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Eur J Emerg Med. 2017 Oct;24(5):371-376. doi: 10.1097/MEJ.0000000000000383.

TIER competency-based training course for the first receivers of CBRN casualties: a European perspective.

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aCRIMEDIM - Research Center in Emergency and Disaster Medicine Università del Piemonte Orientale bResearch and Development, Novareckon, Novara, Italy cResearch and Development, Viseo Company, Paris dInfection Control Unit eDisaster Medicine Unit, Hospices Civils de Lyon, Lyon fDepartment of Epidemiology and Public Health, Universite Lyon 1, Villeurbanne, France gISW Institute for Structural Policy and Economic Development, Halle (Saale), Germany hTECNALIA, Parque tecnologico de Bizkaia, Derio, Spain.



Education and training are key elements of health system preparedness vis-à-vis chemical, biological, radiological and nuclear (CBRN) emergencies. Medical respondents need sufficient knowledge and skills to manage the human impact of CBRN events.


The current study was designed to determine which competencies are needed by hospital staff when responding to CBRN emergencies, define educational needs to develop these competencies, and implement a suitable delivery method.


This study was carried out from September 2014 to February 2015, using a three-step modified Delphi method. On the basis of international experiences, publications, and experts' consensus, core competencies for hospital staff - as CBRN casualty receivers - were determined, and training curricula and delivery methods were defined.


The course consists of 10 domains. These are as follows: threat identification; health effects of CBRN agents; planning; hospital incident command system; information management; safety, personal protective equipment and decontamination; medical management; essential resources; psychological support; and ethical considerations. Expected competencies for each domain were defined. A blended approach was chosen.


By identifying a set of core competencies, this study aimed to provide the specific knowledge and skills required by medical staff to respond to CRBN emergencies. A blended approach may be a suitable delivery method, allowing medical staff to attend the same training sessions despite different time zones and locations. The study output provides a CBRN training scheme that may be adapted and used at the European Union level.

[Indexed for MEDLINE]

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