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Contact: President Jerome Hauer




Medical Response Work Group

Health physicists play a major role in medical radiological emergency response. Preparedness will ensure that treatment of life-threatening injuries or medical conditions takes priority over surveys for and removal of radioactive contamination. Hospital emergency planning, training, and drills will instill confidence in the staff to manage these emergencies.
Drill Preparation

The Medical Response Work Group members are:

Adela Salame-Alfie (yta1@cdc.gov), Chair

Isaf Al-Nabulsi, PhD, DOE
Armin Ansari, PhD, CDC
Stan Bravenec, MS Michael DeBakey VA Med Center
Marcia Hartman, MS, UC Davis Health System
Amir Huda, PhD, California State University Fresno
Linda Kroger, MS, UC Davis Health System
John Lanza, MD, PhD, MPH, FAAP, Florida County Health Department
Edwin Leidholdt, PhD, Western Region Veterans Affairs
Chunsheng Li, PhD, Health Canada
Steve Maheras, PhD, CHP, Battelle
Carol Marcus, MD, UCLA
Miles McCord, PhD, Howard University
Kevin Nelson, PhD, Mayo Clinic
Glen Reeves, MD, DTRA
CM Wood, consultant

The websites and other documents listed below are useful references on the medical response to a radiological emergency:

Hospital Training
The presentation "Emergency Department Management of Radiation Casualties" was prepared by the Health Physics Society for hospital staff training.
Also available, Hospital Response Following a Terrorist Incident Involving Radioactive Material.
Comments may be sent to Jerrold T. Bushberg, PhD, at jtbushberg@ucdavis.edu.

Past HPS President Kevin Nelson presented Medical Reponse Plan and a Poster at his chapter visits.

The Radiation Emergency Assistance Center/Training Site (REAC/TS) provides training, guidance, and assistance in the medical management of radiation incidents. REAC/TS team of physicians, nurses, health physicists, radiobiologists, and emergency coordinators is prepared to provide around-the-clock assistance on the local, national, or international level. The 24-hour emergency telephone number for REAC/TS is 1-865-576-1005.

CDC released Interim Planning Guidance for Preparedness and Response to a Mass Casualty Event Resulting from Terrorist Use of Explosives. (Although the document does not address an IND event, some of the guidance and concepts may be of interest)

http://emergency.cdc.gov/masscasualties/pdf/cdc_guidance-508.pdf

CDC released a Blast Injury mobile application to assist in the response and clinical management of injuries resulting from terrorist bombings and other mass casualty explosive events. The application provides clear, concise, up-to-date medical and healthcare systems information to assist healthcare providers and public health professionals in the preparation, response, and management of injuries resulting from terrorist bombing events. Download the mobile application for free from the iTunes store:

https://itunes.apple.com/au/app/cdc-blast-injury/id890434999

CDC released seven new short video clips listed below:

http://emergency.cdc.gov/radiation/protectiveactions.asp

Protective Actions for Radiation Emergencies

Medical Treatments (countermeasures) for Radiation Emergencies

Health Effects

NEW! A Guide to Operating Public Shelters in a Radiation Emergency (February 2015)(http://emergency.cdc.gov/radiation/pdf/operating-public-shelters.pdf) has been developed to assist with planning and response efforts related to shelter operations in a radiation emergency. This guide is the result of a multiagency collaboration exploring the unique challenges radiation emergencies pose for shelter operations.

NEW! Medical Countermeasures for Radiation Exposure and Contamination(http://emergency.cdc.gov/radiation/countermeasuretraining.asp) is a training module that aids in better understanding what medical countermeasures (treatments) are available for radiation exposure and contamination, how they work, and how and when they should be used.

NEW! Radiation Basics Made Simple(http://emergency.cdc.gov/radiation/radbasics.asp)
A training module that introduces participants to the fundamentals of radiation and radioactivity. This training features an enhanced lecture-style video and interactive knowledge checks to deliver and reinforce key concepts.



The Centers for Disease Control and Prevention has many resource documents to assist hospitals for radiation emergency response. Of particular interest are:

Radiation Event Medical Management Website

The Radiation Event Medical Management (REMM) website provides guidance for health care providers, primarily physicians, about clinical diagnosis and treatment during mass casualty radiological/nuclear events.

The Radiation Injury Treatment Network® (RITN) provides comprehensive evaluation and treatment for victims of radiation exposure or other marrow toxic injuries. RITN develops treatment guidelines, educates health care professionals, works to expand the network, and coordinates situation response. RITN is a cooperative effort of the National Marrow Donor ProgramÃÆÙ‚® (NMDP) and the American Society for Blood and Marrow Transplantation (ASBMT).

Medical Reserve Corps Website

The mission of the Medical Reserve Corps (MRC) is to improve the health and safety of communities across the country by organizing and utilizing public health, medical, and other volunteers. MRC units are community-based and function as a way to locally organize and utilize volunteers who want to donate their time and expertise to prepare for and respond to emergencies and promote healthy living throughout the year.

ARTICLES & REPORTS

DHS and HHS released “Patient Decontamination in a Mass Chemical Exposure Incident: National Planning Guidance for Communities” on December 2014. The document provides non-binding recommendations for first responders dealing with mass chemical exposure incident. The guidance may also benefit the care that is provided to individually contaminated patients in other circumstances. The guidance can be downloaded from http://www.phe.gov/Preparedness/responders/Documents/patient-decon-natl-plng-guide.pdf.

The National Academies of Science released the summary of the 2014 Gilbert W. Beebe Symposium presentations and discussions titled The Science of Responding to a Nuclear Reactor Accident. A summary may be downloaded free of charge at http://www.nap.edu/catalog/19002/the-science-of-responding-to-a-nuclear-reactor-accident-summary.

NCRP Report No. 161, Management of Persons Contaminated With Radionuclides, provides guidance to those who may be called to respond to radionuclide contamination incidents.NEW!

NCRP Report No. 165, Responding to Radiological or Nuclear Terrorism Incidents: A Guide for Decision Makers, provides the most comprehensive summary to date of recommendations and key decision points for planners preparing responses to radiological or nuclear terrorism incidents. NEW!

NCRP Report No. 138, Management of Terrorist Events Involving Radioactive Material. The Report's main emphasis is on guidance to "first responders" and "emergency medicine personnel" that would be involved in the management of terrorist events involving radioactive material.

Medical Management of Internally Radiocontaminated Patients issued by Los Angeles County Emergency Medical Services

Nuclear/radiological terrorism: Emergency department management of radiation casualties is a recent journal article. (Bushberg JT, Kroger LA, Hartman MB, Leidholdt EM Jr, Miller KL, Derlet R, Wraa C. J Emerg Med. 2007 Jan;32(1):71-85.)

Disaster Preparedness for Radiology Professionals: A Primer for Radiologists, Radiation Oncologists, and Medical Physicists was prepared by the ACR, ASTRO, and AAPM.

The Armed Forces Radiobiological Research Institute (AFRRI) provides a pocket guide and Medical Management of Radiological Casualties that contain guidance on the medical management of radiation incidents. Emergency (24 hours): 301-295-0530

"Management of Persons Accidentally Contaminated with Radionuclides" National Council on Radiation Protection (NCRP) Report No. 65 provides information on the management of internal contamination in patients.

Medical Management of Radiation Accidents, by Fred A. Mettler, Angelina K. Guskova, and Igor A. Gusev (Eds), is an excellent book on medical management that includes many case studies of accidents. (2nd Edition, ISBN: 0849370043 [April 2001], University of New Mexico, Albuquerque, New Mexico)

The Department of Homeland Security Working Group on RDD Preparedness has prepared a document summarizing Medical Preparedness and Response, which addresses medical guidelines, psychological aspects of an RDD/IND event, and medical countermeasures.

Public Protection from Nuclear, Chemical, and Biological Terrorism, edited by Allen Brodsky, Raymond H. Johnson, and Ronald E. Goans, is the syllabus of the 2004 HPS summer school. Preview the chapter on hospital response.

Operational Radiation Safety has published an article, Health Physics Considerations in Medical Radiation Emergencies, (Health Phys. 87:2; S19-S24, 2004) describing many issues to address in preparing for and handling radiation emergencies. It includes a wall chart that can be used in the ER describing the procedures for handling medical emergencies (printed copies of the wall chart can be obtained from Ken Miller at kmiller@psu.edu).

"Dirty Bomb Pills, Shots, Weeds, and Spells," written by Armin Ansari, PhD, CHP, describes several pharmaceuticals and homeopathic remedies that have made the news as "anti-radiation pills" or "radiation antidotes."