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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
Ali S Al-Shareef, Loui K Alsulimani, Hattan M Bojan, Taha M Masri, Jennifer O Grimes, Michael S Molloy, Gregory R Ciottone
BACKGROUND: Makkah (Mecca) is a holy city located in the western region of the Kingdom of Saudi Arabia. Each year, millions of pilgrims visit Makkah. These numbers impact both routine health care delivery and disaster response. This study aimed to evaluate hospitals' disaster plans in the city of Makkah. METHODS: Study investigators administered a questionnaire survey to 17 hospitals in the city of Makkah. Data on hospital characteristics and three key domains of disaster plans (general evaluation of disaster planning, structural feasibility of the hospitals, and health care worker knowledge and training) were collated and analyzed...
February 2017: Prehospital and Disaster Medicine
Anthony P Cardile, Christopher T Littell, Michael G Backlund, Richard A Heipertz, Jerod A Brammer, Sean M Palmer, Todd J Vento, Felix A Ortiz, William R Rosa, Michael J Major, Patrick M Garman
BACKGROUND: The U.S. Army 1st Area Medical Laboratory (1st AML) is currently the only deployable medical CBRNE (Chemical, Biological, Radiological, Nuclear, and Explosives) laboratory in the Army's Forces Command. In support of the United States Agency for International Development Ebola response, the U.S. military initiated Operation United Assistance (OUA), and deployed approximately 2,500 service members to support the Government of Liberia's Ebola control efforts. Due to its unique molecular diagnostic and expeditionary capabilities, the 1st AML was ordered to deploy in October of 2014 in support of OUA via establishment of Ebola testing laboratories...
November 2016: Military Medicine
Hideaki Anan, Yasuhiro Otomo, Hisayoshi Kondo, Masato Homma, Yuichi Koido, Kazuma Morino, Kenichi Oshiro, Kiyokazu Harikae, Osamu Akasaka
This report outlines the need for the development of an advanced course in mass-casualty life support (MCLS) and introduces the course content. The current problems with education on disasters involving chemical agents, biological agents, radiation/nuclear attacks, or explosives (CBRNE) in Japan are presented. This newly developed "MCLS-CBRNE" program was created by a Ministry of Health, Labour, and Welfare (Tokyo, Japan) research group based on these circumstances. Modifications were then made after a trial course...
October 2016: Prehospital and Disaster Medicine
Joseph G Kotora
INTRODUCTION: Emergency healthcare providers are required to care for victims of Chemical, Biological, Radiologic, Nuclear, and Explosive (CBRNE) agents. However, US emergency departments are often ill prepared to manage CBRNE casualties. Most providers lack adequate knowledge or experience in the areas of patient decontamination, hospital-specific disaster protocols, interagency familiarization, and available supply of necessary medical equipment and medications. This study evaluated the CBRNE preparedness of physicians, nurses, and midlevel providers in an urban tertiary care emergency department...
2015: American Journal of Disaster Medicine
Gillian K SteelFisher, Robert J Blendon, Amanda S Brulé, Keri M Lubell, Loretta Jackson Brown, Dahna Batts, Eran Ben-Porath
OBJECTIVE: To provide a more comprehensive view than previously available of US physician preparedness for public health emergencies, this study examined physicians' assessments of their preparedness, training, participation in institutional activities, information practices, and experiences with patient education. Four kinds of public health emergencies were considered: natural disasters, major airborne infections, major foodborne illness outbreaks, and chemical, biological, radiological, nuclear, or explosives (CBRNE) incidents...
December 2015: Disaster Medicine and Public Health Preparedness
Joseph G Kotora
INTRODUCTION: Emergency healthcare providers are required to care for victims of Chemical, Biological, Radiologic, Nuclear, and Explosive (CBRNE) agents. However, US emergency departments are often ill prepared to manage CBRNE casualties. Most providers lack adequate knowledge or experience in the areas of patient decontamination, hospital-specific disaster protocols, interagency familiarization, and available supply of necessary medical equipment and medications. This study evaluated the CBRNE preparedness of physicians, nurses, and midlevel providers in an urban tertiary care emergency department...
September 2015: Journal of Emergency Management: JEM
Ivette Motola, William A Burns, Angel A Brotons, Kelly F Withum, Richard D Rodriguez, Salma Hernandez, Hector F Rivera, Saul Barry Issenberg, Carl I Schulman
BACKGROUND: Chemical, biologic, radiologic, nuclear, and explosive (CBRNE) incidents require specialized training. The low frequency of these events leads to significant skill decay among first responders. To address skill decay and lack of experience with these high-impact events, educational modules were developed for mobile devices to provide just-in-time training to first responders en route to a CBRNE event. This study assessed the efficacy and usability of the mobile training. METHODS: Ninety first responders were randomized to a control or an intervention group...
October 2015: Journal of Trauma and Acute Care Surgery
Martin Richter, Christian Herzog
The discovery of undefined powders that are content of letters or parcels with or without threats in writing addressed to institutions, groups or persons, often raises the suspicion of an attack involving biological agents such as anthrax. Subsequent investigations and analyses by local authorities often aim at excluding anthrax or anthrax spores. Suspicion and actions are then mistakenly justified by referring to the 2001 anthrax letter attacks in the USA, which now lie more than 10 years in the past. In Germany to date there has never been a terrorist attack involving dangerous biological agents, neither in letters nor in any other possible form...
July 2015: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
Lauren Walsh, Hillary Craddock, Kelly Gulley, Kandra Strauss-Riggs, Kenneth W Schor
INTRODUCTION: This study aimed to learn from the experiences of well-established, disaster preparedness-focused health care coalition (HCC) leaders for the purpose of identifying opportunities for improved delivery of disaster-health principles to health professionals involved in HCCs. This report describes current HCC education and training needs, challenges, and promising practices. METHODS: A semi-structured interview was conducted with a sample of leaders of nine preparedness-focused HCCs identified through a 3-stage purposive strategy...
April 2015: Prehospital and Disaster Medicine
David Siegel, Kandra Strauss-Riggs, Scott Needle
Children are the members of our population who are most vulnerable to the effects of a chemical, biological, radiological, nuclear or explosive (CBRNE) attack. It has been over 12 years since 9/11 and the majority of clinicians who would be providing care to children in the event of another attack still lack the requisite disaster preparedness training. The purpose of this report is to provide an overview of the recent developments that will enable the affordable creation of key CBRNE educational and just in time material...
December 1, 2014: Clinical Pediatric Emergency Medicine
John W Strain
The implementation of Tactical Combat Casualty Care (TCCC) guidelines for the Operation Enduring Freedom and Operation Iraqi Freedom contingency operations has dramatically reduced preventable combat deaths. A study of these principles and their application to medical treatment in the chemical, biological, radiological, nuclear, and high-yield explosives (CBRNE), weapons of mass destruction (WMD) environment is presented as a potential readiness and force multiplier for units engaged in this area of operations...
2013: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Barry Bouwsema
Risk assessments utilising the consolidated risk assessment process as described by Public Safety Canada and the Centre for Security Science utilise the five threat categories of natural, human accidental, technological, human intentional and chemical, biological, radiological, nuclear or explosive (CBRNE). The categories of human intentional and CBRNE indicate intended actions against specific targets. It is therefore necessary to be able to identify which pieces of critical infrastructure represent the likely targets of individuals with malicious intent...
2013: Journal of Business Continuity & Emergency Planning
Christina J Mitchell, W George Kernohan, Ray Higginson
UNLABELLED: Two main areas exist within emergency care where chemical, biological, radiological, nuclear and explosive preparedness can be focused: departmental preparedness and staff preparedness. This study focused upon the latter. AIM: To identify areas where nurses require training in order to improve preparedness for a CBRNe incident. METHODS: A competency questionnaire was developed from the literature and completed by 50 nursing staff across three Emergency Departments within one NHS Trust in Northern Ireland...
July 2012: International Emergency Nursing
Hope M Williamson
Although training and education have long been accepted as integral to disaster preparedness, many currently taught practices are neither evidence based nor standardized. The need for effective evidence-based disaster education for healthcare workers at all levels in the multidisciplinary medical response to major events has been designated by the disaster response community as a high priority. This article describes a disaster management mobile application of systematic evidence-based practice. The application is interactive and comprises portable principles, algorithms, and emergency protocols that are agile, concise, comprehensive, and response relevant to all healthcare workers...
January 2011: American Journal of Disaster Medicine
Andrew C S Linney, W George Kernohan, Ray Higginson
UNLABELLED: Emergency planning is a new science and there is a lack of UK standardisation in regard to NHS emergency planning. A first step to achieving standardisation within emergency planning is elucidation of national training competencies. AIM: This study was designed to find consensus amongst multi-agency chemical, biological, radiological, nuclear and explosive (CBRNe) experts on the factors that must be included in future NHS CBRNe competencies. METHODS: Data was collected using an anonymised online Delphi study...
April 2011: International Emergency Nursing
Wm Leroy Heinrichs, Patricia Youngblood, Phillip Harter, Laura Kusumoto, Parvati Dev
INTRODUCTION: Training emergency personnel on the clinical management of a mass-casualty incident (MCI) with prior chemical, biological, radioactive, nuclear, or explosives (CBRNE) -exposed patients is a component of hospital preparedness procedures. OBJECTIVE: The objective of this research was to determine whether a Virtual Emergency Department (VED), designed after the Stanford University Medical Center's Emergency Department (ED) and populated with 10 virtual patient victims who suffered from a dirty bomb blast (radiological) and 10 who suffered from exposure to a nerve toxin (chemical), is an effective clinical environment for training ED physicians and nurses for such MCIs...
September 2010: Prehospital and Disaster Medicine
Diana Wilkinson, Barbara Waruszynski, Laurie Mazurik, Ann-Marie Szymczak, Erin Redmond, Fred Lichacz
The Workshop on Medical Preparedness for Chemical, Biological, Radiological, Nuclear, and Explosives (CBRNE) events: national scan was held on 20 and 21 May 2010 at the Diefenbunker Museum in Ottawa, Canada. The purpose of the workshop was to provide the CBRNE Research and Technology Initiative with a Canadian national profile of existing capabilities and anticipated gaps in casualty management consistent with the community emergency response requirements. The workshop was organised to enable extensive round-table discussions and provide a summary of key gaps and recommendations for emergency response planners...
November 2010: Radiation Protection Dosimetry
Garry Stevens, Alison Jones, George Smith, Jenny Nelson, Kingsley Agho, Melanie Taylor, Beverley Raphael
Paramedics play a pivotal role in the response to major emergencies. Recent evidence indicates that their confidence and willingness to respond to chemical, biological, radiological, nuclear, and explosives-related (CBRNE) incidents differs from that relating to their "routine" emergency work. To further investigate the factors underpinning their readiness to respond to CBRNE incidents, paramedics in New South Wales (NSW), Australia, were asked to complete a validated online survey instrument. Univariate and multivariate analyses were performed to examine associated factors determining readiness...
June 2010: Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science
Jennifer E C Lee, Louise Lemyre
The volume of research on terrorism has increased since the events of September 11, 2001. However, efforts to develop a contextualized model incorporating cognitive, social-contextual, and affective factors as predictors of individual responses to this threat have been limited. Therefore, the aim of this study was to evaluate a series of hypotheses drawn from such a model that was generated from a series of interviews with members of the Canadian public. Data of a national survey on perceived chemical, biological, radiological, nuclear, and explosives (CBRNE) terrorism threat and preparedness were analyzed...
September 2009: Risk Analysis: An Official Publication of the Society for Risk Analysis
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