Radiation Accident Preparedness: A European Approach to Train Physicians to Manage Mass Radiation Casualties

Abstract

Mass casualties after radiation exposure pose an enormous logistical challenge for national health services worldwide. Successful medical treatment of radiation victims requires that a plan for medical radiation accident management be established, that the plan be tested in regular exercises, and that it be found to be effective in the management of actual victims of a radiological incident. These activities must be provided by a critical mass of clinicians who are knowledgeable in the diagnosis and management of radiation injury. Here, we describe efforts to provide education to physicians engaged in clinical transplantation. Following intensive discussion among European experts at the International Center for Advanced Studies in Health Sciences and Services, University of Ulm, Germany, an advanced training program on "radiation syndromes" was developed for physicians with experience in the management of patients with pancytopenia and multi-organ failure occurring in a transplant setting. The first European advanced training course using this educational tool took place at Oberschleissheim, Germany, on 28-30 November 2007. Small group discussions and practical exercises were employed to teach general principles and unique features of whole body radiation exposure. Topics included the biological effects of contamination, incorporation of radionuclides, clinical consequences of exposure to radiation, and approaches to medical management. Recommendations resulting from this initial educational experience include (1) provision of funding for attending, conducting and updating the curriculum, and (2) development of an educational program that is harmonized among European and non-European experts in medical management of mass casualties from a radionuclear incident.

Characterizing Hospital Workers' Willingness to Respond to a Radiological Event

“…Some practicum courses have added skills objectives through hands-on workshops [35]. Additional strategies to mitigate such concerns include the application of internet-based learning courses on aspects of radiation emergency management and hazard mitigation [36], as well as conferences or medical symposia to educate medical professionals on the aspects of patient management in radiation injury scenarios [37], and extensive preparatory planning [38].…”

-tocotrienol protects mouse and human hematopoietic progenitors from -irradiation through extracellular signal-regulated kinase/mammalian target of rapamycin signaling

“…2 The hematopoietic system is among the most radiationsensitive organs. 3 A dose of ionizing radiation above 1 Gy in humans poses a risk of injury to the bone marrow and hematopoietic system, which leads to long-term compromised immune function and increased susceptibility to infection and internal and external hemorrhage.…”

Prevention of future incidents and investigational lines

“…In this sense, specialists with professional competence in this field are haematologists, radiation oncologists, nuclear medicine and health physicits. 45 In terms of detecting genetic damage, certain individuals' genetic status must be taken into account depending on the biodosimetrical system used, as the most commonly laboratory procedures usually quantify DNA alterations. A genetic bank would be useful to compare biological situations before and after radioactive impact.…”