A review of CBRN topics related to military and civilian patient exposure and decontamination.

Chemical and biological (CB) warfare have long been practiced, and although these types of warfare are not acceptable in modern times, this does not prevent them from occurring. This makes it important for societies to be able to appropriately respond to these events, including the best way to decontaminate victims to keep them and emergency responders safe. Decontamination methods such as chemical, physical, wet, and dry methods are discussed, as well as their downsides. Secondary contamination, which played a significant role in the Tokyo sarin attacks, has long been noted by anecdotal evidence, although it has been little studied. Biological agents cause more problems after infection has taken place, and thus preventing the spread of infection is the largest concern. There are many differences between military and civilian populations, and the response to mass casualty attacks differs accordingly. There are several emerging technologies that can make this process easier on all parties, such as bioscavengers, antitoxins, and color changing bleach for visualization. A reliable way to quantify decontamination is also needed, which would allow for better care of victims both in normal hospital situations, as well as during aeromedical transport. In addition, several gaps were identified, such as the lack of scientific basis for 90 percent reduction during decontamination, a way to quantify decontamination, and the lack of studies on toxic industrial chemicals and secondary contamination.