Getting Started

Potential Incidents
Planning
Decontamination
Triage
Treatment
Pharmacotherapy

Scenario 1
Scenario 2
Scenario 3
Scenario 4
Scenario 5
Scenario 6

Glossary
Resources
Self Test

Getting Started

Potential Incidents
Planning
Decontamination
Triage
Treatment
Pharmacotherapy

Scenario 1
Scenario 2
Scenario 3
Scenario 4
Scenario 5
Scenario 6

Glossary

Resources

Self Test

Radiological and Nuclear Terrorism:
Medical Response to Mass Casualties

Scenario 5

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In this scenario, which of the following resources could be used for 24/7 diagnostic and treatment consultation?

Incorrect! Each of these resources could provide pertinent information and assistance. Contact information should be kept in a readily accessible location. Internal ingestion of significant quantities of radionuclides is exceptionally rare. Consultative resources for this type of scenario will be critical. REAC/TS physicians are consulted internationally in situations requiring highly specialized, state-of-the-art knowledge in treating patients with radiation illness. Contact information is provided in the CDC publication Radiological Terrorism: Emergency Management Pocket Guide for Clinicians. Consider storing this pocket guide in a convenient location in emergency services.

Correct! Each of these resources could provide pertinent information and assistance. Contact information should be kept in a readily accessible location. Internal ingestion of significant quantities of radionuclides is exceptionally rare. Consultative resources for this type of scenario will be critical. REAC/TS physicians are consulted internationally in situations requiring highly specialized, state-of-the-art knowledge in treating patients with radiation illness. Contact information is provided in the CDC publication Radiological Terrorism: Emergency Management Pocket Guide for Clinicians. Consider storing this pocket guide in a convenient location in emergency services.

Poison Control resources

In-house physicians with radiation expertise

Hospital-based health physicists

REAC/TS (Radiation Emergency Assistance Center/Training Site)

All of the above

In this scenario, the following actions should be taken:

Incorrect! Since possibly high levels of radioactive material may have been ingested by many of these patients, and the internal contamination may be severe, each of these actions may be appropriate. In-house radiation experts will be needed to assess this situation and assist in decision-making.

Correct! Since possibly high levels of radioactive material may have been ingested by many of these patients, and the internal contamination may be severe, each of these actions may be appropriate. In-house radiation experts will be needed to assess this situation and assist in decision-making.

Standard precautions PPE should be worn by the caregivers.

Excretions should be labeled as radioactive waste.

Patient clothing should be double-bagged and labeled as radioactive.

A survey of the patient’s body should be conducted with a survey meter.

All of the above

Which of the following drugs would be appropriate for use in this scenario?

Incorrect! Prussian Blue, ferric hexacyanoferrate, is FDA-approved to treat internal contamination with cesium or thallium. Administered orally, it binds to cesium ions in the gastrointestinal tract to accelerate cesium elimination and reduce the radiation dose. Calcium and Zinc salts of Diethylenetriaminepentaacetate (DTPA) are chelating agents for plutonium and other transuranic elements such as americium, californium and curium. Potassium Iodide use is limited to prevention of radioactive iodine uptake by the thyroid. Cytokines such as filgrastim, are FDA-approved for treatment of neutropenia resulting from myelosuppressive cancer therapy. Although not approved by the FDA for use in radiation emergencies, cytokines have been used to treat patients who suffered ARS following accidental uptake of radioactive cesium in Goiania, Brazil.

Correct! Prussian Blue, ferric hexacyanoferrate, is FDA-approved to treat internal contamination with cesium or thallium. Administered orally, it binds to cesium ions in the gastrointestinal tract to accelerate cesium elimination and reduce the radiation dose. Calcium and Zinc salts of Diethylenetriaminepentaacetate (DTPA) are chelating agents for plutonium and other transuranic elements such as americium, californium and curium. Potassium Iodide use is limited to prevention of radioactive iodine uptake by the thyroid. Cytokines such as filgrastim, are FDA-approved for treatment of neutropenia resulting from myelosuppressive cancer therapy. Although not approved by the FDA for use in radiation emergencies, cytokines have been used to treat patients who suffered ARS following accidental uptake of radioactive cesium in Goiania, Brazil.

Prussian Blue (Radiogardase®)

Ca-DTPA or Zn-DTPA

Potassium Iodide

Granulocyte Colony-stimulating Factors (such as filgrastim)

A and D

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