Nuclear, biological and chemical (NBC) terrorism counter measures are a major priority with healthcare providers, municipalities, states and the federal government. Significant resources are being invested to enhance civilian domestic preparedness through training in anticipation of a NBC terroristic incident. The key to a successful response, in addition to education, is integration of efforts as well as thorough communication and understanding the role that each agency would play in an actual or impending NBC incident. In anticipation of a NBC event, a regional counter-terrorism task force was established in southwestern Pennsylvania to identify resources, establish responsibilities and coordinate the response to NBC terrorism. Members of the task force include first responders, hazmat, law enforcement (local, regional, national), government officials, health departments, the statewide emergency management agency and the regional poison information center. The poison center is one of several critical components of a regional counter-terrorism response force. It can conduct active and passive toxicosurveillance and identify sentinel events. To be responsive, the poison center staff must be knowledgeable about biological and chemical agents. The development of basic protocols and a standardized staff education program is essential. The use of the RaPID-T (R-recognition, P-protection, D-detection, T-triage/treatment) course can provide basic staff education for responding to this important but rare consultation to the poison center.