The UK is currently in the process of implementing a modified response to chemical, biological, radiological and nuclear and hazardous material incidents that combines an initial operational response with a revision of the existing specialist operational response for ambulant casualties. The process is based on scientific evidence and focuses on the needs of casualties rather than the availability of specialist resources such as personal protective equipment, detection and monitoring instruments and bespoke showering (mass casualty decontamination) facilities. Two main features of the revised process are: (1) the introduction of an emergency disrobe and dry decontamination step prior to the arrival of specialist resources and (2) a revised protocol for mass casualty (wet) decontamination that has the potential to double the throughput of casualties and improve the removal of contaminants from the skin surface. Optimised methods for performing dry and wet decontamination are presented that may be of relevance to hospitals, as well as first responders at the scene of a chemical incident.
- major incidents, cbrn
- mass incidents
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Contributors All authors contributed to the writing of this review article.
Funding The original research projects described in this practical review article were sponsored by the Department of Health (England), European Union (Executive Agency for Health and Consumers), UK Home Office and US Department of Health and Human Services (Office of the Assistant Secretary for the Preparedness and Response, Biomedical Advanced Research and Development Authority).
Disclaimer The opinions expressed in this article are those of the authors and do not necessarily reflect the policies, opinion or guidance of the UK or US governments. The guidance in this document may be subject torevision as new evidence becomes available.
Competing interests None declared.
Patient consent Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
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