation technology I edicated telephone numbers/ D lines rovision of food and drink, P sleeping accommodation and administration facilities for victims dditional analysis capability A esignated laboratories D

ost incident medical care P rovide information to General ufficient numbers of trained P S Practitioners personnel to provide (short rovide health surveillance P medium term) medical (short-medium term) support, casualty bureau staff rovide emergency P accommodation stablish casualty bureau E Information to public:

mplement communication plan re-agreed communication plan repared literature I P P rovide timely warnings or P advice to public rovide regular updates P rovide health advice to public P MS-message S re-agreed advice (what to do, se of media (television, radio) P U where to go, what to expect etc) re-agreed communication P channels/method ebsite W

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Procedure
Site decontamination/ restoration and remediation: econtaminate responder D vehicles/equipment econtaminate hospitals D ecover and decontaminate R contaminated bodies econtaminate/restore D affected buildings

Capability

Equipment

nvironmental impact E assessment

etection, Identification and D Monitoring Equipment

eclared environmental/ D pecialist equipment and S infrastructure decontamination personnel to decontaminate capability large sites ortuaries for contaminated M bodies ersonnel and equipment to P remove contaminated waste/ rubble

egal powers of L enforcement regarding building and environmental econtaminate and remediate D decontamination impact on environment ffective staged E ispose of medical waste D implementation plan ispose of site waste/rubble D ass fatality plan M ody identification B aste/rubble removal W Post incident and long term considerations: rovide multi-agency P debriefings for all responders rovide psychological P counselling for victims and responders rovide long term health P monitoring (victims and responders) ritical incident debriefing C sychological counselling P (responders, victims, affected population) arge scale health monitoring L iaison with family L ong term accommodation L inancial assistance for victims F

etwork of counsellors N ealth monitoring facilities H emporary/permanent T accommodation und raising facilities F

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Notes
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Civil Emergency Planning, Operations Division - NATO International Staff Tel : + 32 2 707 5117 Fax : +32 2 707 7900 Email : cepd@hq.nato.int EADRCC, Operations Division - NATO International Staff Tel : + 32 2 707 2670 GSM : +32 475 82 90 71 Email : eadrcc@hq.nato.int

1196-07 NATO GRAPHICS & PRINTING