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Devin R DeFeo, Melissa L Givens
The authors would like to introduce TCCC [Tactical Combat Casualty Care] + CBRN [chemical, biological, radiological, and nuclear] = (MARCHE)2 as a conceptual model to frame the response to CBRN events. This model is not intended to replace existing and well-established literature on CBRNE events but rather to serve as a response tool that is an adjunct to agent specific resources.
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Albert Brizio, Jean-Christophe Hubert, Brigitte Hennequin, Jeremy Bouchez, Marie-Clément Kouka
In 2016 France hosted the European football championship. In a context of an increased terrorist threat, Chemical, Bacteriological, Radiological, Nuclear (CBRN) attacks were considered possible. Three days prior to the beginning of the event, the Health Authorities required that a medium sized hospital close to a major potential target, prepare a chemical decontamination centre. Despite a low level of preparedness, little external help, and very few extra resources, an efficient decontamination chain (all premises necessary for the management of contaminated victims: from the entrance gate to the post-decontamination dressing cabins) was set up in 15 days (12 days after the unrealistic deadline)...
February 21, 2018: Disaster Medicine and Public Health Preparedness
Eliezer Be'eri, Simon Owen, Maurit Beeri, Scott R Millis, Arik Eisenkraft
OBJECTIVES: Chemical-biological-radio-nuclear (CBRN) gas masks are the standard means for protecting the general population from inhalation of toxic industrial compounds (TICs), for example after industrial accidents or terrorist attacks. However, such gas masks would not protect patients on home mechanical ventilation, as ventilator airflow would bypass the CBRN filter. We therefore evaluated in vivo the safety of adding a standard-issue CBRN filter to the air-outflow port of a home ventilator, as a method for providing TIC protection to such patients...
February 21, 2018: Disaster Medicine and Public Health Preparedness
Mayumi Kako, Karen Hammad, Satoko Mitani, Paul Arbon
OBJECTIVES: This review was conducted to explore the literature to determine the availability, content, and evaluation of existing chemical, biological, radiological, and nuclear (CBRN) education programs for health professionals. METHODS: An integrative review of the international literature describing disaster education for CBRN (2004-2016) was conducted. The following relevant databases were searched: Proquest, Pubmed, Science Direct, Scopus, Journals @ OVID, Google Scholar, Medline, and Ichuschi ver...
February 19, 2018: Prehospital and Disaster Medicine
Matthew J Maley, Joseph T Costello, David N Borg, Aaron J E Bach, Andrew P Hunt, Ian B Stewart
Objectives: A commercial chemical, biological, radiological and nuclear (CBRN) protective covert garment has recently been developed with the aim of reducing thermal strain. A covert CBRN protective layer can be worn under other clothing, with equipment added for full chemical protection when needed. However, it is unknown whether the covert garment offers any alleviation to thermal strain during work compared with a traditional overt ensemble. Therefore, the aim of this study was to compare thermal strain and work tolerance times during work in an overt and covert ensemble offering the same level of CBRN protection...
2017: Frontiers in Physiology
Luc J M Mortelmans, Menno I Gaakeer, Greet Dieltiens, Kurt Anseeuw, Marc B Sabbe
Introduction Being one of Europe's most densely populated countries, and having multiple nuclear installations, a heavy petrochemical industry, and terrorist targets, the Netherlands is at-risk for chemical, biological, or radionuclear (CBRN) incidents. Recent world and continental events show that this threat is real and that authorities may be underprepared. Hypothesis The hypothesis of this study is that Dutch hospitals are underprepared to deal with these incidents. METHODS: A descriptive, cross-sectional study was performed...
October 2017: Prehospital and Disaster Medicine
Wenli Fang, Beibei Gu, Xiuna Jing, Songhua Xiao, Shengnuo Fan, Wang Liao, Yuqiu Zheng, Jun Liu
Background: Cystic brain radionecrosis (CBRN) is a late-onset devastating complication after radiotherapy for head and neck neoplasms, especially for nasopharyngeal carcinoma (NPC). To our knowledge, it has scarcely been reported. Methods: We retrospectively reviewed all available medical records of NPC patients with CBRN who were treated with surgical intervention. Results: Sixteen patients were identified in this study and the mean latency of CBRN was 9...
June 1, 2017: Japanese Journal of Clinical Oncology
Ilan Gur, Arik Eisenkraft, Ephraim Bar-Yishay
OBJECTIVE: Mobile RTX (MRTX), a portable light-weighted ventilator, provides noninvasive respiratory support using biphasic extrathoracic cuirass-assisted ventilation. Despite the effectiveness of chemical-biological-radiological-nuclear (CBRN) gas masks, they cause respiratory loading as a result of added dead space and resistance. This prospective comparative pilot study was conducted to investigate the safety and efficacy of assisted ventilation provided by MRTX in healthy adult volunteers wearing CBRN gas masks at rest...
March 2017: Military Medicine
J Schumacher, J Arlidge, F Garnham, I Ahmad
Recent incidents involving chemical, biological, radiological and nuclear substances have stressed the importance of sufficient personal protection equipment for medical first-responders. Modern lightweight, battery-independent, suit ensembles may prove superior to the current protective suit used in the UK. This study compared the powered respiratory protective suit (PRPS ensemble) with a lightweight suit consisting of a SARATOGA® Multipurpose CBRN Protective Coverall Polyprotect 12 in conjunction with the Avon C50 Respirator/Avon CBRNF12CE filter canister and butyl rubber protective gloves (Polyprotect 12 ensemble)...
May 2017: Anaesthesia
Frédéric Dorandeu, Daniel Gillet
No abstract text is available yet for this article.
April 1, 2017: Chemico-biological Interactions
Benoit Gilquin, Michel Jaquinod, Mathilde Louwagie, Sylvie Kieffer-Jaquinod, Alexandra Kraut, Myriam Ferro, François Becher, Virginie Brun
A proteomics assay was set up to analyze food substrates for eight toxins of the CBRN (chemical, biological, radiological and nuclear) threat, namely ricin, Clostridium perfringens epsilon toxin (ETX), Staphylococcus aureus enterotoxins (SEA, SEB and SED), shigatoxins from Shigella dysenteriae and entero-hemorragic Escherichia coli strains (STX1 and STX2) and Campylobacter jejuni cytolethal distending toxin (CDT). The assay developed was based on an antibody-free sample preparation followed by bottom-up LC-MS/MS analysis operated in targeted mode...
January 2017: Proteomics
Holly Carter, Richard Amlôt
INTRODUCTION: Mass casualty decontamination is an intervention employed by first responders at the scene of an incident involving noxious contaminants.  Many countries have sought to address the challenge of decontaminating large numbers of affected casualties through the provision of rapidly deployable temporary showering structures, with accompanying decontamination protocols.  In this paper we review decontamination guidance for emergency responders and associated research evidence, in order to establish to what extent psychosocial aspects of casualty management have been considered within these documents...
September 27, 2016: PLoS Currents
Mary Sproull, Kevin Camphausen
With the possibility of large-scale terrorist attacks around the world, the need for modeling and development of new medical countermeasures for potential future chemical, biological, radiological and nuclear (CBRN) has been well established. Project Bioshield, initiated in 2004, provided a framework to develop and expedite research in the field of CBRN exposures. To respond to large-scale population exposures from a nuclear event or radiation dispersal device (RDD), new methods for determining received dose using biological modeling became necessary...
November 2016: Radiation Research
Vijay K Singh, Patricia L P Romaine, Victoria L Newman, Thomas M Seed
The global threat of a chemical, biological, radiological, or nuclear (CBRN) disaster is an important priority for all government agencies involved in domestic security and public health preparedness. Radiological/nuclear (RN) attacks or accidents have become a larger focus of the United States Food and Drug administration (US FDA) over time because of their increased likeliness. Clinical signs and symptoms of a developing acute radiation syndrome (ARS) are grouped into three sub-syndromes named for the dominant organ system affected, namely the hematopoietic (H-ARS), gastrointestinal (GI-ARS), and neurovascular systems...
December 2016: Expert Opinion on Therapeutic Patents
Vijay K Singh, Melissa Garcia, Stephen Y Wise, Thomas M Seed
The threat of chemical, biological, radiological, and nuclear (CBRN) warfare has been addressed as the uppermost risk to national security since the terrorist attacks on 11 September 2001. Despite significant scientific advances over the past several decades toward the development of safe, non-toxic and effective countermeasures to combat CBRN threats, relatively few countermeasures have been approved by the US Food and Drug Administration (US FDA). Therefore, countermeasures capable of protecting the population from the effects of CBRN attack remain a significant unmet medical need...
December 2016: Expert Opinion on Therapeutic Patents
Thomas Peponis, Elie Ramly, Kym A Roth, David R King
BACKGROUND: Chemical, biological, radiological, and nuclear threats (CBRNs) are uncommon; however, Special Operations Forces (SOF) are likely at the highest risk for tactical exposure. In the event of exposure, SOF will rely on the Joint Service Lightweight Integrated Suit Technology (JSLIST) for survival. Doctrine dictates that a tourniquet should be applied over the JSLIST after a severe limb injury with hemorrhage. There is no evidence in the literature that the Combat Application Tourniquet (C-A-T), which is currently the most widely available tourniquet on the battlefield, can effectively occlude arterial blood flow when applied over the JSLIST...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Franz Worek, Timo Wille, Marianne Koller, Horst Thiermann
The implementation of the Chemical Weapon Convention (CWC), prohibiting the development, production, storage and use of chemical weapons by 192 nations and the ban of highly toxic OP pesticides, especially class I pesticides according to the WHO classification, by many countries constitutes a great success of the international community. However, the increased interest of terrorist groups in toxic chemicals and chemical warfare agents presents new challenges to our societies. Almost seven decades of research on organophosphorus compound (OP) toxicology was mainly focused on a small number of OP nerve agents despite the fact that a huge number of OP analogues, many of these agents having comparable toxicity to classical nerve agents, were synthesized and published...
September 2016: Archives of Toxicology
Carlo Olivieri, Pier L Ingrassia, Francesco Della Corte, Luca Carenzo, Jean-Marc Sapori, Laurent Gabilly, Fredrique Segond, Fiene Grieger, Philippe Arnod-Prin, Xabier Larrucea, Chrisitan Violi, Cédric Lopez, Ahmadreza Djalali
INTRODUCTION: Chemical, biological, radiological, and nuclear (CBRN) emergencies need particular hospital preparedness and resources availability. Also, specific skills and capabilities are required for efficient response to these types of events. The aim of this study was to develop an assessment tool to evaluate hospital preparedness and response performance with respect to CBRN emergencies. METHODS: An evaluation tool was developed using the Delphi technique...
October 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Pierre-Géraud Claret, Renaud Asencio, Damien Rogier, Claire Roger, Philippe Fournier, Tu-Anh Tran, Mustapha Sebbane, Xavier Bobbia, Jean Emmanuel de La Coussaye
BACKGROUND: The purpose of this study was to evaluate the performance of orotracheal intubation with the Miller laryngoscope compared with the Airtraq laryngoscope by emergency and pediatric physicians wearing CBRN-PPE type III on infant manikins with conventional airway. We hypothesized that in this situation, the orotracheal intubation with the Airtraq laryngoscope would be faster and more effective than with the Miller laryngoscope. METHODS: This was a prospective, randomized, crossover, single-center study who recruited emergency department physicians on a voluntary basis...
March 22, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Mahdi F H Al Jewari, Gregory D Koblentz
Since 2004, the Republic of Iraq has undertaken a concerted effort to comply with all of its international obligations to prevent the proliferation and the use of chemical, biological, radiological, and nuclear (CBRN) weapons. A centerpiece of this effort is Iraq's development of a National Biorisk Management System. The Iraqi National Monitoring Authority (INMA), which is responsible for CBRN security and non-proliferation in Iraq, has played a key role in establishing this system. This article provides an overview of Iraq's international non-proliferation commitments, describes the legal and organizational steps it has taken to implement these commitments, and examines current initiatives to strengthen Iraq's biosecurity...
2016: Frontiers in Public Health
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