Preparedness of German emergency departments for chemical, biological, radiological and nuclear (CBRN) incidents

Abstract

Abstract Background Post-pandemic considerations, as well as lessons learned from terrorist attacks, wars, and disasters worldwide demonstrate that emergency departments must be prepared for mass casualty events related to chemical, biological, radiological, and nuclear (CBRN) hazardous materials. Our aim was to evaluate whether German emergency departments are sufficiently prepared for such events. Methods We developed a survey and distributed it to all chairpersons of emergency departments in Germany via the German Emergency Department Directory. Results of the survey were described using total numbers and percentages. Capacity for decontamination at different sites was graphically displayed using box-and-whisker plots. The primary endpoint of this study was whether German emergency departments are sufficiently prepared for CBRN incidents. Results Of 963 emergency departments, 262 (27.21%) answered the survey: 80.43% (189/235) of the hospitals had a plan for biological incidents, 49.36% (116/235) for chemical incidents, and 34.47% (81/235) for radionuclear incidents. Furthermore, 50% (116/232) reported some kind of decontamination site, but only 31.42% (71/226) reported having a water supply to their decontamination area. Sufficient protective equipment was only available in 27.51% (63/229) of emergency departments. Only 12.02% (25/208) of hospitals were able to decontaminate supine patients properly, following a decontamination scheme. Conclusion Most German hospitals are not adequately prepared to handle casualties resulting from chemical, biological, radiological, or nuclear hazardous materials. Given these results, there is a need for systemic intervention at the national level in order to improve preparedness.