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Previous editions of AMedP-6 series, Handbooks on the Medical Aspects of NBC Defensive Operations, have focused on CBRN defensive operations. This new edition applies to any medical support operation and supports the NATO ‘defence against terrorism’ (DAT) programme even if the CBRN threat is low.

This publication is intended to guide CBRN casualty management from point of exposure (PoE) through to a role 3 Medical Treatment Facility (MTF). The guidance uses the 10-1-2 time framework of MC 326/3¹ as a goal for optimal care while understanding the limitations of operating in a CBRN environment. Role 4 care is likely to use home nation health resources as well as international and civilian cooperation and networks and is therefore beyond the scope of this publication.

AMedP-7.1 focuses on the delivery of medical countermeasures (MedCM) and casualty care, post-incident response and, in the case of covert CBRN incidents, medical recognition, health surveillance and operational epidemiology by deployed medical personnel.

This publication is not intended to provide specific treatment protocols as these remain the responsibility of each member nation. During implementation, nations may customise the treatment protocols shown for illustration by the custodian nation (GBR).

AMedP-7.1 is intended to be used as a template to support national CBRN medical training programs in conjunction with AMedP-7.3: Training of Medical Personnel for CBRN Defence.

Changes and revisions of this publication will reflect:

a. Scientific advice from the NATO Science and Technology Organisation including the Human Factors and Medicine Panels (HFM-041, HFM-099, HFM-186, HFM-222, HFM-253²), as well as other expert organisations and panels.

b. Lessons identified or best practice from national, NATO and international operations and exercises including the NATO Exercise Clean Care 2016.

c. Peer-reviewed international guidelines and reviews including ‘Surviving Sepsis’.

¹ MC 326/3 NATO Medical Support Principles and Policies.

² STO related documents are listed at the end of this publication.