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Care of Nuclear Injuries (From Weapons of Mass Destruction: Emergency Care, P 82-101, 2000, Robert A. De Lorenzo, Robert S. Porter, -- See NCJ-192399)

NCJ Number
192405
Author(s)
Robert A. De Lorenzo M.D.; Robert S. Porter M.A.
Date Published
2000
Length
20 pages
Annotation
In this chapter the event of a nuclear explosion as part of a terrorist act is examined, specifically the energy production of a nuclear explosion, the injury mechanisms in a nuclear detonation, casualty and situation assessment, search and rescue, evacuation and sheltering, and triage and emergency care.
Abstract
The power of atoms was discovered through United States efforts to develop a nuclear bomb in the 1940's. Over the years, various wartime nuclear detonations across the world have confirmed the probability for casualty generation. The injuries incurred from a nuclear detonation offer a critical challenge in the assessment and care skills of EMS providers. This chapter examined how a nuclear explosion produces energy, and how from that force of energy and various detonation mechanisms it produces devastating injuries. It discusses casualty assessment, search and rescue, evacuation and sheltering, and triage and emergency care. Nuclear detonation energy is released as light and thermal energy, a shock wave and blast of wind, and direct radiation, then fallout. It causes injury or death through the three mechanisms of radiation, blast, and thermal burns. As an EMS provider, the responsibilities during a nuclear detonation drastically change and involve triage, evacuation or sheltering, search and rescue, radioactive monitoring, decontamination, and limited patient care. Nuclear detonation scenarios are presented and include: strategic, tactical, and terrorist detonations, reactor or fuel processing accident, and transportation accident. These scenarios are presented to assist in scene size-up and determining initial responsibilities. Determining the mechanisms of injury and exposure, gives the EMS provider the necessary information to perform different activities. Emergency medical care at a nuclear incident is limited and very different from that of normal emergency care. A restrictive triage must be employed to save the greatest number of casualties. Injuries requiring a provider's attention are limited to conventional burns and blunt or pressure injuries.