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 6

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Which statement regarding the immediate effects of a 1 kiloton burst of an improvised nuclear device is not true?

Incorrect! An IND will release energy in three ways: radiation (15%), heat (35%) and blast (50%). The other statements are true. Given her location from ground zero and her husband’s immediate evacuation 30 miles upwind to avoid fallout, this patient is at minimal risk for health effects from radiation. Traumatic injury (presence of penetrating and/or blast injuries with percentage of burns) will determine triage and prognosis.

Correct! An IND will release energy in three ways: radiation (15%), heat (35%) and blast (50%). The other statements are true. Given her location from ground zero and her husband’s immediate evacuation 30 miles upwind to avoid fallout, this patient is at minimal risk for health effects from radiation. Traumatic injury (presence of penetrating and/or blast injuries with percentage of burns) will determine triage and prognosis.

Radiation energy is released in greater percentages than blast and heat.

People located greater than one mile from ground zero are likely to have no immediate health effects from radiation.

An electromagnetic pulse (EMP) could disrupt function of electronic devices.

Fallout will result if the IND is a ground surface burst, as opposed to an air burst.

Third degree burns may result within an approximate radius of one-half mile.

Which of the following statements regarding the potential health effects of an IND are true?

Incorrect! Each of these is true. Mass casualties with high volumes of patients with combined injury will test limited health care resources significantly, requiring difficult triage decisions that consider long-term prognosis. Patients with combined injury syndrome due to significant physical trauma and radiation exposure with a dose greater than 4.5 gray may be considered as expectant [Waselenko, et al. Medical Management of ARS: Recommendations of the Strategic National Stockpile Radiation Working Group. Ann Internal Med. 2004; 140(12): 1037-1051].

Correct! Each of these is true. Mass casualties with high volumes of patients with combined injury will test limited health care resources significantly, requiring difficult triage decisions that consider long-term prognosis. Patients with combined injury syndrome due to significant physical trauma and radiation exposure with a dose greater than 4.5 gray may be considered as expectant [Waselenko, et al. Medical Management of ARS: Recommendations of the Strategic National Stockpile Radiation Working Group. Ann Internal Med. 2004; 140(12): 1037-1051].

The highest percentage of injuries will be combined injuries from thermal burns and radiation.

Both flash (temporary) and retinal (permanent) blindness may result.

Beta skin surface burns to the face and neck may result from fallout.

Radiation exposure results in significant immune system compromise and delayed wound healing.

All of the above

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