Managing CBRN mass casualty incidents at hospitals—Find a simple solution for a complex problem: A pilot study

Maximilian Kippnich, MD; Nora Schorscher, MD; Helmut Sattler; Uwe Kippnich; Patrick Meybohm, MD; Thomas Wurmb, MD

doi:10.5055/jem.0650

Authors

Maximilian Kippnich, MD
Nora Schorscher, MD
Helmut Sattler
Uwe Kippnich
Patrick Meybohm, MD
Thomas Wurmb, MD

DOI:

https://doi.org/10.5055/jem.0650

Keywords:

mass casualty incident, terrorism, decontamination, emergency preparedness

Abstract

Objective: Chemical, biological, radiological, and nuclear (CBRN) incidents are a major challenge for emergency medical services and the involved hospitals, especially if decontamination needs to be performed nearby or even within the hospital campus. The University Hospital Wuerzburg has developed a comprehensive and alternative CBRN response plan. The focus of this study was to proof the practicability of the concept, the duration of the decontamination process, and the temperature management.

Methods: The entire decontamination area can be deployed 24/7 by the hospitals technical staff. Fire and rescue services are responsible for the decontamination process itself. This study was designed as full-scale exercise with 30 participants.

Results: The decontamination area was ready for operation within 30 minutes. The decontamination of the four simulated patients took 5.5 ± 0.6 minutes (mean ± SD). At the end of the decontamination process, the temperature of the undressed upper body of the training patients was 27.25 ± 1°C (81.05 ± 2°F) (mean ± SD) and the water in the shower was about 35°C (95°F).

Conclusion: The presented concept is comprehensive and simple for a best possible care during CBRN incidents at hospitals. It ensures wet decontamination by Special Forces, while the technical requirements are created by the hospital.

Author Biographies

Maximilian Kippnich, MD

Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, Subsection Emergency and Disaster Relief Medicine, University Hospital Wuerzburg, Wuerzburg, Germany

Nora Schorscher, MD

Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, Subsection Emergency and Disaster Relief Medicine, University Hospital Wuerzburg, Wuerzburg, Germany

Helmut Sattler

Fire Department Wuerzburg, Office for Civil Defence and Fire Protection, Wuerzburg, Germany

Uwe Kippnich

Bavarian Red Cross, Headquarters, Munich, Germany

Patrick Meybohm, MD

Professor, Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wuerzburg, Wuerzburg, Germany

Thomas Wurmb, MD

Professor, Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, Subsection Emergency and Disaster Relief Medicine, University Hospital Wuerzburg, Wuerzburg, Germany

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