What to do in case of a CBRN accident?

The notion of the CBRN accident makes it more difficult to manage!

  • Higher risk for first aid: is there a risk of contamination?
  • The risks, even the anxiety, affect a larger population as in the case of a moving toxic cloud.
  • Wearing personal protective equipment requires the first responder to perform medical procedures differently than in normal times.
  • Unusual diagnoses can slow the initiation of treatment and worsen injury morbidity and mortality.
  • The psychological effects are significant, especially when the phenomena experienced are poorly understood, which was the case for example during the Ebola epidemic.
  • The care of the injured is sometimes slowed down if decontamination operations must be carried out beforehand.
  • Wounds often require specific treatment if they have been contaminated.

The management Principles for injured people during a CBRN event

  • Recognition
  • Safety, choice of PPE and risk prevention
  • First aid
  • Sorting
  • Clinical evaluation (primary investigation and recognition of toxidromes)
  • Vital interventions
  • Risk management of cross-contamination (decontamination / isolation)
  • Health management (including intensive care)
  • Definitive management, including antidotes and surgery
  • Rehabilitation (physical, mental and social)

Several major accidents involving a CBRN component have occurred in the past 25 years
– 1995 in Tokyo
– 2007 Iraq in Chlorine
– 2013 Syria in 2013
– 2018 Salisbury in 2018 Novichok

There are many more accidents due to the deliberate use of chemicals but they are sometimes insidious.
Regarding the happening incident due to biological products, this event can be accidental/natural or it can be invented!

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