Preparing for Radiation Incidents

"Just-In-Time" Resource for Hospital Receivers of Radiation Incidents

At a glance

Planning and preparing for disaster scenarios, such as a nuclear detonation, is critical to forming an effective response. All medical care facilities should develop extensive disaster plans to cover a wide range of nuclear/radiological and other emergencies.

A doctor addresses a team of healthcare professionals around a table

Preparing for radiation incidents

Staff should be appointed to "Hospital Response Teams" specific to various disaster types. A nuclear detonation-specific response team should include representatives from the following departments:

  • Medical departments (including emergency medicine, internal medicine, trauma and/or burn surgery, nuclear medicine)
  • Hospital safety/security
  • Nursing
  • Engineering
  • Housekeeping
  • Emergency operations
  • Administration
  • Oncologists/hematologists

To address the needs of special populations, representatives from pediatrics, gerontology, and obstetrics should also be considered.

In planning for a radiation disaster, the Hospital Response Team should review and distribute documents and any available "just-in-time" training to provide guidance during all phases of a disaster response. As infrastructure, including power, internet, phones, and other forms of communication are likely to be disrupted during a nuclear detonation, documents critical to response activities should be printed and distributed in advance.

Multiple high-quality resources have been created by the U.S. Department of Health and Human Services for emergency planning and for use in a radiation disaster:

Damage zones following a nuclear detonation

A nuclear detonation will create several "zones" with varying levels of destruction. Areas closer to the detonation site ("ground zero") will be significantly more damaged and survivors are likely to have worse injuries and higher radiation exposure. The size of the detonation and geography of the local area will also affect the size of the zones.

Severe damage zone (SDZ): Area where few, if any, buildings remain standing or structurally sound. Access and movement in the area will be extremely limited due to rubble and debris. Those outside at the time of detonation will not survive. People in robust structures or underground areas may survive but will be at risk due to building collapse and radiation exposure. Underground infrastructure damage inside the SDZ could affect areas outside of the SDZ (such as damaged water pipes in the SDZ affecting the water pressure in other areas).

Moderate damage zone: This zone will have the most injured people in need of and able to benefit from emergent medical care. Level of exposure to radiation may vary depending on location relative to the blast. More structurally sound or reinforced buildings may still be standing but will have structural damage. Fires may be widespread, and survivors may have burn injuries. Most prehospital medical response should be focused in this zone. Transport through the zone may be difficult due to infrastructure damage and rubble, leading to prolonged times before survivors reach medical care.

Light damage zone: Buildings will have mild to moderate damage due to blast effects. Broken glass and fragile materials may line roads and sidewalks. Most people in this zone should survive the initial blast. Traumatic injuries may occur from flying glass fragments, vehicle accidents, and damage to houses and other non-reinforced structures. Initial radiation exposure from the nuclear detonation should be minimal, but parts of the light damage zone may be exposed to dangerous levels of fallout soon after the detonation. Fallout is generated when dust and debris created by the explosion are combined with radioactive fission products and drawn upward into the cloud produced by the detonation. These highly radioactive particles drop back down to earth as the cloud cools, causing widespread contamination. Medical first responders should focus primarily on those with severe injuries. Lightly injured and uninjured survivors should be directed to shelter in safe locations.

Dangerous radiation zone: Areas within 10-­20 miles downwind from the detonation may have significant amounts of radioactive particles (fallout) dispersed on surfaces and the ground. The dangerous radiation zone is defined by radiation exposure from fallout >10 Roentgens/hour (R/h). This can overlap the moderate and light damage zone.

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Content Source:
National Center for Environmental Health