title: Recent advances in medical device triage technologies for chemical, biological, radiological, and nuclear events.
abstract: In 2010, the US Food and Drug Administration (Silver Spring, Maryland USA) created the Medical Countermeasures Initiative with the mission of development and promoting medical countermeasures that would be needed to protect the nation from identified, high-priority chemical, biological, radiological, or nuclear (CBRN) threats and emerging infectious diseases. The aim of this review was to promote regulatory science research of medical devices and to analyze how the devices can be employed in different CBRN scenarios. Triage in CBRN scenarios presents unique challenges for first responders because the effects of CBRN agents and the clinical presentations of casualties at each triage stage can vary. The uniqueness of a CBRN event can render standard patient monitoring medical device and conventional triage algorithms ineffective. Despite the challenges, there have been recent advances in CBRN triage technology that include: novel technologies; mobile medical applications ("medical apps") for CBRN disasters; electronic triage tags, such as eTriage; diagnostic field devices, such as the Joint Biological Agent Identification System; and decision support systems, such as the Chemical Hazards Emergency Medical Management Intelligent Syndromes Tool (CHEMM-IST). Further research and medical device validation can help to advance prehospital triage technology for CBRN events.
authors: 1Center for Devices and Radiological Health,US Food and Drug Administration,Silver Spring,Maryland,USA.
authors: Krystal
authors: http://orcid.org/0000-0002-1290-8169
authors: K
authors: Lansdowne
authors: 1Center for Devices and Radiological Health,US Food and Drug Administration,Silver Spring,Maryland,USA.
authors: Christopher G
authors: CG
authors: Scully
authors: 1Center for Devices and Radiological Health,US Food and Drug Administration,Silver Spring,Maryland,USA.
authors: Loriano
authors: L
authors: Galeotti
authors: 1Center for Devices and Radiological Health,US Food and Drug Administration,Silver Spring,Maryland,USA.
authors: Suzanne
authors: S
authors: Schwartz
authors: 2Office of the Assistant Secretary for Preparedness and Response,US Department of Health and Human Services,Washington DC,USA.
authors: David
authors: D
authors: Marcozzi
authors: 1Center for Devices and Radiological Health,US Food and Drug Administration,Silver Spring,Maryland,USA.
authors: David G
authors: DG
authors: Strauss
mesh_terms: D004189:Disaster Planning; D004632:Emergency Medical Services / Q000458:organization & administration*; D004864:Equipment and Supplies; D015386:Hazardous Substances; D006801:Humans; D054527:Mass Casualty Incidents; D012308:Risk Management / Q000379:methods; D014218:Triage / Q000458:organization & administration*; D014481:United States; D014486:United States Food and Drug Administration; D054044:Weapons of Mass Destruction
chemical_list: D015386:Hazardous Substances
keywords: Assess; CBRN chemical; CHEMM-IST Chemical Hazards Emergency Medical Management Intelligent Syndromes Tool; Lifesaving Interventions; MCI mass-casualty incident; REMM Radiation Emergency Medical Management; SALT Sort; START Simple Triage and Rapid Treatment; Treatment/Transport; biological/emerging infectious; mass-casualty incidents; nuclear; patient monitoring; radiological; triage; weapons of mass destruction