WASHINGTON, D.C. -- The most streetwise EMTs, paramedics or firefighters are great at what they do because they've seen it or handled it before.

That's why it's essential they know what to do and remain calm when they get the call for a "dirty bomb" or radiological threat, Dr. Jeffrey Runge said Wednesday, addressing the 2009 Radiological Threat Summit.

Runge, who recently stepped down as the nation's first chief medical officer of the Department of Homeland Security, said it has bothered him that the people on the front line -- EMS, firefighters and police officers -- have not been part of the planning or training process.

Anxiety sets in for everyone when they encounter an uncommon situation especially one that involves a possible radiological threat.

The conference -- sponsored by Radiological Threat Awareness Coalition (R-TAC) --attracted a number of the country's experts in nuclear medicine, homeland security and other related disciplines.

Runge said First Responders set the tone. "The public expects them to know what to do," he said, adding that it's imperative that they be prepared and have the tools to do just that.

"First Responders need to respond fearlessly and prudently."

The former NHTSA Administrator said while it's not in the news daily, there are still enemies out there who want to harm us. And, he said it will occur when we are most vulnerable.

The threats are real and possible, and terrorists may strike at anytime, anyplace not just at power plants.

Without awareness, training and equipment, First Responders will run. "It's a very, very scary thing."

Runge said responders are taught that it's essential that they not become victims. That's why they must don proper gear to protect their eyes and skin, as well as breathing apparatus.

If, during their operation, they get word that it may involve a radiological threat, Runge said they do not need to paralyze their response. Instead, he said the trained, well-equipped personnel will adjust plans accordingly.

What's scary is that many responders don't know who their local radiation safety officer is. The time to get to know that person, their capabilities and resources is before an event not during it, said Runge, a former emergency medicine physician.

First Responders who have the proper tools and equipment, and have been involved in awareness, planning and training won't run when they get the dispatch for an incident involving a possible "dirty bomb."