Dainiak Nicholas, Berger Paul, Albanese Joseph
Department of Medicine, Bridgeport Hospital and Yale University School of Medicine, Bridgeport, CT 06610, USA.
Exp Hematol. 2007 Apr;35(4 Suppl 1):17-23. doi: 10.1016/j.exphem.2007.01.007.
Local, regional, and federal response teams play an integrated role in the early management of mass casualties from a radiologic incident. Evaluation of individuals exposed to ionizing radiation requires an assessment of clinical signs and symptoms and an estimation of radiation dose. Here, we determine the relevance and feasibility of multi-parameter assessment for management of mass casualties from a radiological event.
An assessment of the value of signs and symptoms and of individual biological dosimetry is made. To determine the feasibility of applying dosimetric data in a mass casualty event, a survey was conducted of the 32 clinical laboratories meeting criteria in the State of Connecticut. Following completion of a training program, a functional drill was conducted to determine efficacy of training and proficiency of sample preparation for the cytogenetic bioassay.
Based upon reliability and timeliness of clinical information and dosimetric data, it is evident that both forms of data should be provided in a mass casualty scenario. A needs assessment of clinical laboratories in Connecticut identified 30 of 32 clinical laboratories that were qualified and willing to perform initial processing of biodosimetry specimens. Currently, 79 laboratory professionals in 19 of the qualified clinical laboratories were trained in specimen processing. Of these individuals, 37 participated in a functional drill that demonstrated an acceptable cell viability (>95%) and turnaround time for samples (199 minutes).
Multi-parameter assessment provides useful information to clinicians caring for mass casualties from a radiological event. Assessment of individual radiation dose by the cytogenetic bioassay is made more feasible by building clinical laboratory surge capacity.
地方、区域和联邦应急小组在放射性事件所致大规模伤亡的早期管理中发挥着综合作用。对暴露于电离辐射的个体进行评估需要对临床体征和症状进行评估，并估算辐射剂量。在此，我们确定多参数评估在放射性事件所致大规模伤亡管理中的相关性和可行性。
对体征和症状的价值以及个体生物剂量测定进行评估。为了确定在大规模伤亡事件中应用剂量测定数据的可行性，对康涅狄格州符合标准的32个临床实验室进行了调查。在完成培训计划后，进行了一次功能演练，以确定培训效果和细胞遗传生物测定样本制备的熟练程度。
基于临床信息和剂量测定数据的可靠性和及时性，很明显在大规模伤亡情况下应同时提供这两种数据形式。对康涅狄格州临床实验室的需求评估发现，32个临床实验室中有30个有资质且愿意对生物剂量测定标本进行初步处理。目前，19个合格临床实验室中的79名实验室专业人员接受了标本处理培训。其中，37人参加了功能演练，演练结果显示样本的细胞活力可接受（>95%），样本周转时间为199分钟。
多参数评估为护理放射性事件所致大规模伤亡的临床医生提供了有用信息。通过建立临床实验室应急能力，细胞遗传生物测定对个体辐射剂量的评估变得更加可行。
