Swift and Low-Cost Surge in Chemical Threat Response: Is It Possible? The Experience of a French Hospital

Abstract

In 2016 France hosted the European football championship. In a context of an increased terrorist threat, Chemical, Bacteriological, Radiological, Nuclear (CBRN) attacks were considered possible. Three days prior to the beginning of the event, the Health Authorities required that a medium sized hospital close to a major potential target, prepare a chemical decontamination centre. Despite a low level of preparedness, little external help, and very few extra resources, an efficient decontamination chain (all premises necessary for the management of contaminated victims: from the entrance gate to the post-decontamination dressing cabins) was set up in 15 days (12 days after the unrealistic deadline). Numerous practical measures allowed three persons in CBRN personal protective equipment (PPE) to manage the whole chain, providing a maximum flow of 24 persons/hour. Volunteers were trained in PPE dressing, undressing and in decontamination procedures. This experience, offers a novel paradigm in managing chemical decontamination, in terms of attitude, and with adaptations to overcome practical constraints. It demonstrates that it is possible to set up a decontamination chain rapidly at very low cost. This provides an attractive option for less advanced countries and in humanitarian contexts. Some additional refinements, enhancements may be considered to further improve results. (Disaster Med Public Health Preparedness. 2018;12:649-656).

Keywords: CBRN decontamination; chemical threat; hospital’s surge capacity; low cost decontamination chain.