Planning of medical support for a threatened or actual biological environment. principles, policies and procedures

摘要

Suitable approaches for planning medical support for German Armed Forces out-of-area-operations in a threatened or actual BW environment have not as yet been available. Therefore, appropriate principles, policies and procedures for the medical management of BW casualties and for creating a computerized planning system have now been developed. The latter will enable the user to estimate the probable numbers and rate of casualty intake and to calculate the resources required for level A to C medical support in different BW scenarios and on the basis of different planning assumptions. The system includes models for simulating BW scenarios after an assumed exposure of units varying in size, level of physical NBC protection and effectiveness of medical countermeasures (e.g. immuno- and/or chemoprophylaxis) against aerosols of potential biological warfare agents. Unique incidence and epidemic models have been elaborated with the help of which explosive epidemics and the cumulative percentage or absolute numbers of BW casualties over a period of time can be calculated. Based on clinical, epidemiological and logistical aspects, possible clinical syndromes after inhalation of biological agents are reduced to four grades of severity depending on the agent and the percentage distribution of casualties. Policies governing personnel and material requirements for decontamination, evacuation and treatment at each role of the medical evacuation chain are formulated.