Background <p>Postpandemic experiences and lessons learned from terrorist attacks, wars and disasters worldwide demonstrate that emergency departments must be prepared for mass casualty events related to chemical, biological, radiological and nuclear (CBRN) hazardous materials. The aim of this study was to investigate whether German emergency departments are sufficiently prepared for such events. The main results of this survey have previously been published. This article contains additional results on the preparedness of emergency departments in the different German Federal States.</p> Methods <p>We developed an online questionnaire, which was distributed to all heads of emergency departments in Germany via the German joint emergency department directory. The primary endpoint was whether German emergency departments are sufficiently prepared for CBRN incidents. The results of the survey were described using absolute numbers and percentages. The capacity for decontamination was graphically displayed using box and whisker plots.</p> Results <p>Out of 963 hospitals with emergency departments 262 (27.21%) of the heads of emergency departments answered the questionnaire. Of the hospitals 80.43% (189/235) had a&#xa0;hospital alarm and emergency plan for biological incidents, 49.36% (116/235) for chemical incidents and 34.47% (81/235) for radiological and nuclear incidents. Some form of decontamination site was reported by 50% (116/232) but only 31.42% (71/226) reported having a&#xa0;water supply in the decontamination area. Sufficient protective equipment was only available in 27.61% (63/229) of the emergency departments. Only 12.02% (25/208) of the hospitals were able to decontaminate supine patients following a decontamination scheme.</p> Conclusion <p>Most German hospitals are not adequately prepared to handle casualties resulting from CBRN incidents. Given these results, there is an urgent need to systematically improve the preparedness of hospitals for CBRN incidents.</p>