Management of Radiation Accident victim
Physician and Hospital Responses to Radiological Incidents
By: Robert E Henkin, MD, FACNP, FACR
Professor of Radiology
Director, Nuclear Medicine
Robert H. Wagner, MD, MSMIS
Associate Professor of Radiology
Section on Nuclear Medicine/Department of Radiology
Loyola University
Maywood, IL
Experience of Authors
* Dr Wagner trained at Loyola and the DOE in Oak Ridge - Radiation Emergency Assistance Center/Training Site (REAC/TS)
* Drs Wagner and Henkin co-wrote the original manual for hospital management that was used by the State of Illinois
* Dr Wagner is has been consultant for Radiation Management Consultants since 1990 and trains and drills approximately 5 hospitals/year until 1998. Developed the plan for radiation accidents at Loyola
* Dr Henkin is a member of the Radiation Information Network of the American College of Nuclear Physicians
* Drs Wagner and Henkin are Board Certified by ABNM
Radiation and Terrorism
* Public perceptions of radiation
* The good news and the bad news
* Terrorism scenarios
* Types of radiation injuries
* Hospital response to radiation incidents
The Public Perceptions
The Bad News
* Almost nothing creates more terror than radiation
o It’s invisible to touch, taste, and smell
o Most people have unrealistic ideas about radiation
o Most physicians don’t even understand it
* The objective of the terrorist is as much or more panic than it is physical harm
The Good News
* Nuclear Medicine and Radiation Therapy professionals are well trained in the fundamentals of radiation
* Respect radiation, but do not fear it
* Understand what radiation can and cannot do
* There have been industrial radiation accidents that we have learned much from
* It is easily detected in contrast to biological and chemical agents
What Can We Expect?
* Radiological/Nuclear Terrorism
o A true nuclear detonation
o A failed nuclear detonation
o Radiation dispersal device
* Power Plant attacks
A Nuclear Detonation
* Least likely scenario (fortunately)
* Most likely from a stolen nuclear weapon
* Results would be devastating, both psychologically and in terms of damage
The Unthinkable
* Effects of a 1 megaton detonation in Chicago
o 30% of all hospitals destroyed in 50 mile radius
o Transportation and infrastructure compromised
o Emergency vehicles and professionals unable to respond
o Walking wounded with burns may have been fatally irradiated – unknown effects for days to weeks
Radiological Devices
* Not a “nuclear explosion”
* Consists of a bomb designed to disperse radioactive materials in air and water
o Designed to create panic
o Difficult to clean up, material spreads
o Biological effects may take years to appear
* “A Dirty War” HBO/BBC Films 2005
Failed Nuclear Detonation
* Most likely from an improvised nuclear device (IND)
* Beyond the scope of an individual terrorist – would need 10-15 people
* Greatest barrier is availability of weapons grade material
* Would create a critical mass or explosion, but not the same degree as a true nuclear detonation.
* Nuclear material needs to stay in contact for a longer period of time to allow flux to form
Radiological Dispersal Device
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