Treatment of Nuclear Casualties
Most injuries resulting from the detonation of a
nuclear device are likely to be mechanical wounds
resulting from collapsing buildings and flying debris,
and burns caused by heat and light liberated at the time
A burn is a burn, regardless of whether it is caused
by a nuclear explosion or by napalm, and its
management remains the same. This is also true of
fractures, lacerations, mechanical injuries, and shock.
In none of these is the treatment dictated by the cause.
For most of the conventional injuries, standard
first-aid procedures should be followed.
The following word of caution should be
considered when you are treating wounds and burns:
Dressings for wounds and burns should follow a
closed-dressed principle, with application of an
adequate sterile dressing using aseptic techniques.
Make no attempt to close the wound, regardless of its
size, unless authorized by a physician. If signs of
infection and fever develop, give antibiotics. When a
physician is not available to direct treatment, the
Corpsman should select an antibiotic on the basis of
availability and appropriateness, and administer three
times the recommended amount. If the antibiotic does
not control the fever, switch to another. If the fever
recurs, switch to still another.
infection can develop rapidly in the patients due to
burns or damage from radiation.
broad-spectrum antibiotic is given, administer oral
To date, there is no specific therapy for injuries
produced by lethal or sublethal doses of ionizing
radiation. This does not mean that all treatment is
futile. Good nursing care and aseptic control of all
procedures is a must. Casualties should get plenty of
rest, light sedation if they are restless or anxious, and a
bland, nonresidue diet.
If you suspect that you are contaminated, or if
detection equipment indicates you are, report to a
personnel decontamination facility as soon as possible.
In a large-scale nuclear catastrophe, there may be
numerous casualties suffering not only from
mechanical injuries and thermal burns, but from
radiation injuries and psychological reactions as well.
The medical facility should consist of a personnel
monitoring station, both clean and contaminated
emergency treatment stations, a decontamination
station, a sorting station, and various treatment
stations. It should be set up so that personnel must pass
through a monitoring station prior to sorting for
medical care. If there is a need for decontamination,
the casualty should be routed through the
decontamination station on the way to the sorting
station. The physical layout should be arranged so that
no casualty can bypass the monitoring station and go
directly to a treatment station. Also, casualties who are
contaminated should be unable to enter clean areas
without first passing through a decontamination
The medical facility flow chart shown in
figure 8-3 illustrates an appropriate schema for
handling those exposed to nuclear radiation.
TEAMS.Patients brought in by the rescue
teams or arriving on their own should first proceed
through the monitoring station to determine whether or
not they are contaminated with radioactive material.
No medical treatment should be instituted in the
Only personnel who have had
training and experience as members of Radiological
Safety/Decontamination teams or as members of
Damage Control parties should be assigned to the
monitoring station. Those operating the monitoring
station should have a basic knowledge of and
experience with radiac instruments. Of the personnel
available to the treatment facility, several of those most
experienced and knowledgeable in radiological safety
and radiation protection should be assigned
supervisory jobs in the decontamination station. Also,
it is highly desirable to have some personnel with
operating room experience to decontaminate patients
with traumatic injuries. It is not necessary for the other
personnel working in the decontamination station to
have any appreciable training or experience other than
that given when the medical facility is put into
MONITORS.After the patients are monitored,
they are directed or taken down one of four avenues,
depending upon their physical conditions.
requiring immediate lifesaving measures should be
considered contaminated and routed directly through
the monitoring station to the contaminated emergency
Definitive monitoring for these
individuals may be performed at the decontamination
station. Both treatment stations are set up much the
same and should have only those facilities necessary
for immediate lifesaving forms of treatment.
Personnel working in these stations should be better