Protection Professonal Bulletin

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Published 1/9/2026
By Captain Desmond A. Edwards

 

 

According to the updated Army Regulation AR 350-1, Chemical, Biological, Radiological, and Nuclear (CBRN) training is now considered optional. 1 However, because CBRN is a low-density Military Occupational Specialty (MOS) in most units, it is crucial to integrate CBRN training across other warfighting functions to enhance readiness and retention. Building buy-in at echelon requires understanding unit mission sets and identifying training opportunities that improve capabilities and overall unit readiness. This article discusses the integration of CBRN training into medical units to close the knowledge gaps in medical treatment for CBRN casualties. 

Content

 

From my time as a second lieutenant (2LT), I observed that medical treatment of CBRN casualties often took a backseat when assigned to non-CBRN units. The common scenario was as follows: an alarm sounded, a CBRN casualty was identified, the unit transitions into Mission Oriented Protective Posture (MOPP) level 4, and the casualty was transported to Role 1 medical treatment facility. Aside from testing how fast a unit could get into MOPP 4, there was minimal focus on CBRN-specific training. I spoke with medics in that unit about treating CBRN casualties, and their responses varied from focusing on nerve agent treatment with the Antidote Treatment Nerve Agent Auto-Injector (ATNAA) to blank stares followed by, “I thought that was the Chem-O’s job.” 

As a 2LT., I was not aware of this, but this sentiment remained consistent among the medics with whom I interacted until I attended the CBRN Captain’s Career Course. It was there that I received training on the medical treatment of CBRN casualties from the United States Army Chemical, Biological, Radiological, and Chemical School program of instruction (POI) update of 2021. I quickly realized three critical things: 

  1. All CBRN casualty treatment is found in medical doctrine. 
  2. The average CBRN specialist (74D) or CBRN officer (74A) is not trained on the medical side of CBRN defense. 
  3. The average combat medic specialist 68W () is not trained on the CBRN side of medical treatment. 
 

Bridging the Gap

 
While assigned to an air defense brigade in Korea, I wanted to test my hypothesis that the average 68W lacked sufficient CBRN medical treatment training. Units in Korea are subject to a CBRN readiness requirement that exceeds that of most Army units. After speaking with the brigade surgeon and senior medics, I identified a training gap that needed to be addressed before real-world contingencies or large-scale exercises. The brigade protection cell and surgeon cells collaborated to create a cross-training curriculum for the 74Ds and 68Ws within the brigade. 


Address the Gap

 

The training was structured as a two-part academic session to reach the widest audience possible, particularly within a geographically distributed unit. The first portion addressed chemical and biological threats, while the second focused on radiological and nuclear threats. Drawing from Army techniques publication (ATP) 3-11.37, 4-02.84, and ATP 4-02.85, we developed training for the first portion to address the following:2 

  1. Identification and intended use of medical supplies organic to the unit. 
  2. Procedures for determining when to request the release of CBRN Class VIII medical supplies. 
  3. Recognition of common symptoms and appropriate treatments for chemical and biological agents.3 

Consolidated table of known Class VIII medical supplies for CBRN casualties.

For the radiological and nuclear training, we referred to ATP 4-02.83 to address medical treatment for radiological casualties.4 The objective was to demystify nuclear incidents and train planners and medics on how to respond to these scenarios. This training allowed medics to understand how to triage injuries from a medical perspective without immediately defaulting to the chemical team. The key learning objectives for this portion were: 

  1. Identification and use of organic CBRN Class VIII medical supplies. 
  2. Understanding the differences between nuclear and radiological incidents. 
  3. Recognition of common indicators of radiological/nuclear events. 
  4. Triage and treatment procedures in radiological and nuclear scenarios. 
  5. Medical logistics considerations. 

This training was conducted in preparation for a major exercise, where casualties were not considered treated simply by being loaded onto a litter. The training created buy-in from the medics and added credibility to CBRN education within a non-CBRN unit. It also led to greater integration of CBRN training across other unit functions beyond medical support. 

Integrate Medical CBRN as a Force Multiplier 

 
Medical CBRN integration provides an effective entry point for units with limited CBRN training programs. When CBRN knowledge is integrated through medical channels, it fosters trust within the CBRN community and increases overall unit readiness. Medics trained in CBRN casualty care contribute directly to the survivability of troops in combat environments. 

 

Apply Training 

 

The following individual tasks can be trained through the integrated training process previously described. This training prepares medics to provide medical care for CBRN casualties from the point of injury through Role 2. 

Individual Tasks: 

  • 081-000-0114: Treat a Blood Agent (Hydrogen Cyanide) Casualty. 
  • 081-000-0115: Treat a Choking Agent Casualty. 
  • 081-000-0116: Treat a Blister Agent Casualty (Mustard, Lewisite, Phosgene Oxime). 
  • 081-000-0118: Treat a Radiation Casualty. 

Platoon-Level Tasks: 

  • 08-PLT-0311: Establish a Patient Decontamination Station. 

Company-Level Tasks: 

  • 08-CO-0232: Treat Chemical, Biological, Radiological, and Nuclear Contaminated Casualties. 
 

Train at the Individual Level 

 

This integrated training enables medics at all levels to become familiar with medical treatment protocols for effective response to CBRN incidents up to the Role 2 echelon. It will enhance the integration of brigade combat team medical companies, improving unit survivability and overall lethality. 

In addition to internal training for the tasks listed above, 12-16 hours of instruction could be added to the Advanced Leaders Course (ALC) and Senior Leaders Course (SLC) for 68W and 74D Soldiers. This would ensure squad leaders, platoon sergeants, and echelon planners are equipped to plan and resource the necessary materials for combat effectiveness in a CBRN-contaminated environment. 

An additional option is to create a mobile training team (MTT) as an extension of the Maneuver Support Center of Excellence Protection Integration Course. This team could travel and provide large-scale training across various units, ensuring widespread exposure to CBRN readiness. Integrating the MTT at training centers could also be used to supplement these additional requirements.  

Conclusion

 

While the changes to AR 350-1 have identified CBRN training as an opportunity for optional integration, CBRN officers and noncommissioned officers must find creative ways to embed CBRN readiness into all aspects of unit training without compromising lethality. The key strength of the Chemical Branch is its ability to serve as a force multiplier. Integrated CBRN increases survivability, enhances Soldier readiness, and degrades enemy capabilities. An integrated approach to CBRN training saves Soldiers time, allowing them to focus on their primary tasks. As adversaries become increasingly sophisticated, we must remain vigilant and ready to protect the force. 

Endnotes:

1 Headquarters, Department of the Army. 2025. AR 350-1 Army Training and Leader Development. June 1, 2025. 

2 Headquarters, Department of the Army. 2019. ATP 4-02.84 Multi-service Tactics, Techniques, and Procedures for Treatment of Biological Warfare Agent Casualties. Washington, DC: Headquarters, Department of the Army, November 21, 2019; Headquarters, Department of the Army. ATP 4-02.85 — Multi-Service Tactics, Techniques and Procedures for Treatment of Chemical Warfare Agent Casualties and Conventional Military Chemical Injuries. August 2, 2016.. 

3 Headquarters, Department of the Army. 2021. ATP 3-11.37 Multi-Service Tactics, Techniques, and Procedures for Chemical, Biological, Radiological, and Nuclear Reconnaissance and Surveillance. August 2, 2021. 

4 Headquarters, Department of the Army. ATP 4-02.83 — Multiservice Tactics, Techniques, and Procedures for Treatment of Nuclear and Radiological Casualties. May 5, 2014. 

Captain Edwards is the Company Commander for Greenville Recruiting Company in Greenville, South Carolina. He holds a bachelor’s degree in biology from Susquehanna University, Selinsgrove, PA.