Whether it is COVID in New York, chemicals in Syria, or a radiological exposure from a dirty bomb or nuclear detonation, trauma is increasingly mixed with CBRN. Decontamination, isolation, and newer treatments all impact the patient as well as the physician. Military physicians regularly plan for these patients, but the civilian world has not. Civilian CBRN training has been spotty, at best. Our recent experience with COVID and the current threats of nuclear attack, emphasize the need to integrate CBRN exposure into our trauma treatment plans, both to help our patients and to protect the caregivers.

Literature review and US Department of Health and Human Services Guidelines.

A template for patient flow and treatment priorities is presented along with just-in-time references. Triage guidelines for trauma patients with Acute Radiation Syndrome (ARS) are also provided.

Civilian preparation for managing the CBRN contaminated trauma patient starts with a mental model of treatment priorities and self-protection strategies. Just-in-time treatment references can provide additional support and confidence.