Jane's Chem-Bio Handbook: 3rd Edition (United States)

A Complete Resource for Chemical and Biological Emergency Response

The depth and breadth of information covering

• chemical agents
• biological agents
• potential scenarios
• victim symptoms
• decontamination
• scene control

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Jane’s Chem-Bio Handbook provides detailed information to support development of emergency procedures and design relevant drill and exercise scenarios. While written specifically for training to respond during chem-bio terror attacks, the emergency response information also applies to potential industrial releases of chemical and biological agents making the Handbook useful as a supplement to all hazardous materials emergency planning and training.

The depth of detail and background information contained in the Handbook makes it a logical choice as a classroom text for training first responders and emergency management support personnel. Jane’s Chem-Bio Handbook covers classroom training topics such as

• threat assessment
• site vulnerability
• medical response considerations
• strategic planning considerations
• incident command structure
• actions upon arrival at the incident site
• site management and set-up procedures
• site boundaries diagram for open area attack and closed area attack
• zones of operation - hot, warm, cold
• crowd control procedures and public reassurance
• biological agent effects
• chemical agent effects
• treatment

The Handbook is sized, tabbed, and bound so that it can easily be taken into the field. Even with detailed planning and regular exercises chem-bio emergency response often requires managing unplanned for conditions. Jane’s Handbook can provide incident command and off-scene support with critical information covering topics such as

• decontamination
• agent characteristics
• symptoms casualties may present on scene
• initial actions and treatment
• cold zone triage
• scene control

The comprehensive and versatile Jane’s Chem-Bio Handbook is a training resource no emergency planning and response organization should be without. We offer volume pricing options making the Handbook a cost effective option for classroom training, first responder use, and emergency operations support.

TABLE OF CONTENTS

CHAPTER 1: PRE-INCIDENT PLANNING

1.1 Assessing the threat - basis for response planning involving chemical and biological hazards
1.2 Site vulnerability - use of FEMA and DHS criteria for vulnerability assessment and prioritization
1.3 Medical response considerations - steps for establishing medical facility capacity and capabilities following chem-bio hazard incident
1.4 Strategic considerations - chemical and biological incident coordination with multiple first responders and federal organizations
1.5 Response planning - steps to establish chem-bio incident response system
1.5.1 Plan scenarios - descriptions of types of incidents for emergency planning
1.5.2 Tactical considerations and on-scene communication - description and possible solutions for on-scene and command problems
1.5.3 Personal Protective Equipment (PPE) - planning points regarding PPE limitations and expectations
1.5.4 Decontamination planning - factors for effective decontamination in response to chemical or biological attack or incident
1.6 Detection, identification and monitoring equipment - points for assuring effective use of chemical and biological agent monitoring equipment
1.6.1 Chemical materials - monitoring equipment planning and preparedness actions
1.6.2 Biological materials - limitations of monitoring equipment for biological threats
1.6.3 Ancillary equipment - list of general equipment for use on scene
1.7 Training and exercises - list of first responder core skills for chem-bio incident response
1.8 National Incident Management System (NIMS) - describes Incident Command System (ICS), standard emergency response terminology, and reporting
1.9 Pre-incident checklist - specialist chem-bio response team requirements

CHAPTER 2: ON-SCENE PROCEDURES

2.1 Initial response procedures - issues to consider when developing procedures for initial response to potential chemical or biological hazard incident
2.2 Situation reports - list of information first responders should gather and report
2.3 Victims - points for first responders dealing with victims on scene
2.4 Chemical incidents - factors to consider when initially responding to a potential chemical hazard incident
2.5 Chemical indicator matrix - technique for best approximation of chemical agent used
2.6 Biological incidents - initial concerns for potential biological agents
2.6.1 Prior to arrival - points to address when potential chem - bio incident is reported to minimize contamination and control potential crime scene
2.7 Arrival at the incident site - initial concerns and goals when responding to biological incident or chemical incident
2.8 Site set-up - actions for first responders establishing scene control
2.8.1 The incident site - general criteria for initial site control and alternative command locations
2.8.2 Site management - steps for effective site management and control
2.8.3 Site set-up procedures - factors determining steps for site control during initial response
2.8.4 Site boundaries diagram – open area - common layout of site for open air incident
2.8.5 Site boundaries diagram – closed area - common layout of site for contained hazards
2.8.6 Set-up of site diagram - identifies activities that occur in each zone of site and general distances
2.9 Zones of operation - concerns, controls, activities in each zone of incident area
2.9.1 The hot zone - factors to consider and controls when setting boundaries for hot zone
2.9.2 The warm zone - factors to consider and controls when setting boundaries for warm zone2.9.3 The cold zone - factors to consider and controls when setting boundaries for cold zone
2.10 Crowd control procedures and public reassurance - duties of law enforcement personnel and victim concerns
2.11 Cold zone triage - description of actions to assess victims removed from hot or worm zones
2.11.1 EMS personnel - decontamination at medical facilities
2.11.2 Cold zone triage set-up procedures - steps for effective triage once victims exit area
2.11.3 First responder considerations - identifies issues and goals dealing with victims and crime scene
2.12 Decontamination - general dry decontamination and wet decontamination considerations
2.12.1 Unprotected personnel - decontamination steps when no PPE
2.12.2 Personnel in PPE - general steps for decontamination of people with PPE

CHAPTER 3: CHEMICAL AGENTS

3.1 Chemical agent quick reference - table listing effects, decon, first aid etc. for various groups of chemical agents
3.2 General agent properties - chemical warfare (CW) agents use, concerns, and antidotes
3.2.1 Chemical agents: solid, liquid or gas - dispersion characteristics and concerns
3.2.2 Chemical agent persistency - factors and considerations regarding persistence of CW agents
3.2.3 Effects - clinical effects in humans of chemical agents
3.2.4 Early recognition - symptoms first responders may encounter and what to look for during response to chemical agent incident
3.3 Chemical delivery - background of delivery systems to provide understanding of potential scenarios
3.3.1 Weaponization - use of munitions as delivery system for terror attack with chemical agents
3.3.2 Commercial delivery systems - potential dual use or dual purpose methods of chemical agent delivery
3.3.3 Meteorological conditions - discussion of effects of weather on chemical attack
3.4 Nerve agents - symptoms casualties exposed to a nerve agent may present when first responders arrive
3.4.1 Effects of nerve agent liquid on the skin - physical symptoms of victims exposed to varying amounts of nerve agent
3.4.2 Effects of nerve agent vapor - physical symptoms of nerve agents and chemical and physical properties
3.4.3 Nerve agents – early recognition - signs for first responders to look for in victims
3.4.4 Nerve agents – physical examination - observable signs of exposure to nerve agent vapor or liquid
3.4.5 Nerve agent properties - physical characteristics and major effects to victims
3.5 Cyanide - symptoms casualties exposed to cyanide may present when first responders arrive
3.5.1 Effects of cyanide - physical symptoms for exposure to varying amounts of cyanide
3.5.2 Effects of cyanogen chloride - physical symptoms following exposure and physical and chemical properties
3.5.3 Cyanide – early recognition - symptoms expected to be encountered by first responders
3.5.4 Cyanide – physical examination - provides differences in symptoms between cyanide exposure and nerve agents
3.5.5 Cyanide properties - provides legitimate cyanide uses, factors impacting effectiveness in an attack, and sympotoms
3.6 Blister agents (vesicants) - exposure symptoms and chemical and physical properties
3.6.1 Early effects of blister agents - victim symptoms
3.6.2 Effects of Lewisite and phosgene oxime - victim symptoms
3.6.3 Blister agents – early recognition - symptoms expected to be encountered by first responders
3.6.4 Blister agents – physical examination - observable signs of mustard, Lewisite, and phosgene oxime exposure
3.6.5 Blister agent properties - exposure signs and actions for first responders
3.7 Pulmonary agents - exposure symptoms and chemical and physical properties
3.7.1 Effects of pulmonary agents - victim symptoms and timing following chemical agent exposure
3.7.2 Pulmonary agents – early recognition - symptoms expected to be encountered by first responders
3.7.3 Pulmonary agents – physical examination - observable signs following exposure
3.7.4 Pulmonary agent properties - exposure signs, general treatment, and actions for first responders
3.8 Riot control agents - exposure symptoms and chemical and physical properties
3.8.1 Effects of riot control agents - symptoms and timing following exposure
3.8.2 Riot control agents – early recognition - exposure symptoms for first responders
3.8.3 Riot control agents – physical examination - signs to look for if exposed to riot control agents
3.8.4 Riot control agent properties - types and differences between riot control agents and general treatment

CHAPTER 4: CHEMICAL TREATMENT

4.1 Nerve agents - list of first responder actions when dealing with victims exposed to nerve agent
4.1.1 Triage - how to categorize victims as immediate, delayed, or minimal
4.1.2 Antidotes - discusses antidotes for nerve agent exposure and symptom treatment
4.1.2.1 Mild effects - recommended actions based on symptoms indicating mild exposure
4.1.2.2 Moderate effects - recommended actions based on symptoms indicating moderate exposure
4.1.2.3 Severe effects - recommended actions based on symptoms indicating severe exposure
4.1.2.4 Other effects - expected reactions to treatment
4.1.3 Further care - medical facility requirements for nerve agent victims
4.2 Cyanide - list of first responder actions when dealing with victims exposed to cyanide
4.2.1 Triage - how to categorize victims as expectant, immediate, delayed, or minimal
4.2.2 Antidotes - discusses antidotes for cyanide exposure and symptom treatment
4.2.3 Further care - medical facility requirements for cyanide victims
4.3 Blister agents (vesicants) - list of first responder actions when dealing with victims exposed to blister agents
4.3.1 Triage - how to categorize victims as immediate, delayed, or minimal following exposure to mustard or Lewisite and phosgene oxime
4.3.2 Antidotes - antidotes and recovery expectations for blister agent exposure provided
4.3.3 Further care - medical facility requirements for blister agent victims
4.4 Pulmonary agents - list of first responder actions when dealing with victims exposed to pulmonary agents
4.4.1 Triage - how to categorize victims as immediate or delayed,
4.4.2 Antidotes - no antidotes available for pulmonary agents
4.4.3 Further care - medical facility requirements for pulmonary agent victims
4.5 Riot control agents - treatment for eyes, airways, and skin
4.6 Management of chemical casualties - establishes need to assess situation before entering an area with unknown incident causes
4.6.1 Casualty decontamination - CW agent decontamination steps for litter casualties and ambulatory casualties

CHAPTER 5: BIOLOGICAL AGENTS

5.1 Biological agent quick reference - use and effects of various biological agents
5.2 General agent properties - describes general preparation and delivery options and uses and threats for lethal and incapacitating biological agents
5.2.1 Liquid agents - description of liquid formulations
5.2.2 Dried agents - description and properties of dried agents
5.3 Biological delivery - background for first responders and planners to understand possible scenarios
5.3.1 Munitions - describes methods for terrorists to disseminate biological agents using munitions
5.3.2 Delivery systems - possible use of a dual use or general purpose delivery system described
5.4 Meteorological conditions - describes weather and other external effects for open-air targets
5.5 Physics of the primary aerosol - description of munitions dissemination of biological agent
5.5.1 Secondary aerosols - description of conditions needed to create a secondary aerosol
5.5.2 Biological decay in aerosols - identify affected areas using biological decay factors
5.6 Alternative bio-agent delivery methods - hard-to-detect methods for biological agent delivery
5.6.1 Oral - viability of contamination of food or water supplies
5.6.2 Dermal exposure - effectiveness as delivery option described
5.6.3 Vector transmissions - use of carrier such as mosquitoes or fleas discussed
5.7 Biological agent effects - delineates symptoms, incubation period, and treatment for biological agents
5.7.1 Bacteria - description of factors in biological agent event involving bacteria
5.7.1.1 Anthrax - time lags, skin contamination, inhalation, and ingestion concerns presented
5.7.1.2 Brucellosis - likely methods of dissemination and symptoms presented
5.7.1.3 Cholera - water treatment and viability of aerosol delivery presented
5.7.1.4 Glanders - delivery methods, symptoms, and treatments described
5.7.1.5 Melioidosis - attractiveness as biological weapon discussed
5.7.1.6 Plague - symptoms, forms, and viability as a weapon discussed
5.7.1.7 Tularemia, rabbit fever or deer fly fever - presents how infection occurs, symptoms, and delivery methods
5.7.1.8 Typhoid fever - symptoms and delivery options for use as a biological weapon presented
5.7.2 Rickettsia - description of factors in biological agent event
5.7.2.1 Epidemic typhus and endemic typhus - exposure routes, incubation period, and symptoms provided
5.7.2.2 Q fever - delivery method, incubation, symptoms, and diagnosis methods discussed
5.7.3 Toxins - description of factors in terror attack involving toxins
5.7.3.1 Botulinum toxin - potential as weapon, symptoms, treatment, lethality presented
5.7.3.2 Ricin - viability as a weapon, delivery method, symptoms described
5.7.3.3 Saxitoxin - delivery, progression, symptoms, and treatment discussed
5.7.3.4 Staphylococcus Enterotoxin B (SEB) - suitability as biological warfare (BW) agent assessed, symptoms, contamination scenarios presented
5.7.3.5 Trichothecene mycotoxins - use as BW agent, symptoms, lethality covered
5.7.4 Viruses - description of factors in terror attack involving viruses
5.7.4.1 Chikungunya - symptoms of infection and progression of illness described
5.7.4.2 Congo-Crimean hemorrhagic fever - fatality rate and symptoms provided
5.7.4.3 Dengue fever - gives incubation period, symptoms, and treatment
5.7.4.4 Ebola - provides incubation period, symptoms, likelihood of use as BW agent
5.7.4.5 The Marburg virus - history, incubation, potential delivery method provided
5.7.4.6 Junin - incubation, recovery period, progression discussed
5.7.4.7 Rift Valley fever - symptoms, convalescence, weapon use discussed
5.7.4.8 Smallpox - availability, symptoms, incubation described
5.7.4.9 Venezuelan Equine Encephalitis (VEE) - incubation period, symptoms, treatment, past weaponization discussed
5.7.4.10 Yellow fever - recovery period and treatment described

CHAPTER 6: BIOLOGICAL TREATMENT

6.1 Bacteria - points to consider when developing procedures for emergency response
6.1.1 Anthrax - vaccination availability and effectiveness covered along with actions for unvaccinated exposure
6.1.2 Brucellosis - treatment, therapy, managing contaminated materials discussed
6.1.3 Cholera - treatment and vaccination effectiveness covered
6.1.4 Glanders - treatment and contamination management discussed
6.1.5 Melioidosis - decontamination and treatment described
6.1.6 Plague - requirements for effective treatment and decontamination covered
6.1.7 Tularemia, rabbit fever or deer fly fever - treatment options and status of vaccine covered
6.1.8 Typhoid fever - vaccine criteria and treatment discussed
6.2 Rickettsia - points to consider when developing procedures for emergency response
6.2.1 Endemic Typhus/Epidemic Typhus - decontamination method and treatment needs provided
6.2.2 Q fever - treatment and vaccination concerns discussed
6.3 Toxins - points to consider when developing procedures for emergency response
6.3.1 Botulinum toxins - immediate and long term treatment needs noted
6.3.2 Ricin - vaccine availability and contamination management provided
6.3.3 Saxitoxin - caution related to treating incorrectly provided
6.3.4 Staphylococcus Enterotoxin B toxin (SEB) - severity and supportive therapy discussed
6.3.5 Trichothecene mycotoxins - vaccine availability and long-term treatment noted
6.4 Viruses - points to consider when developing procedures for emergency response
6.4.1 Dengue fever - treatment availability and control noted
6.4.2 Marburg - preventing transmission during treatment discussed
6.4.3 Rift Valley fever (RVF) - treatment and care management discussed
6.4.4 Smallpox - vaccination protection discussed
6.4.5 Venezuelan Equine Encephalitis (VEE) - vaccination and supportive therapy discussed
6.4.6 Yellow Fever virus - supportive treatment and vaccination covered
6.5 Management of Biological Casualties - issues with biological attack response identified

CHAPTER 7: POST INCIDENT

7.1 Psychological impact - describes potential impacts from CW and BW events
7.1.1 Psychological impact to Communities - initial impacts as well as long term impacts described
7.1.2 Individual psychological impact - physical, emotional, behavioral, and cognitive changes listed with steps for appropriate intervention
7.2 Maintain the crime scene - steps to preserve evidence on scene while still performing response activities covered
7.3 Conduct an after-action review - topics to cover in team de-briefing
7.4 Implement a public relations plan - established need for PR plan and what information to disseminate
7.5 Post-incident care checklist - steps for successful organization and individual recovery following response
7.6 Community post-incident response checklist - keys to assuring public needs addressed

CHAPTER 8: APPENDICES

8.1 Appendix A: Detection, identification and monitoring equipment
8.1.1 Equipment overview - equipment limitations and steps to assure effective equipment use
8.1.2 Biological detection challenges - problems with identification of biological attack
8.1.3 Equipment technologies - test methods available for biological agent detection and identification discussed
8.1.4 Hand-held equipment - concerns regarding use of hand-held equipment noted
8.1.5 User considerations - questions to identify the suitability of equipment
8.1.6 Available equipment - personal monitors, team monitors, and forensic analysis discussed
8.2 Appendix B: Personal protective equipment - gives benefits of combination respiratory and clothing
8.2.1 Respiratory protection - covers air purifying respirators and SCBA
8.2.2 Air purifying respirators - types available and limitations or points to consider
8.2.3 Self Contained Breathing Apparatus (SCBA) - issues to consider regarding SCBA options
8.2.4 Dermal protection - purpose of skin protection ensembles
8.2.5 Levels of protection (A, B & C) - descriptions and considerations of generally accepted PPE designations
8.3 Appendix C: Decontamination - general information in the event of a chem-bio incident
8.3.1 Location of decontamination site - considerations when located decontamination sites on-scene
8.3.2 Decontamination materials - list of potential supplies for decontamination
8.3.3 Decontamination options - dry and wet decontamination described
8.3.3.1 Physical removal - options to accomplish physical removal
8.3.3.2 Mechanical removal - methods to accomplish mechanical removal
8.3.3.3 Chemical removal - chemical solutions to consider if soap and water ineffective
8.3.4 General decontamination procedures - steps to include in individual decontamination procedures
8.3.4.1 Outer garments and equipment points to improve effectiveness of decontamination
8.3.4.2 Responder decontamination - factors to handle decontaminating responders
8.3.4.3 Ambulatory casualty and self decontamination procedure - steps to perform effective self-decontamination
8.3.5 Non-ambulatory/stretcher patient decontamination - special considerations when casualty is unconscious or unable to move
8.3.6 Transfer to medical facility - considerations if casualty needs to be transported prior to decontamination on-scene
8.3.7 Contaminated clothing and equipment disposal - interim steps to deal with accumulation of decontamination waste
8.3.7.1 Equipment decontamination - long term and short term options for various types of equipment.
8.3.7.2 Care and decontamination of stretchers - decontamination methods based on materials
8.3.8 Verifying decontamination - steps to assure decontamination is effective
8.3.9 Additional considerations - emergency decontamination points to consider
8.4 Appendix D: Phased training guide - criteria to support development of emergency training
8.5 Appendix E: Case studies - chemical and biological agent incident summaries
8.5.1 Chemical case one - self-presenting case at ER
8.5.2 Chemical case two - emergency arrival at hospital
8.5.3 Chemical case three - industrial field scenario
8.5.4 Biological case one - geographically widespread scenario
8.5.5 Biological case two - industrial accident with fatalities
8.6 Appendix F: Glossary of medical terms - terms useful for treatment and response discussions regarding chem-bio incidents
8.7 Appendix G: Precursor chemicals - civil uses for materials used in production of chemical weapons agents