Abstract
Chemical, biological, radiological, nuclear, and explosive devices can all be used to cause mass disruption and mass casualties. These incidents can occur naturally but are usually associated with terrorism and often require prehospital and hospital care for patients and various precautions for clinicians. It is important to consider for each kind of exposure how clinical and ethical demand for rescue should be balanced against field-based risk of injury, contamination, or death to tactical personnel. Chemical exposures typically require prompt extrication, decontamination, and medical management; biological and radiation exposures generally require donning personal protective equipment; and explosives could contain "dirty bombs" or secondary devices.
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