EMERGENCY MEDICAL SERVICE PROVIDER'S PREPAREDNESS AGAINST CHEMICAL, BIOLOGICAL, RADIOLOGICAL, AND NUCLEAR (CBRN) INCIDENTS: A SYSTEMATIC REVIEW

Abstract

INTRODUCTION: The preparedness of the prehospital emergency medical system (PEMS) for chemical, biological, radiological, and nuclear (CBRN) threats is essential. As they are typically the first responders to these incidents, it is necessary to assess the current readiness and review the key elements of preparation for such incidents. This systemic review aimed to evaluate the current state of preparedness and review the main aspects of preparation against such incidents. MATERIAL AND METHODS: This study followed the Preferred Reporting Items for Systematic Reviews and Meta- analysis guidelines. PubMed, ProQuest, Web of Science (WOS), and Scopus were the primary databases used for the literature search. The Google Scholar search engine was additionally searched from 2000 to 2023. Keywords used in this review were CBRN, EMS, and preparedness. Their equivalents were obtained from Medical Subject Headings (MeSH), and expert opinions or related articles. Papers from various disciplines related to the keywords were included. RESULTS: From the 3,411 articles identified through early electronic database search, 21 articles were selected for this review, followed by an analysis of the characteristics and content of the included studies to answer the study questions. Data analysis revealed a lack of preparedness and inadequate attention from authorities regarding CBRN incident readiness and the strategies needed for improvement. The content analysis identified six key themes: educational issues, mental health challenges, resource shortages, policy-making concerns, legal considerations, improved cooperation among all stakeholders, and various challenges faced in these areas. CONCLUSIONS: It is crucial to be well-prepared for CBRN incidents in the PEMS. This involves creating suitable policies, providing ongoing education and training, conducting regular drills, allocating resources, establishing specific response protocols, collaborating with all stakeholders, and ensuring legal protections for EMS providers during CBRN incidents. © (2025), (Via Medica). All rights reserved.