HHS Resources for Response and Management of Fourth Generation Agents

PUBLISHED: Jan 28, 2019
Relevant to: All Healthcare Organizations

The U.S. Department of Health and Human Services (HHS) recently released resources to assist the emergency response community prepare for and respond to a fourth-generation agent (FGA) incident if one ever occurs in the U.S. These resources have been developed to meet the needs of U.S. emergency response professionals and provide them with more information about the agent used in the U.K. last year. The intent is to assist emergency response professionals understand these fourth-generation agents, learn how to protect themselves and respond if such incidents ever occur in their communities.

Note that no illicit use or manufacture of an FGA or other nerve agent is known to have occurred in the United States (U.S.), and there is no known threat of any nerve agent use in the U.S. at this time.

Fourth-generation agents, also known as Novichoks or A-series nerve agents, belong to a category of chemical warfare agents that are unique organophosphorus compounds. They are more persistent than other nerve agents and are at least as toxic as VX. While fourth-generation agents share similar characteristics with other nerve agents, fourth-generation agents also pose several unique challenges in terms of toxicity, detection, persistence, and potential for delayed onset of symptoms. The following resources were developed to address these characteristics and challenges and provide tailored guidance to various segments of the emergency response community:

  • Safety Awareness for First On-Scene Responders Bulletin – Designed to educate and prepare first responders for situations when law enforcement, fire, and emergency medical services (EMS) personnel are first to arrive on scene and initially may be unaware that a fourth-generation agent is present. This bulletin will assist departments and agencies develop specific guidance and training to enhance overall preparedness efforts.
  • Reference Guide – Designed to educate and prepare hazardous materials (HAZMAT) response teams, the guide includes chemical and physical properties of fourth generation agents, as well as detection, firefighting, personal protective equipment, and decontamination recommendations for situations when responding to a known or suspected fourth generation agent incident. This guide will assist HAZMAT response teams develop specific guidance and training to enhance overall preparedness efforts.
  • Medical Management Guidelines – Designed to educate and prepare fire, EMS, and hospital staff and guide the medical management of patients exposed or potentially exposed to a fourth-generation agent.

Included with today’s notice is a Nerve Agent Fact Sheet. Additional notices will address medical management of FGAs in more detail.

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