Medical Preparedness

Medical response is a critical component of major-event CBRN/HAZMAT response. However, this book is not a guide on how to treat casualties, nor is it an attempt to tell physicians, nurses, paramedics, EMTs, or other medical providers how to do their jobs. It is not my place to do so, and my medical training is not sufficient to give me credibility if I tried. I was trained and licensed at the EMT level, and I received significant additional training in chemical casualty care, so I am not speaking from a position of complete ignorance. Moreover, I had the opportunity to work with some excellent medical providers from a wide variety of civil and military backgrounds. Based on this experience, this chapter provides some basic planning considerations, with an emphasis on dealing with large numbers of casualties. I will also discuss the problem of the “worried well”—people who are physically unharmed but who decide that they need medical attention.


One of the key components of effective planning and preparedness for the emergency medical sector is an understanding of the mechanism of injury. It is important to understand the means by which CBRN/HAZMAT scenarios affect people and create victims who will need help from the medical system. Different types of causative agents will produce different types of victims, which will have varying effects on the medical system that is trying to care for them. ...

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