Overview of CBRN part 4

Within the CBRN context there are a number of processes which staff should be aware of in order to help ensure their safety and wellbeing.

If you are first on scene of a CBRN incident, consider scene management and use of METHANE report. METHANE is the declaration of a major incident and gives a detailed report that can help organise a multi-agency response. The METHANE report goes as follows:

  • Major incident declared/standby
    • This gives your Ambulance Control Centre the information that you are declaring a major incident, or are putting them on standby for a potential major incident
  • Exact location
    • This gives the exact location of the incident so Ambulance Control and other emergency organisations can start to coordinate, plan, and respond. It may be difficult to give an exact location if not immediately obvious, so consider using a grid reference, landmarks, further apps, or vehicle plotting to help
  • Type of incident
    • This gives the type of incident that is currently ongoing. This helps identify what emergency services are required, what specialist teams can be sent, what resources may be needed, and so forth. Explaining the type of incident can be in simple terms, e.g., terrorist attack using chemical weapons
  • Hazards
    • This again give information and knowledge of what services may be required, and what responders need to be aware of when turning up at scene
  • Access and egress
    • This gives Ambulance Control details of what may be the best access to and from the site, which can then be shared among other emergency services and responders
  • Number of casualties
    • This is a close estimation to the number of casualties you believe are involved in the incident. This helps with organising the number of emergency resources that may be needed
  • Emergency services required
    • This is what emergency services you feel may be required given your first-hand information from scene

Considerations when dealing with a major incident involving CBRN:

  • Safety
    • Consider your own safety throughout the event. It’s easy to be tempted to rush in and help but if you become a casualty, you cannot organise the initial emergency response and coordination needed. In a CBRN incident, specialised PPE above that of standard Ambulance PPE will be needed
  • Location
    • Consider how your location may affect the organisation of the major incident. Are you able to have a good overview of the scene to manage resources and gather information. Consider also the safety of your current location. You may not want to be in clear view if there are people armed with weapons. If it is a CBRN event, you need to try and be upwind from the incident so to stop potential contamination from CBRN substances in the air
  • Zoning
    • Consider what may be the ‘Hot’ zone, where there is immediate danger, ‘Warm’ zone, where the risk of danger still may be possible, and ‘Cold’ Zone, where there is no danger
  • Casualties
    • There may be a large number of casualties/people wanting to approach you. Keep everyone calm and give them reassurance that more help is on the way. Although difficult, you need to keep everyone at a distance from you and the operating area so you don’t become disrupted or even contaminated in a CBRN event
  • Multi-organisational response
    • After declaration of a major incident, further emergency service resources will be quickly arriving on scene. Follow the Joint Emergency Service Interoperability Principles and effectively coordinate and communicate with them to organise your next actions moving forward