Hazardous materials and CBRN incidents: Fundamentals of pre-hospital readiness in the State of Qatar

Abstract

Background: Hazardous Materials and Chemical/Biological/Radiological/Nuclear (HazMat-CBRN) incidents represent a serious threat to the population and the environment. They require a pre-hospital medical response system well equipped and supported with logistics and clinicians with appropriate knowledge and skills to prevent exposure and mitigate risks. Our aim is to determine if the Hamad Medical Corporation Ambulance Service (HMCAS) fulfils the pre-hospital readiness requirements for such incidents. Methods: This cross-sectional study was performed in HMCAS. An online survey assessed staff behaviour and knowledge in relation to HazMat-CBRN incidents. Responses were obtained on health risks and pre-hospital medical management of related threats in Qatar. Based on the results, a training module “HazMat Incident Management” was prepared with pre-/post-activity assessments. The results were explored using a multivariate linear regression and non-parametric Wilcoxon test for paired samples. Specialized Emergency Management (SEM) staff opinion about this training was assessed through an online survey. Both surveys’ validity and reliability tests were conducted. Ishikawa cause and effects diagram was built for the identification of the factors leading to a pre-hospital successful response to HazMat-CBRN incidents. Results: HMCAS has the proper logistics and plans to manage potential HazMat-CBRN incidents. The knowledge survey demonstrated that the pre-hospital medical staff information about this topic needs reinforcement. The multivariate linear regression and non-parametric Wilcoxon test demonstrated that this was obtained thanks to the implemented training module. The course satisfaction survey showed not only a big interest in this activity but also staff recommended more related topics. Earlier-RSDAT (Recognition, Safety, Decontamination, Antidot, Transport) is a tool proposed as a response acronym to build a successful risk-based response for HazMat CBRN incidents in pre-hospital setting. Conclusion: HMCAS fulfills the readiness requirements for safe and effective response to potential HazMat-CBRN incidents in Qatar. The RSDAT response matrix might help in mitigating pre-hospital response risks.

Quality improvement tools to manage emergency callbacks from patients with diabetes in a prehospital setting

“…Once patients are medically stabilised, paramedics must transport them to an appropriate healthcare facility. 12 13 The HMCAS’ ambulance response times are short and consistent with international standards. 14 Thus, some patients refuse transport to the hospital after receiving on-scene emergency treatment but call back 999 with a similar complaint soon after.…”

Structural Elements and Requirements in Forming Prehospital Health Response Teams in Response to Chemical, Biological, Radiation, and Nuclear Incidents (CBRN), a Comparative Review Study

“…The development, requirements, and limits of the prehospital RRTs in CBRN events should be established according to the experiences, demands, conditions, and grounds on which these teams are shaped. 31 The requirements of radiation and nuclear teams in the studied countries and international organizations include coordination and communication, radiation assessor, incident command post (ICP), transport of the injured, triage location, decontamination location, priority of actions, collection and isolation, registration, [15][16][17] experience in emergency response, team leadership and management, epidemiology experience in epidemics, familiarity with surveillance system, standards, paramedic, nurse, or doctor, experience in crisis, awareness of false beliefs and rumors related to diseases. Knowledge of leadership structures, familiarity with sampling requirements, knowledge of the location of reference laboratories, 18 radiation monitoring in 2 phases, PPE assuming a terrorist explosion, drafting warning messages, providing security for Hot Zone demarcation and entry restrictions, pollution assessment, 19 the maximum start of response in 24 to 48 h, determination of treatment and decontamination priorities, population monitoring, setting criteria, pollution level evaluation indicators, incidents with mass casualties, radiation triage groups, 20 the registration of all the persons encountered, and the entry of the implementing organizations to respond to terrorist incidents is a source of light.…”

Exploring pre‐hospital healthcare workers' readiness for chemical, biological, radiological, and nuclear threats in the State of Qatar: A cross‐sectional study

“…The course was created to be delivered to all HMCAS HCWs as first responders and also incorporated HCWs from private hospitals in Qatar. 9 , 16 …”

“…The course was created to be delivered to all HMCAS HCWs as first responders and also incorporated HCWs from private hospitals in Qatar. 9,16 The study aims to explore the reliability and validity of the satisfaction survey answered by HMCAS SEM personnel as subject matter experts about the "HazMat Incident Management" course and seek their opinion regarding the HMCAS HCWs' needs regarding other HazMat-CBRN-related topics.…”

“…Hence, HMCAS has established a “Hazardous Material Incident Management” course accredited by Qatar's Ministry of Public Health (MoPH) Department of Healthcare Practitioners (DHP). The course was created to be delivered to all HMCAS HCWs as first responders and also incorporated HCWs from private hospitals in Qatar 9,16 …”