Subsets that had the fewest items that reached consensus were ‘Medicine2’ (31%; n=5); and ‘Airways2’ (35%; n=11). Consensus for each of these subsets increased when items ‘nearing’ consensus (i.e. >70%) were also considered, (see Table 2). Items that gained consensus amongst raters as being important or very important are listed in Table 3. A full list of items and levels of consensus reached is also provided, (see Additional file 1). Table 2 Consensus levels of items’ importance Table 3 Items that gained consensus as ‘Important’ and ‘Very Important’ and their recommended quantities Round one contained 232 items and rounds two and three contained an additional

16 items, bringing the total number Inhibitors,research,lifescience,medical of items to 248 for the last two rounds. The median Likert scores observed for 232 items in each

of rounds one, two and three were 4, 5 and 5, Selleckchem Androgen Receptor Antagonist respectively, (all with IQR 3 to 5). The non-parametric test for independent events failed to compute, most of the responses were tied in pairs, therefore the Wilcoxon Signed Ranks Test Inhibitors,research,lifescience,medical was used to assess whether there was a significant increase in consensus between rounds. A significant difference was found between median Likert scores for the 232 matched pairs of items between round one and round three (Z=-5.26; 151 ties; p<0.001); Inhibitors,research,lifescience,medical but not between round two and round three (Z=-1.79; 215 ties; p=0.074). Quantity of items required Inhibitors,research,lifescience,medical The median quantities, and Inter Quartile Ranges (IQR), of items that gained consensus by raters are listed in Table 3. Whether the recommended quantities of items between rounds was a statistically significant improvement in participants’ consensus was tested using a Wilcoxon Signed Ranks Test. A significant difference was found between the median number of items for the 232 matched pairs of items between round one and round three (Z=-9.83; ties=80; p<0.001); and also between round two and round three (Z=-2.39; ties=160; p=0.017). Whilst participants suggested similar quantities for many items by round three, other items still had considerably wider Inhibitors,research,lifescience,medical recommended

quantities. This is clearly evident in the persistently large IQR of some items (e.g. Large Latex Free gloves Terminal deoxynucleotidyl transferase had a median recommend quantity of 150, but an interquartile range of 107–195). Discussion Providing appropriate quantities of the right clinical equipment to the scene of a mass casualties big bang event is vital. But planning for such emergencies is challenging. This study has, for the first time, produced an expert consensus on the items and quantities of clinical equipment that are required to treat 100 people at the scene of a big bang mass casualties event. The results of this study clearly identify the equipment that is deemed of greatest importance. Items of clinical equipment that are highly likely to be required in the immediate care and treatment of trauma patients (e.g.