The murder of Kim Jong-nam in Malaysia with nerve agents and the gas attacks at Khan Sheikhoun in Idlib, Syria, are gruesome reminders of the dangerously toxic world we live in. Toxic incidents are on the rise and there is a need to plan prevention and response measures with care. An incident (accident or terrorist attack) involving the use of CBRN materials, could inflict large numbers of casualties. It is well recognised that the multi-agency response to a CBRN incident will be challenging, particularly as it is likely to involve:
- high threat scenarios
- multi-agency resources
- several municipal districts/police force areas
- overwhelmed medical services
- intense political and media interest
- a long lasting impact upon communities
It will therefore require a dynamic and joint approach by the emergency services and other agencies to deliver an effective response.
CBRN Incident Response Stages. CBRN response can be large, complex operations. The following stages may be used to understand the overall flow of operations:
- The Preparatory Stage precedes an incident occurrence. This period is devoted to planning, training and equipping the response teams. Optimal training of all responder agencies for various contingencies is essential.
- The Recognition Stage involves discovery of an incident. An on-site emergency unit at the affected site may have resources to minimize the immediate impact on occupants. Activation of local emergency response initiates the response stage. Skilled CBRN Response teams may be required to manage the incident.
- The Response Stage usually begins with emergency control room receiving the call. In some cases this phase may begin simply with first responders arriving on-scene. The focus of this stage is to save lives and prevent escalation of the incident. It would
involve casualty evacuation and isolation of the area.
- The Intervention Stage involves specialists and technicians who will conduct detection, identification, investigation, and intervention, as required. This is an important stage where specialist technicians are deployed. Decontamination operations and Triage would be undertaken by these specialists.
- The Recovery Stage includes ongoing retrieval, monitoring, site remediation, and criminal investigations. Multiple Government agencies and even NGOs may be involved in this stage.
Response Plan. A National CBRN Response Plan must be developed to cater for all contingencies. This Plan should flow from the National CBRN Strategy. The Response Plan must be exercised for all contingencies. Normal practice would be to develop the plan in consultation with all the CBRN stakeholders. Thereafter, a Table Top Exercise (TTE) be held at the CBRNe Response Team level to validate the plan. Once a reasonable confidence is established, mock drills be conducted to further validate the response plan and ensure seamless operations by the CBRNe Response Team. Regular mock drills are needed to keep personnel trained and hone responses.
Response. The response to a CBRN incident begins with the victims and others in the vicinity. These are the actual First Responders. This includes bystanders, volunteers and local police personnel. Immediate actions to mitigate effects of the toxic release and measures to prevent casualties will result in less fatalities. Thus public awareness of basic dos and dont’s in a CBRN incident is very important.
Skilled First Responders are the CBRN Response Teams. These would reach the site after the information/alert is sounded and would depend on transportation, number of affected sites and distance from their location to the site(s). Such response teams would be trained and equipped for structured response actions at the incident site. The Key Response Tasks are:
- Personal Protection
- Control of Situation, isolation and escalation prevention
- Casualty Management
- Seek Additional Resources and specialist support
Incident Command System (ICS). It has been observed that in times of a CBRN incident, apart from lack of resources, lack of coordination among various agencies and an absence of role clarity amongst various stakeholders pose serious challenges. If the response is planned and the stakeholders are trained, there will be no scope for ad-hoc measures and the response will be smooth and effective. For this, it is important to establish an Incident Command System which is recognized by all and approved by the Government.
The ICS is a flexible system and all its Sections need not be activated in every situation at the same time. Only required sections may be made operational as and when required. This system envisages that the roles and duties of various stake holders shall be laid down in advance, the personnel earmarked and trained in their respective roles and duties. The ICS also lays down the chain of command and interoperability amongst the stake holder agencies during different stages of the response operation.
Operational Interoperability. Operational interoperability is essential among the various arms of CBRN response. Detailed instructions contained in the ICS give out the extent to which organisations can work together coherently through:
- Shared concepts and common doctrine (a common set of operating principals or guidance).
- Unified command (clarity of who is in charge of what, when and where).
- Compatible and reliable communication systems.
- Shared language (that ensure common understanding in pressurized operating environments).
- Common equipment and common standards of professional practice.
Response to a CBRN incident is time critical and demands special expertise. Newer threats are emerging at a fast pace. CBRN response teams need to constantly upgrade their skills and knowledge. Contingency planning and sound logistics are needed to support the response plans. In this battle against CBRN threats, we need to be optimally prepared at all times.