CDC’s CHEMPACK Program—The Stockpile that may protect you from a chemical attack

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City life

It’s a terrifying but plausible scenario. You’re in an enclosed crowded place—perhaps a subway or a mall—and a terrorist organization releases lethal quantities of a nerve agent such as sarin into the air. The gas sends your nervous system into overdrive. You begin having convulsions. EMTs rush to the scene while you go into respiratory failure. If they have nerve agent antidotes with them, you may have a greater chance of living. If they don’t, you may be more likely to die. Will you survive?

Thanks to CDC’s Strategic National Stockpile CHEMPACK program, the answer is more likely to be yes.

First responders prepare for CHEMPACK training.
First responders prepare for CHEMPACK training.

CHEMPACKs are deployable containers of nerve agent antidotes that work on a variety of nerve agents and can be used even if the actual agent is unknown. Traditional stockpiling and delivery would take too long because these antidotes need to be administered quickly. CDC’s CHEMPACK team solves this problem by maintaining 1,960 CHEMPACKs strategically placed in more than 1,340 locations in all states, territories, island jurisdictions, and the District of Columbia. Most are located in hospitals or fire stations selected by local authorities to support a rapid hazmat response. More than 90% of the U.S. population is within one hour of a CHEMPACK location, and if hospitals or first responders need them, they can be accessed quickly. The delivery time ranges from within a few minutes to less than 2 hours.

CHEMPACK container
CHEMPACK container

The medications in CHEMPACKs work by treating the symptoms of nerve agent exposure. According to Michael Adams, CHEMPACK fielding and logistics management specialist, “the CHEMPACK formulary consists of three types of drugs: one that treats the excess secretions caused by nerve agents, such as excess saliva, tears, urine, vomiting, and diarrhea; a second one that treats symptoms such as high blood pressure, rapid heart rate, weakness, muscle tremors and paralysis; and a third that treats and can prevent seizures.”

Maintaining CHEMPACKs throughout the nation is challenging, but it is an essential part of the nation’s defenses against terrorism. The CHEMPACK team must coordinate with limited manufacturers to keep the antidote supply chain functioning. CHEMPACK antidotes are regularly tested for potency and are replaced when needed. They must be maintained in ideal locations for quick use by hospitals and first responders. But, having them available is only the first step. Personnel who may use them need to know where they are and must be trained. CDC supports state and local partners as they identify CHEMPACK placement locations and conduct trainings for their responders.

Terrorist nerve agent attacks are not hypothetical. The Aum Shinrikyo group in Japan used sarin gas to attack subway passengers twice: an attack in 1994 killed eight people and a second attack in 1995 killed 12. Experts agree that these attacks were amateurish and a better timed and executed attack could have killed many more people.

CDC’s CHEMPACK team is part of the rarely seen network that protects the people of the United States from unusual threats. You might not have heard much about them, but if you are ever attacked by nerve agents, they may be the reason you survive.

PHPR: Health Security in Action

This post is part of a series designed to profile programs from CDC’s Office of Public Health Preparedness and Response.

The CHEMPACK program is a program run by CDC’s Office of Public Health Preparedness and Response’s (PHPR) Division of Strategic National Stockpile.


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18 comments on “CDC’s CHEMPACK Program—The Stockpile that may protect you from a chemical attack”

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

    Sounds like a good idea. What is the next step after survival? And is there a plan to pay survival bills?

    Good deal. However, curiosity begs the question: why is the main focus (CHEMPACK placement) in the East and primarily along the coastline, whereas population densities of 9.5 x 10^3 – 2.6 x 10^4 & 6.3 x 10^3 – 9.4 x 10^3 in some states appear to be well outside of the 1 hour buffer zone? Would this have something to do with economic resources or are the somewhat neglected pop densities close to potential air transport? In other words, what were the ‘potential threat vs distribution’ criteria? (not that I’m complaining, KCMO appears to be well stocked)

    Hello Dana, thank you for your interest in CHEMPACK. The containers contain auto injectors of a number of different nerve agent antidotes, but due to national security concerns, CDC does not provide information on specific products in the stockpile. Your local public health department and first responders work together on placement of CHEMPACK containers in your community, and most are located at fire houses and hospitals. First responders like EMTs, firemen, healthcare workers, etc. are the people who will access the containers in an emergency in order to administer these life-saving antidotes to the public.

    Thank you, Blog Administrator! I was unaware of the CHEMPACK program and appreciate this information. Considering that neurological agents have been used very recently, we should refresh our training on response, including the physiological signs of the S-L-U-D-G-E acronym!

    It is very important to know this information as nurses because if there were every to be a terrorist attack using nerve agents, as nurses it is our duty to help and protect those injured. These individuals may be our patient or even someone that you are helping off duty. It is a feeling of relief knowing that there are antidotes available in case such an event takes place.

    I found the information in this post, and the links within, to be greatly informative! I had not heard of the CHEMPACK program, but it is good to know that emergency preparedness efforts have been made in the area of chemical terrorism. I am a nurse in one of my community’s major hospital systems and, while I do not work in the emergency department, I was surprised the CHEMPACK program and associated hospital response preparations have not been incorporated in our annual hospital-wide emergency preparedness training. It was eye-opening (and scary) to read about the ways in which the different chemicals impact the body systems. In today’s world, this type of threat is a very real possibility and having a basic understanding of symptoms, precautions, and treatments is important for health care providers. One thing I noticed was the last update to the CHEMPACK webpage was in 2011. I absolutely understand the need to keep the majority of this information secret, but I am curious as to whether progress has been made on rolling out the Enterprise CHEMPACK program. I also wonder if advances have been made to disperse the antidote supply to cover a broader area of the U. S., whether the population increase over the past few years has been accounted for in determining the quantity of antidotes to supply, and if the antidote is believed to be effective for a significant portion of possible chemical weapons. This post certainly gave me a lot to think about.

    Can the Chempack assets be released to persons who are not Pharmacist’s? In trying work out a plan to access the Chempack, the local hospital said it could only be released to a Pharmacist.

    Individual hospital protocol dictates the designated person(s) able to access CHEMPACK materials in an emergency. That person/role may vary from hospital to hospital.

    As a First Responder my Fire -Rescue Dept has a chem pack of nerve agents stored at our main location, which is good, however I have been here a long time and cannot recall ever receiving training on it nor do I even know what type of auto injector we have. I would like to receive contact information of someone I can get in touch with who can provide this training. I am the Training Officer for the Fire District. Thank you.

    CHEMPACK supplies are stored in a locked container on wheels that can easily be moved in an emergency. The approximate footprint of the container is 60.5 x 32.5 x 60.5 (H x W x L), and it does not need to be stored in a cage since it is secured and remotely monitored. For specific questions, please contact CDC-INFO:

    I’m looking into the CHEMPACK program in Colorado. I work for the Colorado Springs Fire Department and putting together a long term plan for CBRN and other threats. Our community has 5 military instillations in close proximity and we have been identified, through threat evaluation, as a high risk area. The CHEMPACK stockpile program looks to be promising to our community as a threat response package. Please email back with local contact, other areas with CHEMPACK program and any further resources you may have. Thank you.

    Brian J. Kurtz
    Colorado Springs Fire Department
    Medical Division FF/PM

    Are there any updated training materials that I can use to train Hospital Leadership and responders?

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Page last reviewed: June 1, 2017
Page last updated: June 1, 2017