BRNE refers to a group of disasters caused by chemical, biological, radiological, nuclear, and explosive incidents. The term “CBRNE” is derived from the first letters of each type of hazard:
- C (Chemical): Incidents involving chemical terrorism or industrial accidents.
- B (Biological): Incidents involving biological terrorism or outbreaks of infectious diseases.
- R (Radiological): Incidents involving radioactive materials, such as in the case of a radiological weapon or nuclear power plant accidents.
- N (Nuclear): Incidents involving nuclear weapons or related terrorism.
- E (Explosive): Incidents involving explosives, either from terrorist attacks or industrial accidents.
Activities and Procedures
Initial Detection
When a 119 emergency call reports any of the following, suspect a CBRNE disaster:
- Numerous victims with symptoms like eye and nose irritation or coughing.
- Witnesses have seen chemicals or biological agents being dispersed.
- Plastic bags or containers, possibly containing chemicals, are found at the scene.
If a CBRNE incident is confirmed, immediately contact the Japan Poison Information Center and the police. Ensure that the fire department is on alert, and if your team cannot handle the situation alone, request support from other fire departments.
Arrival at the Scene
Upon arrival, the commander must consider wind direction and speed and instruct the team to park vehicles upwind and in an area where air stagnation is minimal. Vehicles should be positioned at least 120 meters upwind from the disaster site, with windows closed and air conditioning turned off.
To confirm wind direction, use a smoke flare at the scene. Collect information on the hazardous materials from witnesses or involved parties, including:
- The number of victims and their symptoms.
- The type and quantity of hazardous materials present.
Establishing a Controlled Area
Before setting up zoning, ensure a safe area is identified. Perform a basic detection activity to distinguish between hazardous and safe zones.
Procedure:
- At least two team members in Level A protective suits conduct the detection.
- Use detectors to identify a clear area free of hazardous materials and establish a boundary line.
- Clearly mark the controlled area boundary with cones or signs.
- Extend hoses for water decontamination.
Zoning
In response to CBRNE incidents, divide the scene and surrounding areas into three zones:
- Hot Zone: The area where hazardous materials are present. Direct contact with these materials is likely, requiring Level A chemical protective suits.
- Warm Zone: An area where contaminated individuals or objects may be present. Personnel must wear Level B PPE. Triage and decontamination are performed here.
- Cold Zone: A safe area isolated from the hazard. Personnel in this zone follow standard precautions (Level D). This zone houses hospitals, support facilities, and command posts.
These zones are set concentrically around the disaster site.
Hot Zone Operations
The primary objective in the Hot Zone is to evacuate victims quickly. Operations in this zone require at least three people.
Rescue Operations:
- The team leader guides the members and ensures safety while using a basic detector to assess the situation before approaching victims.
- At least two people carry victims on a stretcher.
- Cover the victim’s nose and mouth with tissue to check their breathing.
- Air cylinder changes must occur after decontamination in the Cold Zone.
- If there are many victims, consider a quick evacuation strategy called “short pickup.”
After the rescue operations, remove any hazardous materials.
Hazardous Material Removal:
- If hazardous materials are identified, cover them with plastic.
- If the incident is indoors, turn off air conditioning and close windows.
Warm Zone Operations
Teams in the Warm Zone wear Level B protective suits and perform initial triage and decontamination.
Primary Triage:
The START method is not used. Victims are classified into five categories:
- Unable to walk
- Ambulatory male (wet decontamination)
- Ambulatory male (dry decontamination)
- Ambulatory female (wet decontamination)
- Ambulatory female (dry decontamination)
Decontamination:
Set up a decontamination station at the boundary between the Warm and Cold Zones.
For Ambulatory Victims:
- Remove clothing, as this eliminates over 80% of contaminants.
- Provide a mask and place valuables in a plastic bag.
- Use soap and water with a sponge to wash the entire body, ensuring eyes and mouth are closed, and nails are cleaned.
- Rinse with water for wet decontamination, especially for chemicals on the skin.
- Dry with a towel and provide clean clothing and footwear before moving the victim to secondary triage.
For Non-Ambulatory Victims:
- Cut and remove clothing with scissors.
- Provide a mask and place valuables in a plastic bag.
- Wash the entire body with soap and water, ensuring eyes and mouth are closed, and nails are cleaned.
- Use a stretcher and a roller system to rinse with water for wet decontamination.
- Dry the entire body with a towel.
- The team in the Cold Zone transports the victim to the secondary triage post.
Cold Zone Operations
In the Cold Zone, personnel with Level C or D protection perform public relations, evacuation guidance, secondary triage, and emergency response.
Evacuation Guidance:
- Collaborate with the police, using public address vehicles and loudspeakers to instruct people to evacuate the danger zone.
- Prioritize communication with hospitals and childcare facilities.
Secondary Triage:
- Use triage tags.
- Paramedics and doctors collaborate to categorize victims based on their conditions.
Classification of Protective Measures
Level A:
Wearing a full-body chemical protective suit and using a self-contained breathing apparatus for respiratory protection.
Level B:
Wearing a chemical protective suit and using either a self-contained breathing apparatus or an oxygen breathing apparatus for respiratory protection.
Level C:
Wearing a chemical protective suit and using either a self-contained breathing apparatus or a gas mask for respiratory protection.
Level D:
Wearing clothing for firefighting activities, not a chemical protective suit.
Gesture Signals
When wearing protective suits, voice communication may be difficult, so it’s important to know the following gesture signals:
Calling Someone (When They Are Close):
Strongly tap their shoulder.
Calling Someone (When They Are Far Away):
Beckon them with both hands.
Abnormality in Breathing Apparatus:
Point to your throat and make an “X” sign.
Abnormality in Radio:
Point to your ear and make an “X” sign.
Damage to Protective Suit:
Point to the damaged area and make an “X” sign.
Emergency Evacuation:
Repeatedly point in the direction of evacuation.
Regular Evacuation:
Move your finger from your chest toward the evacuation direction.
Emergency Situation at a Dangerous Location:
Point to the dangerous area and make an “X” sign.
Checking Remaining Air Pressure in Breathing Apparatus:
Point to the other person’s pressure gauge and then look at your own.
Acknowledgment (When Close):
Give an “OK” sign.
Acknowledgment (When Far):
Make a circle with both hands.
Emergency Response Checklist and Forms
Pre-Deployment Measures:
- □ Ensure extra equipment is loaded, such as air cylinders, chemical protective suits (including positive pressure chemical suits), detection devices, and decontamination equipment.
- □ Check wind direction and speed, terrain, building conditions, the size of the team, activity space, and water supply locations.
- □ Use maps and other tools to confirm the route.
- □ Ensure all team members are properly protected.
- □ Identify safe locations for deployment, preferably upwind and at least 120 meters away from hazardous substances.
In-Transit Measures:
- □ Start up detection devices during transit.
- □ Obtain details about the current location of the informant, the situation at the scene, and the events leading up to the incident.
- □ Look out for unusual situations such as people collapsing or strange odors, and report them.
- □ Stay updated on any changes to the deployment location, wind direction, etc.
- □ Close windows, turn off the air conditioning, and switch to internal air circulation.
On-Scene Arrival Measures:
- □ Quickly make contact with the informant and gather information.
- □ Report the positions of the vehicle and any incoming units.
- □ Report any unusual conditions like collapsed people or strange odors.
- □ Use tools like windsocks or flares to confirm wind direction.
Information Gathering:
- □ Use your senses and information from the informant, labels, and materials like yellow cards to gather and report the following:
- □ The exact location of the disaster and the condition of buildings.
- □ The number and symptoms of those needing rescue or medical assistance.
- □ Check for any strange smells.
- □ Confirm if there is damage from hazardous substances and assess the risk of it spreading.
- □ Identify the hazardous material, its properties, and any leaks.
- □ Check if residents or employees have evacuated.
- □ Confirm the emergency measures taken by those involved and their effectiveness.
- □ Check the status and operation of firefighting equipment.
- □ Assess the condition of electrical and substation equipment, leak detection, inert gas firefighting systems, etc.
- □ Identify areas of concern for firefighting activities (e.g., areas at risk for water damage, collapse, or restricted entry).
- □ Collect any other information vital for firefighting.
Setting Up a Safety Perimeter:
- □ Consider the scale of the team and future activities, like setting up decontamination stations or ambulance operations, and ensure adequate space.
- □ Clearly mark the outer perimeter with signs, etc.
- □ Work with police to enforce the perimeter.
- □ Instruct non-symptomatic pedestrians and residents, with police assistance, and ensure the area within the perimeter is secure.
Setting an Access Control Line:
- □ Until the boundary between the warm and cold zones is clear, set up an access control line at a safe location, typically more than 120 meters upwind from the hazard.
- □ Mark the line clearly with ropes, signs, etc.
Simplified Detection Activities:
- □ Use devices for detecting chemical agents, biological agents, radiation, personal dosimeters, flammable gases, oxygen levels, and toxic gases.
- □ At least two team members, protected with Level A suits, should conduct detection activities.
- □ Work with police, health departments, and other relevant agencies if they have detection equipment.
- □ Report detection results to the on-site command post for each location.
- □ Provide information to police, the Poison Control Center, health departments, medical facilities, etc.
Emergency Evacuation:
- □ If any of the following occurs during detection, move to a safe location immediately:
- □ Tear or damage to protective suits.
- □ Malfunction of air breathing apparatus.
- □ Injury or accident during activities.
- □ Failure of detection equipment.
- □ Sudden increase in radiation levels.
- □ Activation of personal dosimeters.
- □ Detection of high concentrations of flammable gases (over 30% of the lower explosive limit).
- □ Advice from experts or authorities.
- □ Any other abnormal situations.
- □ If high concentrations of flammable gases are detected, evacuate. If rescue operations or other essential activities must continue, take the following safety measures:
- □ Wear fire-resistant clothing over chemical protective suits (note: positive pressure chemical protective suits are not fire/explosion-proof).
- □ Prevent static electricity (e.g., wet protective suits and fire-resistant clothing).
- □ Avoid operating spark-generating equipment (e.g., radios, lights).
- □ Disperse flammable gases to prevent explosions (e.g., water misting, ventilation).
- □ Ensure backup water spraying readiness.
Zone Setup (Zoning):
- □ Before identifying the hazardous substance:
- □ Mark the outer perimeter of each zone clearly with signs, etc.
- □ If the incident is underground (e.g., subway), set up the hot zone at entrances, ventilation shafts, etc., to contain the spread. If the hazard is inside a facility and no people are inside, consider sealing it off. For acts of terrorism involving air conditioning systems, set up the hot zone downwind outdoors.
- □ Set up upwind from the incident site.
- □ After identifying the hazardous substance:
- □ Adjust the boundaries as needed based on the evolving situation and the properties of the identified substance.
- □ Use resources like the Emergency Response Guidebook (ERG 2016) for chemical incidents.
Rescue Activities:
- □ A minimum of three members should carry out rescue activities, with at least one guiding and managing safety and two carrying a stretcher.
- □ Keep at least two team members in Level A protection on standby.
- □ Track and report the duration of activities.
- □ Immediately report any discovered victims to the command post.
- □ Swap out air cylinders for self-contained breathing apparatuses in the cold zone.
Hazard Elimination:
- □ If feasible, cover hazardous materials with plastic, etc., or place them in sealed containers.
- □ Take care not to interfere with the subsequent police investigation.
- □ Ensure that samples are securely sealed.
- □ Use specialized equipment like bio-agent collectors in case of biological agent attacks.
Guiding Exposed Individuals:
- □ Guide those possibly exposed in the hot zone to the gathering area.
Gathering Management (Biological Disasters Only):
- □ If a substance is identified as a biological agent, treat everyone in the building or outdoor area as exposed. Keep them gathered until an epidemiological investigation is conducted by a doctor or health official, except for those already showing symptoms.
- □ Instruct individuals to cover their mouths and noses with towels or handkerchiefs.
Primary Triage:
- □ In principle, do not use triage tags or the START method.
- □ Distinguish between those who need immediate decontamination for lifesaving purposes and those who can be decontaminated efficiently at the decontamination site.
- □ Divide individuals into categories such as “non-ambulatory exposed,” “ambulatory males (for wet decontamination),” “ambulatory males (for dry decontamination),” “ambulatory females (for wet decontamination),” and “ambulatory females (for dry decontamination).”
- □ Set the gathering point upwind from the hot zone and clearly mark it with signs or designate a location with identifiable landmarks.
- □ Divide the gathering area into sections for symptomatic and asymptomatic individuals.
Decontamination Activities:
- □ Use methods like wiping, dry sand, disrobing, and water decontamination.
- □ Decontaminate exposed individuals as needed.
- □ Ensure the decontamination of all team members and used equipment.
- □ Properly manage and treat contaminated wastewater.
Public Information and Evacuation Guidance:
- □ Use public address vehicles, loudspeakers, etc., to direct people to evacuation locations and instruct them to leave the cold zone (fire safety perimeter).
- □ Give special attention to vulnerable facilities like hospitals, nursing homes, and daycare centers.
- □ Tell individuals who may have been exposed to cover their mouths and noses with towels or handkerchiefs.
- □ Direct anyone who evacuated from the hot zone without undergoing primary triage to the decontamination site.
- □ Guide non-symptomatic individuals in the cold zone (excluding those evacuated from the hot zone) to the secondary triage post and instruct them to leave the fire safety perimeter after being observed.
- □ Advise individuals who were outside the cold zone and later feel unwell to go to a designated hospital.
Secondary Triage:
- □ Coordinate with doctors and other medical personnel to tag and assess the severity of symptoms for injured individuals.
- □ Use protective clothing, gloves, and masks (N95 equivalent or better).
Emergency Medical Activities:
- □ Take measures to prevent the spread of contamination from injured persons and vehicles.
- □ Ensure proper ventilation in ambulances during chemical incidents.
- □ Stop ventilation fans, air conditioning, etc., inside ambulances during biological disasters.
- □ Ensure that responding team members receive medical evaluations.
If the First Response Team is at Level D:
- □ Position vehicles in a safe area, typically 120 meters or more upwind from the hazardous location.
- □ Provide a report on the surrounding situation (e.g., collapsed individuals, strange odors).
- □ Lay out hoses as needed.
- □ Make contact with the informant to gather necessary firefighting information.
- □ Establish a safety perimeter for the firefighting area.
- □ Establish the access control line as needed.
- □ Assist in public information dissemination and guide evacuations.
