Medical Planning and Response for a Nuclear Detonation: A Practical Guide

Coleman, C. Norman; Adams, Steven; Adrianopoli, Carl; Ansari, Armin; Bader, Judith L.; Buddemeier, Brooke; Jaime, J.; Casagrande, Rocco; Case, Cullen; Caspary, Kevin; Chang, Arthur; Chang, H. Florence; Chao, Nelson J.; Cliffer, Kenneth D.; Confer, Dennis L.; Deitchman, Scott; DeRenzo, Evan G.; Dobbs, Allen R.; Dodgen, Daniel; Donnelly, Elizabeth H.; Gorman, Susan E.; Grace, Marcy B.; Hatchett, Richard; Hick, John L.; Hrdina, Chad; Jones, Robert E.; Kane, Elleen; Knebel, Ann R.; Koerner, John F.; Laffan, Alison M.; Larson, Leon; Livinski, Alicia A.; MacKinney, John; Maidment, Bert W.; Manning, Ronald G.; Marinissen, Maria Julia; Martin, Colleen; Michael, Gretchen; Miller, Charles W.; Murrain-Hill, Paula; Nemhauser, Jeffrey B.; Norwood, Ann E.; Nystrom, Scott; Raheem, Murad; Redlener, Irwin E.; Sheehan, Kevin; Simon, Steven L.; Taylor, Tammy P.; Toner, Eric; Wallace, Katherine; Weinstock, David M.; Whitcomb, Robert C.; Wieder, Jessica; Wiley, Albert L.; Yeskey, Kevin

doi:10.1089/bsp.2012.1025

Cited by 29 publications

(20 citation statements)

References 18 publications

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“…While an RDD will expose individuals to relatively low levels of radiation in the immediate vicinity, an IND will lead to significant deaths in a large radius around the epicenter and thousands of other individuals exposed due to ground shine or radioactive fallout. Various planning scenarios have been drafted for the immediate action after such an event (DiCarlo et al, 2011, Coleman et al, 2012, Sullivan et al, 2013, Homer et al, 2016), with evacuation and assessment of levels of radiation exposure of each individual followed by medical triage as the top priorities.…”

Section: Introductionmentioning

confidence: 99%

“…Neupogen ® and Neulasta ® [filgrastim and polyethylene glycol (PEG)-filgrastim, respectively] have been approved as mitigators to increase survival of individuals exposed to doses that can lead to myelosuppression (Farese and MacVittie, 2015, Homer et al, 2016, Singh et al, 2016) and were developed with support from the National Institute of Allergy and Infectious Diseases (NIAID). Protectors, however, require prior knowledge of an incident and therefore can only be practically administered to first responders and military personnel (Coleman et al, 2012, Moulder, 2014). In addition, the FDA approved radioprotector Amifostine ® has a very narrow window for administration in order to protect normal tissue and is unfortunately associated with severe side effects (Singh et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

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Metabolomic applications in radiation biodosimetry: exploring radiation effects through small molecules

Pannkuk

Fornace

Laiakis

2017

International Journal of Radiation Biology

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Purpose Exposure of the general population to ionizing radiation has increased in the past decades, primarily due to long distance travel and medical procedures. On the other hand, accidental exposures, nuclear accidents, and elevated threats of terrorism with the potential detonation of a radiological dispersal device or improvised nuclear device in a major city, all have led to increased needs for rapid biodosimetry and assessment of exposure to different radiation qualities and scenarios. Metabolomics, the qualitative and quantitative assessment of small molecules in a given biological specimen, has emerged as a promising technology to allow for rapid determination of an individual's exposure level and metabolic phenotype. Advancements in mass spectrometry techniques have led to untargeted (discovery phase, global assessment) and targeted (quantitative phase) methods not only to identify biomarkers of radiation exposure, but also to assess general perturbations of metabolism with potential long-term consequences, such as cancer, cardiovascular, and pulmonary disease. Conclusions Metabolomics of radiation exposure has provided a highly informative snapshot of metabolic dysregulation. Biomarkers in easily accessible biofluids and biospecimens (urine, blood, saliva, sebum, fecal material) from mouse, rat, and minipig models, to non-human primates and humans have provided the basis for determination of a radiation signature to assess the need for medical intervention. Here we provide a comprehensive description of the current status of radiation metabolomic studies for the purpose of rapid high-throughput radiation biodosimetry in easily accessible biofluids and discuss future directions of radiation metabolomics research.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Metabolomic applications in radiation biodosimetry: exploring radiation effects through small molecules

Pannkuk

Fornace

Laiakis

2017

International Journal of Radiation Biology

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“…There is substantial ongoing scientific participation by nongovernment SMEs, as illustrated in the authorship of the Scarce Resources for a Nuclear Detonation Project (Coleman et al 2011a) and the medical planning guide (Coleman et al 2012a). …”

Section: Coordinationmentioning

confidence: 99%

“…For a sense of scope of a nuclear detonation incident, general estimates of the numbers and types of casualties following an improvised nuclear device detonation are in Table 1 (Knebel et al 2011, Coleman et al 2012a). …”

Section: Scenario and Impactmentioning

confidence: 99%

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Public Health and Medical Preparedness for a Nuclear Detonation

Coleman¹,

Sullivan²,

Bader³

et al. 2015

Health Physics

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Resilience and the ability to mitigate the consequences of a nuclear incident are enhanced by (1) effective planning, preparation and training; (2) ongoing interaction, formal exercises, and evaluation among the sectors involved; (3) effective and timely response and communication; and (4) continuous improvements based on new science, technology, experience and ideas. Public health and medical planning require a complex, multi-faceted systematic approach involving federal, state, local, tribal and territorial governments, private sector organizations, academia, industry, international partners, and individual experts and volunteers. The approach developed by the U.S. Department of Health and Human Services Nuclear Incident Medical Enterprise (NIME) is the result of efforts from government and nongovernment experts. It is a “bottom-up” systematic approach built on the available and emerging science that considers physical infrastructure damage, the spectrum of injuries, a scarce resources setting, the need for decision making in the face of a rapidly evolving situation with limited information early on, timely communication and the need for tools and just-in-time information for responders who will likely be unfamiliar with radiation medicine and uncertain and overwhelmed in the face of the large number of casualties and the presence of radioactivity. The components of NIME can be used to support planning for, response to, and recovery from the effects of a nuclear incident. Recognizing that it is a continuous work-in-progress, the current status of the public health and medical preparedness and response for a nuclear incident is provided.

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Medical Response

Karam

2021

Advanced Sciences and Technologies for Security Applications

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Medical Planning and Response for a Nuclear Detonation: A Practical Guide

Cited by 29 publications

References 18 publications

Metabolomic applications in radiation biodosimetry: exploring radiation effects through small molecules

Metabolomic applications in radiation biodosimetry: exploring radiation effects through small molecules

Public Health and Medical Preparedness for a Nuclear Detonation

Medical Response

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