title: Clinical guidelines for responding to chemical, biological, radiological, nuclear and trauma/burn mass casualty incidents: Quick reference guides for emergency department staff.
abstract: The word 'DISASTER' may be used as a mnemonic for listing the critical elements of emergency response. The National Disaster Life Support Education Foundation's (NDLSEC) DISASTER paradigm emphasises out-of-hospital emergency response and includes the following elements: (1) detect; (2) incident command system; (3) security and safety; (4) assessment; (5) support; (6) triage and treatment; (7) evacuate; and (8) recovery. This paper describes how the DISASTER paradigm was used to create a series of clinical guidelines to assist the preparedness effort of hospitals for mitigating chemical, biological, radiological, nuclear incidents or explosive devices resulting in trauma/burn mass casualty incidents (MCIs) and their initial response to these events. Descriptive information was obtained from observations and records associated with this project. The information contributed by a group of subject matter experts in disaster medicine, at the Yale New Haven Health System Center for Emergency Preparedness and Disaster Response was used to author the clinical guidelines. Akin to the paradigm developed by the NDLSEC for conducting on-scene activities, the clinical guidelines use the letters in the word 'disaster' as a mnemonic for recalling the main elements required for mitigating MCIs in the hospital emergency department.
authors.forename: Joseph
authors.initials: J
authors.lastname: Albanese
authors.forename: David
authors.initials: D
authors.lastname: Burich
authors.forename: Deborah
authors.initials: D
authors.lastname: Smith
authors.forename: Lynn
authors.initials: L
authors.lastname: Hayes
authors.forename: James
authors.initials: J
authors.lastname: Paturas
authors.forename: Anthony
authors.initials: A
authors.lastname: Tomassoni
mesh_terms: D000465:Algorithms; D002056:Burns / Q000453:epidemiology* / Q000628:therapy*; D004189:Disaster Planning / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D054527:Mass Casualty Incidents; D017410:Practice Guidelines as Topic; D014218:Triage / Q000458:organization & administration
keywords: CBRN; clinical guidelines; emergency department; hospital readiness; mass casualty incidents