Vulnerability of populations and the urban health care systems to nuclear weapon attack-examples from four American cities
Vulnerability of populations and the urban health care systems to nuclear weapon attack-examples from four American cities
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DOI：
10.1186/1476-072x-6-5
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发表时间：
2007-02-28
影响因子：
4.9
通讯作者：
Dallas, Cham E.
中科院分区：
文献类型：
--
作者：
Bell, William C.;Dallas, Cham E.
背景资料：近年来，在美国境内使用大规模毁灭性武器所构成的威胁显著增加，使人们关注国家在大规模危机中的医疗和公共卫生救灾能力。虽然核武器造成的数十万或数百万人伤亡本身就超过了我们目前的医疗反应能力，但反应的困境进一步加剧，因为这些资源本身将受到严重威胁。大规模伤亡管理所需的资源有许多限制，如获得足够的医院病床，包括烧伤受害者专用病床、呼吸和支持治疗、药物干预和大规模去污。结果：20千吨和550千吨核爆炸对高优先目标城市的影响为纽约市，芝加哥，华盛顿D。C.亚特兰大。热，爆炸和辐射的影响进行了说明，受影响的人口计算使用2000块级普查数据。100 Kts及以上的武器主要是燃烧武器或辐射武器，能够在远于严重破坏建筑物的距离上造成烧伤和起火，并在表面爆炸的情况下通过辐射伤害毒害顺风的人口。对于100 Kts以下的武器，爆炸效应往往比表面爆炸的主要热效应更强。从医疗事故处理和行政应对的角度来看，有一种不祥的模式，即这些死亡和伤亡的地理分布与医院和行政设施的位置有关。事实证明，数量惊人的主要医院、创伤中心和其他医疗资产很可能处于死亡羽流中，使它们在危机中基本上无法运作。结论：这一结果的后果之一是可能失去指挥和控制，大规模伤亡将不得不由外围医院在无组织的反应中进行治疗，以及危机中管理不善所带来的其他预期混乱结果。负责应对大规模杀伤性武器的联邦机构、军事资源、学术机构和地方应对者之间的积极、创造性和加速培训和协调对于涉及大规模伤亡的大规模杀伤性武器事件至关重要。
Background: The threat posed by the use of weapons of mass destruction (WMD) within the United States has grown significantly in recent years, focusing attention on the medical and public health disaster capabilities of the nation in a large scale crisis. While the hundreds of thousands or millions of casualties resulting from a nuclear weapon would, in and of itself, overwhelm our current medical response capabilities, the response dilemma is further exacerbated in that these resources themselves would be significantly at risk. There are many limitations on the resources needed for mass casualty management, such as access to sufficient hospital beds including specialized beds for burn victims, respiration and supportive therapy, pharmaceutical intervention, and mass decontamination.Results: The effects of 20 kiloton and 550 kiloton nuclear detonations on high priority target cities are presented for New York City, Chicago, Washington D. C. and Atlanta. Thermal, blast and radiation effects are described, and affected populations are calculated using 2000 block level census data. Weapons of 100 Kts and up are primarily incendiary or radiation weapons, able to cause burns and start fires at distances greater than they can significantly damage buildings, and to poison populations through radiation injuries well downwind in the case of surface detonations. With weapons below 100 Kts, blast effects tend to be stronger than primary thermal effects from surface bursts. From the point of view of medical casualty treatment and administrative response, there is an ominous pattern where these fatalities and casualties geographically fall in relation to the location of hospital and administrative facilities. It is demonstrated that a staggering number of the main hospitals, trauma centers, and other medical assets are likely to be in the fatality plume, rendering them essentially inoperable in a crisis.Conclusion: Among the consequences of this outcome would be the probable loss of command-and-control, mass casualties that will have to be treated in an unorganized response by hospitals on the periphery, as well as other expected chaotic outcomes from inadequate administration in a crisis. Vigorous, creative, and accelerated training and coordination among the federal agencies tasked for WMD response, military resources, academic institutions, and local responders will be critical for large-scale WMD events involving mass casualties.