This 2010 edition of a classic military handbook produced by the Armed Forces Radiobiology Research Institute at Bethesda, Maryland on the medical effects of ionizing radiation is a vital reference and superb source of official information, with practical emergency information and guidance.

This handbook addresses medical management of casualties in the first 72 hours of a radiation event. The most important consideration in the medical evaluation of a radiation event is the relative magnitude of the situation and the resources needed to address the emergency. In many cases, order of magnitude estimates of the scale of the event will be sufficient for emergency response.

Small-scale events are those occurring in laboratories, hospitals, nuclear power plants, etc., involving small amounts of radionuclides with the potential exposure and/or contamination of one or a few individuals. Large-scale events are those involving relatively large quantities of radionuclides and the potential exposure or contamination of large numbers of people, e.g., terrorist attacks with radiological weapons, nuclear weapons detonation, and large-scale nuclear power plant disasters. High-level external ionizing radiation poses the greatest danger to living organisms. Low levels of internal or external contamination generally pose very low risk. A site known to be radiologically contaminated should be surveyed before entering and responders should be advised to limit their time in high dose-rate areas. There is generally no hazard associated with handling a radiologically contaminated casualty. U.S. military planning. The U.S. military has established a system for mission-specific risk-based dose limits that includes life-saving activities. In current doctrine, U.S. military personnel become restricted from engaging in operational radiological/nuclear missions once they have exceeded a 125-cGy dose accumulation.

Topics covered include: Emergency Response * Acute Radiation Syndrome * Biodosimetry * Medical Management of Skin Injury * Medical Management of Internally Deposited Radionuclides * Other Injuries from Nuclear Weapons * Psychological Support * Delayed Effects * Decontamination Techniques * Command Guidance * Appendices

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