Although agent identification may help to drive the treatment course, it is not required prior to providing casualty care in a CBRN environment. Casualty treatment should never be delayed pending confirmatory agent identification. Clinical assessment (using CRESS described below and in Table 3) is necessary to determine immediate therapy. Decisive efforts for agent identification can be done in parallel with timely medical treatment. It should be recognized that intelligence reporting may be incomplete or inadequate. There are a variety of detectors that can aid in agent identification and providers should be familiar with the technology that is part of their organization.

Combine available intelligence, technology, and patient presentation to create a comprehensive picture for agent identification to help guide treatment. Mixed exposures are possible and correlating patient signs and symptoms with adjunctive agent identification techniques can help ensure the proper treatment is pursued.

**Casualty treatment should never be delayed pending confirmatory agent identification. Clinical assessment (using CRESS described below) is necessary to determine immediate therapy. Decisive efforts for agent identification can be done in parallel to timely medical treatment.**