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Background The chemical, biological, nuclear, and radiological (CBNR) risk is indisputable and constant, but real situations are rare [1, 2]. The objectives of the emergency services facing these situations are primarily tactical, whether on the field or at the hospital door, and include reducing the morbidity and mortality of those exposed and limiting the risk for workers and care structures [3]. Their success meets the strategic and national objectives to minimize people’s panic and, as a result, the political effects. One of the challenges of emergency system personnel, who are the first responders, is to maintain the high level of performance required of pre-hospital and hospital workers, whether or not they are care providers [4]. However, effective preparation remains complex due to the low level of evidence to support tactical concepts, the pedagogical and logistical challenges of simulating the agents involved, and the scarcity of experts.

The chemical, biological, radiological and nuclear (CBRN) chain of survival: a new pragmatic and didactic tool used by Paris Fire Brigade