SynthesisBMC emergency medicine2025
Bridging the preparedness gap: a systematic review of recommended stockpile items for radiological and nuclear emergencies.
Synthesis in BMC emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
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Corrections and comments
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhile rare, radiological and nuclear (RN) emergencies pose complex challenges that require tailored preparedness strategies. A key aspect is the strategic stockpiling of medical countermeasures (MCMs), yet existing literature offers limited and fragmented recommendations regarding their appropriate composition.
methodsThis systematic review, conducted following PRISMA guidelines, aims to consolidate and critically appraise available evidence on stockpiling for RN emergencies. Seven databases and selected grey literature sources were screened from 2011 onward. Studies were included if they provided direct or indirect recommendations on stockpiling items. Data extraction was conducted in two steps by independent pairs of reviewers, and identified items were categorized as therapeutics, medical devices, personal protective equipment (PPE), or RN-specific equipment. Items were further analyzed for regulatory status, administration route, shelf-life, and storage requirements.
resultsThirty-two articles met the inclusion criteria. Therapeutics dominated the findings, with 50 distinct agents identified, most frequently potassium iodide, Prussian Blue, Ca-/Zn-DTPA, and hematopoietic growth factors such as filgrastim. In contrast, medical devices were not supported by a sufficient level of stockpiling recommendation, while PPE (6 of 32 articles) and RN equipment (14 of 32 articles) were cited less often. Pediatric considerations were rarely addressed, with 2 studies explicitly focused on this population. Gaps in operational guidance, regulatory harmonization, and standardized planning emerged across the literature.
conclusionsThis review highlights that stockpiling recommendations for RN emergencies remain limited, with greater guidance concentrated on a few therapeutics and little direction for other items. The findings provide an informative evidence base to support more consistent policy and preparedness planning.
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