Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNE) Science and the CBRNE Science Medical Operations Science Support Expert (CMOSSE)

Abstract

A national need is to prepare for and respond to accidental or intentional disasters categorized as chemical, biological, radiological, nuclear, or explosive (CBRNE). These incidents require specific subject-matter expertise, yet have commonalities. We identify 7 core elements comprising CBRNE science that require integration for effective preparedness planning and public health and medical response and recovery. These core elements are (1) basic and clinical sciences, (2) modeling and systems management, (3) planning, (4) response and incident management, (5) recovery and resilience, (6) lessons learned, and (7) continuous improvement. A key feature is the ability of relevant subject matter experts to integrate information into response operations. We propose the CBRNE medical operations science support expert as a professional who (1) understands that CBRNE incidents require an integrated systems approach, (2) understands the key functions and contributions of CBRNE science practitioners, (3) helps direct strategic and tactical CBRNE planning and responses through first-hand experience, and (4) provides advice to senior decision-makers managing response activities. Recognition of both CBRNE science as a distinct competency and the establishment of the CBRNE medical operations science support expert informs the public of the enormous progress made, broadcasts opportunities for new talent, and enhances the sophistication and analytic expertise of senior managers planning for and responding to CBRNE incidents.

Meeting radiation dosimetry capacity requirements of population-scale exposures by geostatistical sampling

“…Processing and analysis of samples from all known or suspected irradiated individuals for biodosimetry is too labor intensive, a significant bottleneck in identifying treatment-eligible exposures [32]. While rapid interpretation of cytogenetic biodosimetry data is feasible [36], sample acquisition and data generation exceed the capacities of small teams of first responders and individual testing laboratories [37]. The proposed approach may partially overcome capacity resource limitations of first responders and biodosimetry laboratories to provide data for triage assessment of entire populations.…”

Meeting radiation dosimetry capacity requirements of population-scale exposures by geostatistical sampling

“…Processing and analysis of samples from all known or suspected irradiated individuals for biodosimetry is too labor intensive, a significant bottleneck in identifying treatment-eligible exposures (32). While rapid interpretation of cytogenetic biodosimetry data is feasible (36), sample acquisition and data generation exceeds the capacities of small teams of first responders and individual testing laboratories (38). The proposed approach may partially overcome capacity resource limitations of first responders and biodosimetry laboratories to provide data for triage assessment of entire populations.…”

What A Disaster! The Hydrofluoric Acid Leak in Gumi City in 2012: Lessons What We Have Earned From Review of the Past Hospital’s Disaster Response

“…In order to maintain the continuity of the standard of care in MCI or CBRNE disaster, hospitals must distinguish 3 levels of care situations: "Conventional care" as usual care, "Contingency care" as functionally equivalent care in contingency situation, and "Crisis care" as crisis standard of care for space, staff, and supplies such as securing disaster reserve beds by using nonpatient care areas like conference room for patient care [5,24]. It is important to separate patient with guardian, staff entry areas, triage areas, and parking lots and to manage uni ed entrances and exits of hospitals in MCI or CBRNE disaster [1,2,5,7]. ED staff require administrative support to manage patients e ciently by avoiding bottleneck phenomena of ED registration.…”

“…In terms of disaster response, in the conventional traumatic mass casualty incident (MCI) situation, based on the evaluation of the extent of damage by the physical injury mainly by the medical resource provider, the patient severity classi cation and prioritization of treatment are promoted for e cient resource distribution [5]. However, in the special situation that corresponds to chemical, biological, radiological, nuclear, and explosive (CBRNE) disaster, including previous considerations covered by the conventional traumatic MCI, another consideration of special situations such as zone setup, personal protective equipment (PPE), most suitable special triage in CBRNE situation, decontamination, and antidote management if applicable is required [6][7][8]. Gumi, Gyeongsangbuk-do, Republic of Korea is a state-governed industrial city with factories located in an industrial park [9,10].…”