The creation of a medical incident response plan for the treatment of injured victims contaminated during a chemical incident challenges more man one of me rescue services involved in civil emergency response. Our main objective the was to create an incident management plan compatible with existing rescue service logistics and resources.

Under the supervision of the Schutzkommission des Inneren and with delegates from emergency medical services, fire, technical rescue services, and the German Army, a consensus conference to investigate the general conditions necessary and the existing structure available for managing victims of chemical incidents, was created. Typical injury patterns and their treatment in respect to decontamination procedures were considered, the necessary structure for casualty treatment and decontamination areas were derived, and commercially available products were tested for their usefulness in this situation. Standard operating procedures and algorithms were developed to aid realization of the concept. The suitability of the personal protective equipment and the question, if under these conditions the procedures of advanced life support can be performed, was evaluated in a standardized simulator model. The necessary training for rescue personnel involved was defined. To validate the concept, an exercise was performed.

All persons present at a chemical incident are to be classified as being contaminated. Injured persons must be separated into triage categories, and life threatening conditions treated before being decontaminated. Decontamination at the incident scene is necessary to prevent the transportation of the contaminant away from the incident scene. The principles of the decontamination of injured persons are based on the following pillars: triage, early removal of clothing, management of personal belongings and valuables, basic life support, spot decontamination, management and sealing of open wounds, application of antidotes, and primary decontamination of ambulant and non-ambulant victims.

The cooperation and the definition of roles between fire services (decontamination) and emergency medical services (triage and treatment) are necessary.

The concept uses existing decontamination vehicles used for the decontamination of fire fighters, by expanding its inventory with medical equipment, and extra technical apparatus. Using a modular approach, the system can be easily augmented by further units to treat multiple numbers of victims. However, demands on all rescue services involved are high, and must be complemented with an equally high standard of training, especially where rescue services have to learn skills not akin to their standard duties. An implementation of the system covering all geographical areas with specialized units is not possible, therefore a risk analysis to optimally position limited resources has to be conducted. Legislative bodies must strive to allow for an uncomplicated integration and disposition of disaster management resources.