THE VIEW FROM THE TRENCHES: PART 1-EMERGENCY MEDICAL RESPONSE PLANS AND THE NEED FOR EPR SCREENING
THE VIEW FROM THE TRENCHES: PART 1-EMERGENCY MEDICAL RESPONSE PLANS AND THE NEED FOR EPR SCREENING
复制标题
DOI：
10.1097/hp.0b013e3181a6de7d
复制
发表时间：
2010-02-01
期刊：
影响因子：
2.2
通讯作者：
Swartz, Harold M.
中科院分区：
文献类型：
--
作者：
Gougelet, Robert M.;Rea, Michael E.;Swartz, Harold M.
很少有自然灾害或故意的战争或恐怖主义行为有可能对人口和基础设施造成如此严重的影响，因为在美国主要城市内故意引爆核装置。与其他灾难甚至“脏弹”形成鲜明对比的是，数十万人将受到影响，并可能受到临床上显著剂量的电离辐射。这将导致立即死亡和受伤，并随后发展为急性辐射综合征（ARS）。此外，还有数百万不太可能发展成急性呼吸系统综合症的人将寻求医疗评估和治疗，这使已经受到损害的医疗系统的能力不堪重负。在本文中，作者建议利用体内电子顺磁共振（EPR）剂量测定来筛选大量潜在暴露的受害者，并将此筛选过程纳入目前正在全国范围内实施的其他灾难性突发公共卫生事件的医疗激增框架。国家事故管理系统（NIMS）、国家响应框架（NRF）、目标能力列表（TCL）、国土安全总统指令（HSPD）以及来自多个联邦机构的其他指导为这种响应提供了坚实的框架。在核攻击后直接对可能受到辐射的受害者进行有效筛查，可以将寻求立即医疗护理的患者人数减少90%以上。健康物理98（2）：118-127; 2010
Few natural disasters or intentional acts of war or terrorism have the potential for such severe impact upon a population and infrastructure as the intentional detonation of a nuclear device within a major U.S. city. In stark contrast to other disasters or even a "dirty bomb," hundreds of thousands will be affected and potentially exposed to a clinically significant dose of ionizing radiation. This will result in immediate deaths and injuries and subsequently the development of Acute Radiation Syndrome (ARS). Additionally, millions more who are unlikely to develop ARS will seek medical evaluation and treatment, overwhelming the capacity of an already compromised medical system. In this paper, the authors propose that in vivo electron paramagnetic resonance (EPR) dosimetry be utilized to screen large numbers of potentially exposed victims, and that this screening process be incorporated into the medical-surge framework that is currently being implemented across the nation for other catastrophic public health emergencies. The National Incident Management System (NIMS), the National Response Framework (NRF), the Target Capabilities List (TCL), Homeland Security Presidential Directives (HSPD), as well as additional guidance from multiple federal agencies provide a solid framework for this response. The effective screening of potentially-exposed victims directly following a nuclear attack could decrease the number of patients seeking immediate medical care by greater than 90%. Health Phys. 98(2):118-127; 2010