August 2005 EMS & Trauma Systems Section Office of Public Health Preparedness RADIOLOGICAL NUCLEAR EXPLOSIVE

August 2005EMS & Trauma Systems Section Office of Public Health Preparedness RADIOLOGICAL AGENTS NULCEAR WEAPONS Objectives Objectives Identify indicators that may cause the EMS provider to suspect a radiological or nuclear incident Identify indicators that may cause the EMS provider to suspect a radiological or nuclear incident Identify signs, symptoms and management of common radiological or nuclear injuries and illnesses Identify signs, symptoms and management of common radiological or nuclear injuries and illnesses Ensure adequate protection for EMS providers in a radiological or nuclear incident Ensure adequate protection for EMS providers in a radiological or nuclear incident

August 2005EMS & Trauma Systems Section Office of Public Health Preparedness RADIOLOGICAL AGENTS NULCEAR WEAPONS There are two different threats in the area of radiological/nuclear terrorism There are two different threats in the area of radiological/nuclear terrorism Dirty Bomb or Radiological Dispersion Device (RDD) – The use of common explosives to spread radioactive materials over a targets area. Dirty Bomb or Radiological Dispersion Device (RDD) – The use of common explosives to spread radioactive materials over a targets area. It does not cause a nuclear blast It does not cause a nuclear blast Nuclear Bomb or Improvised Nuclear Device (IND) – Any explosive device to cause a nuclear fission reaction, resulting in a nuclear blast. Nuclear Bomb or Improvised Nuclear Device (IND) – Any explosive device to cause a nuclear fission reaction, resulting in a nuclear blast. Nuclear fission is the splitting of an atom into two smaller atoms. Nuclear fission is the splitting of an atom into two smaller atoms.

August 2005EMS & Trauma Systems Section Office of Public Health Preparedness DIRTY BOMB / RADIOLOGICAL DISPERSION DEVICE Uses ordinary explosives to spread radiological materials Uses ordinary explosives to spread radiological materials Low-level radioactive material readily available Low-level radioactive material readily available Blast force and radioactivity much lower and more localized than for an Improved Nuclear Device (IND). Blast force and radioactivity much lower and more localized than for an Improved Nuclear Device (IND). Blast will be immediately obvious Blast will be immediately obvious The presence of radiation will not be clearly defined without specialized equipment The presence of radiation will not be clearly defined without specialized equipment

August 2005EMS & Trauma Systems Section Office of Public Health Preparedness NUCLEAR BOMB / IMPROVISED NUCLEAR DEVICE An IND causes a nuclear fission reaction, resulting in a nuclear blast. An IND causes a nuclear fission reaction, resulting in a nuclear blast. Explosion with intense light and heat, Explosion with intense light and heat, Damaging pressure wave Damaging pressure wave Widespread radioactive contamination Widespread radioactive contamination Contaminates air, water and ground surfaces for miles around. Contaminates air, water and ground surfaces for miles around. INDs require highly enriched uranium or plutonium, which is difficult to obtain INDs require highly enriched uranium or plutonium, which is difficult to obtain Unlike RDDs that can be made with almost any radioactive material Unlike RDDs that can be made with almost any radioactive material An IND could consist of diverted nuclear weapon components, a modified nuclear weapon, or an indigenous-designed device. An IND could consist of diverted nuclear weapon components, a modified nuclear weapon, or an indigenous-designed device.

August 2005EMS & Trauma Systems Section Office of Public Health Preparedness NUCLEAR vs. CONVENTIONAL BLASTS A blast or explosion is a rapid release of a large amount of energy within a limited space. A blast or explosion is a rapid release of a large amount of energy within a limited space. Nuclear blasts are far more destructive than conventional blasts: Nuclear blasts are far more destructive than conventional blasts: Power of explosion Power of explosion Amount of heat and light generated Amount of heat and light generated Amount of radiation produced Amount of radiation produced

August 2005EMS & Trauma Systems Section Office of Public Health Preparedness POWER OF EXPLOSION Nuclear explosions can be millions of times more powerful than the largest conventional explosions Nuclear explosions can be millions of times more powerful than the largest conventional explosions The explosive energy released is equivalent to thousands of tons (kilotons) or millions of tons (megatons) of TNT The explosive energy released is equivalent to thousands of tons (kilotons) or millions of tons (megatons) of TNT A 10 kiloton nuclear blast can damage buildings as far away as 1.5 miles A 10 kiloton nuclear blast can damage buildings as far away as 1.5 miles

August 2005EMS & Trauma Systems Section Office of Public Health Preparedness HEAT AND LIGHT Nuclear explosions create much higher temperatures and much brighter light flashes than conventional explosions. Nuclear explosions create much higher temperatures and much brighter light flashes than conventional explosions. Burns and fire can occur at considerable distances Burns and fire can occur at considerable distances A 10 kiloton nuclear blast can cause burns 2 miles away A 10 kiloton nuclear blast can cause burns 2 miles away

August 2005EMS & Trauma Systems Section Office of Public Health Preparedness RADIATION PRODUCED Most of the damage from a nuclear blast comes from the blast wave and the heat and light produced. Most of the damage from a nuclear blast comes from the blast wave and the heat and light produced. The blast generates significant amounts of radiation. The blast generates significant amounts of radiation. Radiation from nuclear blast is much greater than RDD Radiation from nuclear blast is much greater than RDD RDD disperses radioactive materials using conventional explosives. RDD disperses radioactive materials using conventional explosives.

August 2005EMS & Trauma Systems Section Office of Public Health Preparedness TYPE OF RADIATION Three types of ionizing radiation: Three types of ionizing radiation: Alpha Alpha Beta Beta Gamma Gamma

August 2005EMS & Trauma Systems Section Office of Public Health Preparedness ALPHA PARTICLES Heaviest and most highly charged of nuclear particles. Heaviest and most highly charged of nuclear particles. Cannot travel more than a few inches Cannot travel more than a few inches Can be completely stopped by a sheet of paper. Can be completely stopped by a sheet of paper. Epidermis can stop alpha particles Epidermis can stop alpha particles Extremely hazardous when inhaled or ingested Extremely hazardous when inhaled or ingested

August 2005EMS & Trauma Systems Section Office of Public Health Preparedness BETA PARTICLES Smaller and travel faster than alpha Smaller and travel faster than alpha Cannot penetrate body tissue far enough to reach inner organs Cannot penetrate body tissue far enough to reach inner organs Layered clothing/protective garments provide adequate protection Layered clothing/protective garments provide adequate protection Hazardous if inhaled or ingested Hazardous if inhaled or ingested Can also enter the body through open wounds Can also enter the body through open wounds

August 2005EMS & Trauma Systems Section Office of Public Health Preparedness GAMMA RAYS Gamma rays are a type of electromagnetic radiation transmitted through space in the form of waves Gamma rays are a type of electromagnetic radiation transmitted through space in the form of waves Greatest penetration ability Greatest penetration ability Can travel up to a mile Can travel up to a mile Can penetrate most materials Can penetrate most materials Can attack all tissues and organs Can attack all tissues and organs

August 2005EMS & Trauma Systems Section Office of Public Health Preparedness HEALTH EFFECTS OF RADIATION Except in extremely high doses, the onset of symptoms requires days to weeks. Except in extremely high doses, the onset of symptoms requires days to weeks. Typically no characteristic signatures. Typically no characteristic signatures. Time required for symptoms is dependent of the type and dose of radioactive material. Time required for symptoms is dependent of the type and dose of radioactive material. Acute radiation sickness occurs when exposed to a large amount of radiation in a short period of time Acute radiation sickness occurs when exposed to a large amount of radiation in a short period of time Exposure can increase the risk of cancer Exposure can increase the risk of cancer

August 2005EMS & Trauma Systems Section Office of Public Health Preparedness HEALTH EFFECTS OF RADIATION Symptoms include: Symptoms include: Skin irritation Skin irritation Nausea Nausea Vomiting Vomiting High fever High fever Hair loss Hair loss Skin burns Skin burns

August 2005EMS & Trauma Systems Section Office of Public Health Preparedness Radiation effects and thermal burns

August 2005EMS & Trauma Systems Section Office of Public Health Preparedness Radiation burns

August 2005EMS & Trauma Systems Section Office of Public Health Preparedness Petachiae

August 2005EMS & Trauma Systems Section Office of Public Health Preparedness Key safety factors for EMS personnel Key safety factors for EMS personnel Approach/stand up wind Approach/stand up wind TIME - Limit time personnel are exposed to the radiation source. TIME - Limit time personnel are exposed to the radiation source. Distance-Reducing the proximity to the radiation source. Distance-Reducing the proximity to the radiation source. Shielding- The use of materials to block radiation. Shielding- The use of materials to block radiation. Respiratory PPE protects from particulate inhalation Respiratory PPE protects from particulate inhalation

August 2005EMS & Trauma Systems Section Office of Public Health Preparedness Epidemiology The onset of symptoms varies depending on the type and amount of radiation to which a victim is exposed. Low exposure is one to three hours; high exposure is 5-14 days. The onset of symptoms varies depending on the type and amount of radiation to which a victim is exposed. Low exposure is one to three hours; high exposure is 5-14 days. Radiation effects appear within hours after severe exposure. Radiation effects appear within hours after severe exposure.

August 2005EMS & Trauma Systems Section Office of Public Health Preparedness RADIOLOGICAL / NUCLEAR CONTAMINATION Can contaminate food and water Can contaminate food and water Consuming contaminated food or water can be harmful Consuming contaminated food or water can be harmful Land and buildings can become contaminated and rendered unusable for a long time Land and buildings can become contaminated and rendered unusable for a long time

August 2005EMS & Trauma Systems Section Office of Public Health Preparedness RADIOLOGICAL / NUCLEAR EMS Response EMS Response Stay upwind Stay upwind Isolate / secure area Isolate / secure area Be alert for secondary devices Be alert for secondary devices Use PPE – Especially respiratory Use PPE – Especially respiratory Avoid any smoke or fumes Avoid any smoke or fumes Conduct decontamination Conduct decontamination