Is Rome ready to react to chemical, biological, radiological, nuclear, and explosive attacks? A tabletop simulation

Francesco Rosiello,Antonio Vinci, Matteo Vitali, Manuel Monti,Lidia Ricci, Elisa D'oca, Felice Marco Damato, Virgilio Costanzo, Giovanni Ferrari,Matteo Ruggeri,Serafino Ricci

Italian Journal of Medicine(2024)

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Abstract
Rome is vulnerable to chemical, biological, radiological, nuclear, and explosive (CBRNe) attacks. The study evaluates Rome’s advanced emergency departments’ state of emergency plans for massive influx of injures (PEIMAF) plans for CBRNe attacks. We propose a chemical attack on Saint Peter’s Square during the Pope’s General Assembly and its effects. The National Stockpile Antidotes’ activation and territorial distribution timing work well for chemical attacks. We also estimated activation timing. Our data show that despite a good organization, travel times can be improved. We also believe that all major Roman hospitals must develop the PEIMAF, which should be followed by an organized training plan involving theoretical teaching and indoor and outdoor simulation to train hospital staff and evaluate PEIMAF weaknesses and vulnerabilities. The effectiveness and efficiency of first aid depend on timing, and each PEIMAF analyzed, while coherent and adequate for internal purposes, fails to integrate with the other hospitals. Integration can speed up National Stockpile Antidotes delivery and save lives. For the best CBRNe response, detailed intervention protocols must be created, updated daily, and exercised.
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Key words
CBRNe,hospital management,stockpiles warehouse,health management
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