A Sustainable Training Strategy for Improving Health Care Following a Catastrophic Radiological or Nuclear Incident

Abstract The detonation of a nuclear device in a US city would be catastrophic. Enormous loss of life and injuries would characterize an incident with profound human, political, social, and economic implications. Nevertheless, most responders have not received sufficient training about ionizing radiation, principles of radiation safety, or managing, diagnosing, and treating radiation-related injuries and illnesses. Members throughout the health care delivery system, including medical first responders, hospital first receivers, and health care institution support personnel such as janitors, hospital administrators, and security personnel, lack radiation-related training. This lack of knowledge can lead to failure of these groups to respond appropriately after a nuclear detonation or other major radiation incident and limit the effectiveness of the medical response and recovery effort. Efficacy of the response can be improved by getting each group the information it needs to do its job. This paper proposes a sustainable training strategy for spreading curricula throughout the necessary communities. It classifies the members of the health care delivery system into four tiers and identifies tasks for each tier and the radiation-relevant knowledge needed to perform these tasks. By providing education through additional modules to existing training structures, connecting radioactive contamination control to daily professional practices, and augmenting these systems with just-in-time training, the strategy creates a sustainable mechanism for giving members of the health care community improved ability to respond during a radiological or nuclear crisis, reducing fatalities, mitigating injuries, and improving the resiliency of the community. BlumethalD, BaderJ, ChristensenD, KoernerJ, CuellarJ, HindsS, CrapoJ, GlassmanES, PotterAB, SingletaryL. A sustainable training strategy for improving health care following a catastrophic radiological or nuclear incident. Prehosp Disaster Med. 2014;29(1):80-86 .

[1]  Wolfgang Weiss,et al.  Radiological protection issues arising during and after the Fukushima nuclear reactor accident , 2013, Journal of radiological protection : official journal of the Society for Radiological Protection.

[2]  Italo Subbarao,et al.  Core Competencies for Disaster Medicine and Public Health , 2012, Disaster Medicine and Public Health Preparedness.

[3]  Steven M Becker,et al.  Emergency communication and information issues in terrorist events involving radioactive materials. , 2004, Biosecurity and bioterrorism : biodefense strategy, practice, and science.

[4]  M. Akashi,et al.  CONCERNS OF DISASTER MEDICAL ASSISTANCE TEAM (DMAT) MEMBERS ABOUT TROUBLES AT THE NUCLEAR POWER PLANT: EXPERIENCE FROM THE NIIGATA CHUETSU-OKI EARTHQUAKE, 16 JULY 2007, IN JAPAN , 2010, Health physics.

[5]  S. Becker,et al.  Improving Hospital Preparedness for Radiological Terrorism: Perspectives From Emergency Department Physicians and Nurses , 2008, Disaster Medicine and Public Health Preparedness.

[6]  S. Sheikh,et al.  Radiological preparedness-awareness and attitudes: A cross–sectional survey of emergency medicine residents and physicians at three academic institutions in the United States , 2012, Clinical toxicology.

[7]  Karin E. Johnson,et al.  Assessing physicians' continuing medical education (CME) needs in the U.S.-associated Pacific jurisdictions. , 2002, Pacific health dialog.

[8]  V. Curran,et al.  A comparative analysis of the perceived continuing medical education needs of a cohort of rural and urban Canadian family physicians. , 2007, Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la medecine rurale : le journal officiel de la Societe de medecine rurale du Canada.

[9]  Julian N. Robinson,et al.  Recent Trends in Continuing Medical Education Among Obstetrician–Gynecologists , 2011, Obstetrics and gynecology.

[10]  Jacqueline P. Williams,et al.  Factors Affecting Hospital-based Nurses' Willingness to Respond to a Radiation Emergency , 2008, Disaster Medicine and Public Health Preparedness.

[11]  S. Rockwell,et al.  American Society for Radiation Oncology (ASTRO) survey of radiation biology educators in U.S. and Canadian radiation oncology residency programs. , 2009, International journal of radiation oncology, biology, physics.

[12]  Edbert B Hsu,et al.  Perspectives of Future Physicians on Disaster Medicine and Public Health Preparedness: Challenges of Building a Capable and Sustainable Auxiliary Medical Workforce , 2009, Disaster Medicine and Public Health Preparedness.

[13]  David Markenson,et al.  Preparing Health Professions Students for Terrorism, Disaster, and Public Health Emergencies: Core Competencies , 2005, Academic medicine : journal of the Association of American Medical Colleges.

[14]  Edbert B. Hsu,et al.  Disaster Curricula in Medical Education: Pilot Survey , 2012, Prehospital and Disaster Medicine.

[15]  D. Cone,et al.  Hospital disaster staffing: if you call, will they come? , 2006, American journal of disaster medicine.

[16]  C. Colenda,et al.  A Short Medical School Course on Responding to Bioterrorism and Other Disasters , 2005, Academic medicine : journal of the Association of American Medical Colleges.

[17]  Michael McGeary,et al.  Assessing Medical Preparedness to Respond to a Terrorist Nuclear Event: Workshop Report , 2009 .

[18]  Rocco Casagrande,et al.  Triage and Treatment Tools for Use in a Scarce Resources-Crisis Standards of Care Setting After a Nuclear Detonation , 2011, Disaster Medicine and Public Health Preparedness.