IMPLEMENTATION AND APPLICATION OF A CONTINGENCY PLAN IN CASE OF AN UNCONVENTIONAL CBRNe EVENT: A CASE STUDY IN A HOSPITAL FACILITY

Guidelines on health emergency systems, published by the Official Gazette of the Republic of Italy No. 114 on 11 May 1996, emphasize that effective management of complex events requires seamless functional linkage of all facilities involved in an emergency, whether medical or non-medical. In the context of Chemical, Biological, Radiological, Nuclear and Explosive (CBRNe) emergencies, these principles acquire critical significance. The guidelines delegate the coordination of territorial rescue units to the First Aid Operations Center, demanding an integrated and rapid response from all hospital facilities, directly or indirectly involved. Consequently, every hospital must develop internal emergency plans tailored to their unique capabilities, ensuring readiness for rapid evacuation, large-scale patient intake and synchronization with the regional emergency plan. This work specifically addresses the challenges posed by CBRNe emergencies, outlining the roles and responsibilities of hospitals based on the organizational levels of their Departments of Emergency, Urgency, and Acceptance (DEAs). It also underscores the pivotal role of non-DEA hospitals in supporting the system by facilitating the transfer of stabilized patients to technologically advanced facilities capable of managing large numbers of critically ill patients exposed to unconventional threats. The paper details the protocols and steps to be activated in a hospital setting to manage external CBRNe catastrophes, receive and care for patients evacuated from impacted areas, and respond to internal emergencies requiring evacuation of the facility itself. The aim is to provide a comprehensive framework for enhancing hospital preparedness and resilience in response to CBRNe incidents.