After the detonation of an improvised nuclear device, several key actions will be necessary to save the greatest number of lives possible. Among these tasks, the identification of patients with impending acute radiation sickness is a critical problem that so far has lacked a clear solution in national planning. We present one possible solution: the formation of a public-private partnership to augment the capacity to identify those at risk for acute radiation sickness.
After the detonation of an improvised nuclear device, several actions will be necessary to save the greatest number of lives possible. Among these tasks, the identification of patients with impending acute radiation sickness is a critical problem. The authors propose the formation of a public-private partnership with clinical lab firms to identify those at risk for acute radiation sickness.
U.S. Department of Health and Human Services. U.S. Centers for Disease Control and Prevention; National Cancer Institute. Fallout from nuclear weapons. Report on the Feasibility of a Study of the Health Consequences to the American Population from Nuclear Weapons Tests Conducted by the United States and Other Nations. Volume 1: Technical Report, May2005Chap. 2http://www.cdc.gov/nceh/radiation/fallout/feasibilitystudy/Technical_Vol_1_Chapter_2.pdf. 2011 August 30.
3.
National Security Staff. Interagency Policy Coordination Subcommittee for Preparedness & Response to Radiological and Nuclear Threats. Planning Guidance for Response to a Nuclear Detonation, 2dJune2010. http://www.remm.nlm.gov/PlanningGuidanceNuclearDetonation.pdf. 2011 August 30.
4.
BuddemeierBR, DillonMB. Key Response Planning Factors for the Aftermath of Nuclear TerrorismLLNL-TR-410067Livermore, CA: Lawrence Livermore National Laboratory, August2009.
5.
WolbarstAB, WileyALJr, NemhauserJBet al.Medical response to a major radiologic emergency: a primer for medical and public health practitioners. Radiology Mar, 2010; 254,3:660–677.
6.
FlynnDF, GoansRE. Nuclear terrorism: triage and medical management of radiation and combined-injury casualties. Surg Clin North Am Jun, 2006; 86,3:601–636.
7.
DavidsMS, CaseCJr, ConferDLet al.Medical management of radiation victims in the United States. Health Phys Jun, 2010; 98,6:833–837.
8.
DavidsMS, CaseCJr, HornungR3rdet al.Assessing surge capacity for radiation victims with marrow toxicity. Biol Blood Marrow Transplant, 2010; 16,10:1436–1441.
WaselenkoJK, MacVittieTJ, BlakelyWFet al.Medical management of the acute radiation syndrome: recommendations of the Strategic National Stockpile Radiation Working Group. Ann Intern Med Jun 15, 2004; 140,12:1037–1051.
11.
FliednerTM, PowlesR, SirohiB, NiederwieserD. Radiologic and nuclear events: the METREPOL severity of effect grading system. Blood, 2008; 111,12:5757–5758.
12.
LloydDC, EdwardsAA, MoquetJE, Guerrero-CarbajalYC. The role of cytogenetics in early triage of radiation casualties. Appl Radiat Isot, 2000; 52,5:1107–1112.
13.
AlbaneseJ, MartensK, ArnoldJLet al.Building Connecticut's clinical biodosimetry laboratory surge capacity to mitigate the health consequences of radiological and nuclear disasters: a collaborative approach between the state biodosimetry laboratory and Connecticut's medical infrastructure. Radiation Measurements, 2007; 42,6-7:1138–1142.
14.
FattibeneP, CallensF. EPR dosimetry with tooth enamel: a review. Appl Radiat Isot, 2010Nov68,11:2033–2116.
15.
PattersonAD, LanzC, GonzalesFJet al.The role of mass spectrometry-based metabolomics in medical countermeasures against radiation. Mass Spectrom Rev, 2010May-Jun29,3:503–521.
16.
de BacaME, GulatiG, KocherW, SchwartingR. Effects of storage of blood at room temperature on hematologic parameters measured on Sysmex XE-2100. Lab Medicine, 2006; 37,1:28–36.
17.
The Clinical Laboratory Services Market (Growth Opportunities, Competitive Analysis and Competitor Profiles)New York: Kalorama Information, 2010.
HrdinaCM, ColemanCN, BoguckiSet al.The “RTR” medical response system for nuclear and radiological mass-casualty incidents: a functional TRiage-TReatment-TRansport medical response model. Prehosp Disaster Med May-Jun, 2009; 24,3:167–178.
