Chemical, biological, radiological, nuclear and explosive (CBRNe) events

Hignett, Sue; Hancox, Graham; Otter, Mary Edmunds

doi:10.1108/ijes-05-2018-0030

Cited by 9 publications

(5 citation statements)

References 27 publications

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“…This study synthesized WAI and WAD and identified phases of the ED CBRN response in line with previous literature 50 consisting of general phases (initial response, consolidation phase, and recovery phase) for hospitals responding to major incidents (including CBRN events) and the following: Evacuation Triage Decontamination for vulnerable individuals during CBRN emergencies 51 …”

Section: Discussion and Recommendationsmentioning

confidence: 87%

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The Standardization of the Emergency Department Response to Chemical, Biological, Radiological, and Nuclear (CBRN) Events: Human Factors/Ergonomics Approach

Razak,

Hignett,

Barnes

et al. 2023

Disaster med. public health prep.

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Objective: To provide standardized recommendations for the emergency department (ED) response to chemical, biological, radiological, and nuclear (CBRN) events by combining the human factors/ergonomics method of hierarchical task analysis with the theoretical framework for Work as Imagined versus Work as Done. Methods: Document analyses were used to represent CBRN response operational procedures. Semi-structured interviews using scenario cards were carried out with 57 first receivers (ED staff) to represent CBRN practice at 2 acute hospitals in England. Results: Variability existed in general organizational responsibilities associated with the CBRN response. Variability was further evident in top level CBRN tasks and CBRN phases at both EDs. Operational procedures focused on tasks such as documentation, checking, and timing. CBRN practice focused on patient needs through assessment, treatment, and diagnosis. Conclusion: The findings provide top-down and bottom-up insights to enhance the ED CBRN response through standardization. The standardized CBRN action card template embeds the choice approach to standardization. The standardized CBRN framework implements the streamlined categorization of CBRN phases. Work as Imagined versus Work as Done is a useful theoretical framework to unpack a complex sociotechnical system, and hierarchical task analysis is an effective system mapping tool in health care.

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Section: Discussion and Recommendationsmentioning

confidence: 87%

“…Triage 3. Decontamination for vulnerable individuals during CBRN emergencies 51 Categorizing CBRN actions into phases allows the streamlining of an effective CBRN response, for example, by preparing for the arrival of casualties in line with previous findings 52,53 as a means of freeing resources to deal with the surge of casualties.…”

Section: Confirmabilitymentioning

confidence: 99%

The Standardization of the Emergency Department Response to Chemical, Biological, Radiological, and Nuclear (CBRN) Events: Human Factors/Ergonomics Approach

Razak,

Hignett,

Barnes

et al. 2023

Disaster med. public health prep.

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“…This study aimed to examine the impact of a longitudinal structured evaluation process on the capacity to build and maintain effective emergency preparedness for severe but infrequent risks over time. It has been previously stated that an ongoing evaluation process facilitates improvement of emergency preparedness for 'conventional' MCIs [39], but this has not as yet been sufficiently demonstrated as effective in CBRN events [9,38]. For this purpose, the preparedness of hospitals for a mass casualty incident that involved hazardous materials was chosen and evaluated over a period of a decade.…”

Section: Discussionmentioning

confidence: 99%

“…Since the 11 September 2001 attack in the USA, the interest of governing authorities, as well as of the media and the public, expanded to include chemical and toxicological threats [6]. Many states invest significant resources in building their capacity to manage such events and mitigate their consequences, but nonetheless, it has been stated that such efforts have been too limited and, as of yet, many deficiencies in the level of emergency preparedness are still predominant [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Maintaining Preparedness to Severe Though Infrequent Threats—Can It Be Done?

Siman‐Tov

Davidson

Adini

2020

IJERPH

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Background: A mass casualty incident (MCI) caused by toxicological/chemical materials constitutes a potential though uncommon risk that may cause great devastation. Presentation of casualties exposed to such materials in hospitals, if not immediately identified, may cause secondary contamination resulting in dysfunction of the emergency department. The study examined the impact of a longitudinal evaluation process on the ongoing emergency preparedness of hospitals for toxicological MCIs, over a decade. Methods: Emergency preparedness for toxicological incidents of all Israeli hospitals were periodically evaluated, over ten years. The evaluation was based on a structured tool developed to encourage ongoing preparedness of Standard Operating Procedures (SOPs), equipment and infrastructure, knowledge of personnel, and training and exercises. The benchmarks were distributed to all hospitals, to be used as a foundation to build and improve emergency preparedness. Scores were compared within and between hospitals. Results: Overall mean scores of emergency preparedness increased over the five measurements from 88 to 95. A significant increase between T1 (first evaluation) and T5 (last evaluation) occurred in SOPs (p = 0.006), training and exercises (p = 0.003), and in the overall score (p = 0.004). No significant changes were found concerning equipment and infrastructure and knowledge; their scores were consistently very high throughout the decade. An interaction effect was found between the cycles of evaluation and the hospitals’ geographical location (F (1,20) = 3.0, p = 0.056), proximity to other medical facilities (F (1,20) = 10.0 p = 0.005), and type of area (Urban vs. Periphery) (F (1,20) = 13.1, p = 0.002). At T5, all hospitals achieved similar high scores of emergency preparedness. Conclusions: Use of accessible benchmarks, which clearly delineate what needs to be continually implemented, facilitates an ongoing sustenance of effective levels of emergency preparedness. As this was demonstrated for a risk that does not frequently occur, it may be assumed that it is possible and practical to achieve and maintain emergency preparedness for other potential risks.

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“…Nuclear, radiological, chemical, and biological weapons of mass destruction exist. They are a threat when used by a state in war, by an organization, or by an individual perpetrator in a terrorist attack [ 13 , 14 ]. All types of mass destruction weapons are regulated by international treaties, and there is an effort to ban or at least restrict their possession.…”

Section: Toxins As a Part Of Biological Warfare Agentsmentioning

confidence: 99%

Immunosensors for Assay of Toxic Biological Warfare Agents

Pohanka

2023

Biosensors

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An immunosensor for the assay of toxic biological warfare agents is a biosensor suitable for detecting hazardous substances such as aflatoxin, botulinum toxin, ricin, Shiga toxin, and others. The application of immunosensors is used in outdoor assays, point-of-care tests, as a spare method for more expensive devices, and even in the laboratory as a standard analytical method. Some immunosensors, such as automated flow-through analyzers or lateral flow tests, have been successfully commercialized as tools for toxins assay, but the research is ongoing. New devices are being developed, and the use of advanced materials and assay techniques make immunosensors highly competitive analytical devices in the field of toxic biological warfare agents assay. This review summarizes facts about current applications and new trends of immunosensors regarding recent papers in this area.

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Chemical, biological, radiological, nuclear and explosive (CBRNe) events

Cited by 9 publications

References 27 publications

The Standardization of the Emergency Department Response to Chemical, Biological, Radiological, and Nuclear (CBRN) Events: Human Factors/Ergonomics Approach

The Standardization of the Emergency Department Response to Chemical, Biological, Radiological, and Nuclear (CBRN) Events: Human Factors/Ergonomics Approach

Maintaining Preparedness to Severe Though Infrequent Threats—Can It Be Done?

Immunosensors for Assay of Toxic Biological Warfare Agents

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