Objectives: To understand existing triage algorithms, propose improvement measures through comparison to better deal with mass-casualty incidents caused by bioterrorism. Study Design: Systematic review. Methods: Medline, Scopus and Web of Science were searched up to January 2022. The studies investigating triage algorithms for mass-casualty bioterrorism. Quality assessment was performed using the International Narrative Systematic Assessment tool. Data extractions were performed by four reviewers. Results: Of the 475 titles identified in the search, 10 studies were included. There were four studies on triage algorithms for most bioterrorism events, four studies on triage algorithms for anthrax and two studies on triage algorithms for mental or psychosocial problems caused by bioterrorism events. We introduced and compared 10 triage algorithms used for different bioterrorism situations. Conclusion: For triage algorithms for most bioterrorism events, it is necessary to determine the time and place of the attack as soon as possible, control the number of exposed and potentially exposed people, prevent infection and determine the type of biological agents used. Research on the effects of decontamination on bioterrorism attacks needs to continue. For anthrax triage, future research should improve the distinction between inhalational anthrax symptoms and common disease symptoms and improve the efficiency of triage measures. More attention should be paid to triage algorithms for mental or psychosocial problems caused by bioterrorism events.

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Background: Emergency rescue offers an important means to effectively respond to disasters and quickly restore normalization afterwards. With the rapid development of biotechnology, it is crucial to evaluate rescue capability in response to bioterrorism incidents, yet there is a lack of specific measurement standards and complete evaluation system. The purpose of this article is to establish an evaluation system for emergency rescue capability during bioterrorism events. Methods: The index was established through the improved Delphi method, while the fuzzy comprehensive evaluation model was established on the basis of AHP. Experts in disaster work and research were invited to rate indicator items using the Likert scale, calculating the degree of agreement for each indicator using the Kendall coefficient W to assess expert consensus, then screen and identify indicators using the cutoff method. The fuzzy comprehensive evaluation model was formed by calculating the weight of the judgment matrix. Results: Over two rounds of expert inquiry, 11 experts participated in the improved Delphi study (the response rate was 100%), and the Kendall coordination coefficients of the first and second rounds were 0.303 and 0.632 respectively (P < 0.05). According to the comprehensive score, coefficient of variation and full score ratio, 5 first-level indicators and 25 second-level indicators were determined. A fuzzy comprehensive evaluation model based on AHP was established to evaluate the rescue response from bioterrorism. Conclusions: The expert group reached a consensus on all indicators of the model and overall, the model has sound content validity. The next step is to transform the evaluation model into a scale, verify its operability, and apply it to actual evaluation work to promote capacity building across the biological incident rescue team.

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Hospitals are an important part of a nation’s response to bioterrorism events. At present, research in this field is still in the initial stage. The number of related studies is small, the research direction is relatively concentrated, and a comprehensive analysis and standard evaluation system are lacking. This literature survey was conducted using PRISMA methodology. Collective information was gathered from PubMed, Web of Science, Scopus, and available grey literature sourced through Google and relevant websites. The studies were screened according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flowchart. Analysis and summary of the extracted data was performed according to the World Health Organization (WHO) Rapid Hospital Readiness Checklist (2020). Twenty-three articles were selected for review, data extraction, and data analysis. Referring to the WHO rapid hospital readiness checklist, six main indicator categories were determined, including emergency management, medical service capacity, surge capacity, laboratories, regional coordination, and logistical support, and fifty-two subcategories were finally identified. The study summarizes and analyzes the relevant literature on hospital disaster preparedness and extracts relevant capability elements, providing a reference for the preparation of hospitals against bioterrorism events and a basis for the design and development of hospital preparedness assessment indicators.