Training of public health personnel in handling CBRN emergencies: a table-top exercise card concept.

There is a large concern in the society today about the threat posed from releases of chemical, biological, radiological or nuclear (CBRN) materials, whether accidental or malicious. A rapid and adapted response to a CBRN incident combined with a thorough public communication is believed to decrease the detrimental impacts on health and to reduce the psychosocial effects. To facilitate CBRN exercises, which often can be regarded by non-specialists as rather complicated, a tool in the form of a set of Exercise cards for CBRN emergency response table-top exercises has been developed. The exercise tool is a generic tool intended for an exercise director and consists of a set of adaptable scenarios with supporting instructions and questions that deal with preparedness, acute response and mitigation efforts. The exercise tool was tested in three different settings with positive results and has been assessed to be a cost-efficient means to train and test public health response to CBRN incidents.