NEHA Attends CSEPP Training.

A disgruntled hospital employee slipped into his former workplace with a nondescript briefcase. He left it behind after sabotaging machinery from another department. Soon, vapors hissed from the briefcase and medical staff and patients alike fell to the ground in spasms and pain.

The 911 call came quickly afterwards. Walkie-talkies chirped and squealed as primary responder forces from various agencies arrived on scene.

"Are the HAZMAT people inside?" a sheriff yelled.

"No, where's the DECON team!" another replied.

"The wind is shifting. I repeat, the wind is shifting," a voice on the radio crackled.

Confusion reigned as the wind shifted and emergency personnel fell in droves before the spreading nerve agent vapors.

As this tabletop exercise continued for another hour (see photo above), the NEHA staff and membership in attendance realized that the recent Chemical Stockpile Emergency Preparedness Program (CSEPP) was providing a great base of information and protocols for responding not only to a Chemical Stockpile Program emergency, but also to local acts of chemical terrorism.

We were in Pueblo, Colorado, for CSEPP training designed to educate and prepare medical support providers, nurses, physicians, and other primary responders who might be called on in the event of an accidental chemical agent release from a stockpile site. Pueblo is home to the Pueblo Chemical Depot, which is one of eight chemical weapon storage sites in the continental United States and houses 2,611 tons of the chemical blister agent mustard in the form of 780,078 safely stored weapons. Congressional legislation passed in 1986 has slated all chemical stockpiles for destruction. The goal is to avert potential danger to humans and the environment from aging chemical weapons that were stored after the ban on their production in 1969.

The CSEPP training covers several issues. First, the Chemical Stockpile Disposition Program is explained in totality, and the status of disposal at each site is accounted for. Furthermore, the training covers the entire range of health issues associated with chemical weapons, educating attendees on the clinical symptoms of exposure and the therapeutic interventions required to save lives. Special consideration is also given to performing triage among victims of a chemical release, handling scenes of mass casualties, and the importance of emergency management applications.

After a day of watching graphics-packed PowerPoint presentations and listening to dynamic speakers, the NEHA staff and members were required to use the information they had learned in a tabletop exercise. A mock city was constructed on top of several tables, complete with small cars, hospitals, and skyscrapers. Wearing vests labeled with roles such as EMS, Sheriff, HAZMAT, and Incident Command Team--and holding live walkie-talkies--the entire seminar audience reacted to an event playing out on the tabletop in front of them.

"The largest benefit of the training is that it brings all the agencies together to train and learn what each agency does and what roles they play in a disaster," says James Cody, CSEPP medical coordinator/trainer for the Pueblo City-County Health Department. Cody organized the training opportunity and helped oversee the tabletop scenario. He also works as a medical and HAZMAT evaluator for the Federal Emergency Management Agency (FEMA) and in this capacity travels all the country doing training.

Although CSEPP's preparedness and response training comes to many cities and regions, many people don't take advantage of this resource. "The most difficult part is getting administrators to participate," says Cody. "I travel all over the country, and most states have the same attitude: 'It will never happen here!' Most health departments don't fully realize the major roles they will play in the event of a chemical or biological release."

The CSEPP lectures and lifelike drills do require an investment of time and energy The benefit, however, is substantial: improved protection of public health through effective response to chemical emergencies.

Readers who are interested in CSEPP training can contact James Cody at [phone] or visit the CSEPP Web site at [less than]http://cseppweb-emc.ornl.gov/[greater than].