Topic Collection: Radiological and Nuclear

A large-scale radiological release or nuclear detonation incident could result in a significant surge of patients, including those who may not have actually been exposed, but seek medical attention anyway. Power plant incidents, radiation dispersion devices, and improvised nuclear device detonations result in very different injury/exposure patterns and response planning will need to account for each of these. Patients exposed to radiation may simply be “irradiated” (gamma waves pass through them without any direct material on/in the patient) or can be “contaminated” if internal or external radioactive material is present. Both exposures result in dose-dependent damage to body tissues. In most cases of radiation dispersion devices, the risk of injury is very low, but in nuclear device detonations large numbers of patients may have acute radiation illness and require evaluation and treatment. The resources in this Topic Collection include toolkits, reference guides, plan guidance documents, modeling and simulation reports, and manuals that may help first responders and first receivers assess, triage, and treat casualties of radiological and nuclear emergencies. This Topic Collection was updated in August 2021.

Each resource in this Topic Collection is placed into one or more of the following categories (click on the category name to be taken directly to that set of resources). Resources marked with an asterisk (*) appear in more than one category. (Please note: this Topic Collection does not include a comprehensive overview of responder health and safety issues. Please refer to the Responder Safety and Health and Decontamination Topic Collections for related information.)

"Must Reads" were chosen by Subject Matter Experts based on their overall value and the material covered. However, knowledge about Acute Radiation Syndrome (ARS) and patient management has evolved rapidly and prior conclusions about time to onset of vomiting and its correlation with toxicity as well as management of ARS patients may not reflect current practice. Readers are encouraged to use these resources as a starting point and seek specific assessment and treatment recommendations from websites such as the U.S. Department of Health and Human Services Radiation Emergency Medical Management (REMM).