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

Djalali, Ahmadrezaa; Della Corte, Francescoa; Segond, Frederiquec; Metzger, Marie-Helened,f; Gabilly, Laurente; Grieger, Fieneg; Larrucea, Xabierh; Violi, Christianb; Lopez, Cédricc; Arnod-Prin, Philippec; Ingrassia, Pier L.a

European Journal of Emergency Medicine: October 2017 - Volume 24 - Issue 5 - p 371–376
doi: 10.1097/MEJ.0000000000000383

Introduction 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.

Objective 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.

Methods 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.

Results 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.

Conclusion 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.

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

Correspondence to Ahmadreza Djalali, MD, PhD, CRIMEDIM – Research Center in Emergency and Disaster Medicine, University of Eastern Piedmont, Via Lanino 1, Novara 28100, Italy Tel: +39 032 166 0620; fax: +39 032 166 0531; e-mail:

Received May 20, 2015

Accepted January 22, 2016

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.