title: Mission failure: emergency medical services response to chemical, biological, radiological, nuclear, and explosive events.
abstract: BACKGROUND
  Only 4% of the United States Homeland Security funding for public safety terrorism preparedness is allotted to emergency medical services (EMS), despite the primary threat from a mass-terrorism chemical weapons attack (MTCWA) being personal injury. This study examines the preparedness of the EMS to respond to, treat, and transport victims of such attacks.
  
  
  OBJECTIVE
  It was hypothesized that US EMS agencies lack the necessary equipment to mitigate large-scale morbidity and mortality from a MTCWA.
  
  
  METHODS
  Seventy after-action reports from full-scale, chemical weapons exercises conducted in large cities across the US were examined by the Office of Domestic Preparedness, Chemical Weapons Improved Response Program to ascertain if EMS responders had personal protective equipment sufficient to operate at the scene of a MTCWA.
  
  
  RESULTS
  Of the 50 after action reports that mentioned EMS personal protective equipment, only six (12%) EMS agencies equipped their staff with personal protective equipment.
  
  
  CONCLUSIONS
  Results indicate that EMS responders are not prepared to safely respond to MTCWAs, which may result in a significant loss of life of victims and responders.
authors.affiliation: Graduate School of Public Affairs and Administration, Metropolitan College of New York, 75 Varick Street, New York City, NY 10013, USA. sphelps@metropolitan.edu
authors.forename: Scot
authors.initials: S
authors.lastname: Phelps
mesh_terms: D023482:Bioterrorism; D051337:Chemical Terrorism; D054597:Disaster Medicine / Q000193:education / Q000592:standards; D004189:Disaster Planning / Q000458:organization & administration*; D004632:Emergency Medical Services / Q000458:organization & administration* / Q000600:supply & distribution; D004634:Emergency Medical Technicians / Q000193:education / Q000592:standards; D005107:Explosions; D006801:Humans; D054527:Mass Casualty Incidents; D016272:Occupational Health; D016544:Patient Simulation; D015397:Program Evaluation; D011482:Protective Devices / Q000592:standards / Q000600:supply & distribution*; D011635:Public Health Administration / Q000379:methods / Q000592:standards; D011847:Radioactive Fallout; D018635:Rescue Work / Q000379:methods / Q000592:standards*; D023481:Terrorism / Q000145:classification; D014481:United States
chemical_list: D011847:Radioactive Fallout