Chemical–biological–radiological (CBR) response: a template for hospital emergency departments

David A Bradt
Med J Aust 2003; 178 (3): . || doi: 10.5694/j.1326-5377.2003.tb05111.x
Published online: 3 February 2003

To the Editor: The article by Tan and Fitzgerald1 raises numerous concerns. The authors report that their recommended personal protective equipment (PPE) conforms to standards "in a hospital environment where the chemical vapour concentration will not be high". At the same time, the authors acknowledge data indicating most patients from a disaster will present to the local hospital by private transport (ie, without triage, decontamination, or prehospital care). These two considerations are incompatible and further ignore the possibility of the hospital as a direct terrorist target. The authors' assertion that their three decontamination lines "allow mass casualties, as well as trolleys and equipment, to be decontaminated quickly, efficiently, and in an orderly fashion" is simply not evidence based.


  • 1. Tan GA, Fitzgerald MCB. Chemical–biological–radiological (CBR) response: a template for hospital emergency departments. Med J Aust 2002; 177: 196-199. <MJA full text>
  • 2. Association for Professionals in Infection Control and Epidemiology, Inc, and Center for the Study of Bioterrorism and Emerging Infections. Mass casualty disaster plan checklist: a template for health care facilities. October 2001. Available at
  • 3. Agency for Toxic Substances and Disease Registry. Hospital emergency departments: a planning guide for the management of contaminated patients. Vol 2 revised. In: Managing hazardous materials incidents. Atlanta, Ga: ATSDR, 2001. Available at
  • 4. Van Buynder P. White powder incidents in Victoria: a new role for health services. Health of Victorians — Chief Health Officer's Bulletin 2002; 2: 26-30. Available at


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