If they are equal (for example a generic message like "Are you sure?") then it's almost like no confirmation, because people get trained to click it automatically.
I think that ideally each one must have a "nice" image about the alarm, that is very different from the other images.
Another possibility is to force the user to retype the message, so the user must read and understand the actual message to be send. (Remember to disallow cut and paste.) (Allow a small number of typos, perhaps a Levenshtein distance of 4 or 5, because the user will be probably nervous if there are some incoming missiles.)
Simple: you don't put the button behind the cover, you put the media with the scary message behind it. Then you can test the whole transmission system with less chance for mistakes.
Ironically, this was exactly the solution to the last big EBS failure, the "code word hatefullness" incident in 1971. Back then an operator had to load a tape into the transmitter, but one day he loaded the wrong one because the real and test tapes were stored next to each other. After the incident, they moved the tape to a different location:
http://conelrad.blogspot.com/2010/09/code-word-hatefulness-g...
> …In the past three tapes, one for the test and two for actual emergencies, were hanging on three labeled hooks above the transmitter… In the future only the test tape will be left near the transmitter. The two emergency tapes [will be] be sealed in clearly marked envelopes and placed inside a nearby cabinet.
If I had a bitcoin for every time someone clicked through the confirm dialog without looking...