1 US Department of Energy, National Nuclear Security Administration, Washington DC USA.
2 US Department of Health and Human Services, Washington DC USA.
Prehosp Disaster Med. 2014 Feb;29(1):80-6. doi: 10.1017/S1049023X1400003X.
The detonation of a nuclear device in a US city would be catastrophic. Enormous loss of life and injuries would characterize an incident with profound human, political, social, and economic implications. Nevertheless, most responders have not received sufficient training about ionizing radiation, principles of radiation safety, or managing, diagnosing, and treating radiation-related injuries and illnesses. Members throughout the health care delivery system, including medical first responders, hospital first receivers, and health care institution support personnel such as janitors, hospital administrators, and security personnel, lack radiation-related training. This lack of knowledge can lead to failure of these groups to respond appropriately after a nuclear detonation or other major radiation incident and limit the effectiveness of the medical response and recovery effort. Efficacy of the response can be improved by getting each group the information it needs to do its job. This paper proposes a sustainable training strategy for spreading curricula throughout the necessary communities. It classifies the members of the health care delivery system into four tiers and identifies tasks for each tier and the radiation-relevant knowledge needed to perform these tasks. By providing education through additional modules to existing training structures, connecting radioactive contamination control to daily professional practices, and augmenting these systems with just-in-time training, the strategy creates a sustainable mechanism for giving members of the health care community improved ability to respond during a radiological or nuclear crisis, reducing fatalities, mitigating injuries, and improving the resiliency of the community.
在美国城市引爆核装置将是灾难性的。巨大的生命损失和伤害将是这一事件的特征，其具有深远的人类、政治、社会和经济影响。然而，大多数应对者并没有接受足够的关于电离辐射、辐射安全原则或管理、诊断和治疗与辐射相关的伤害和疾病的培训。医疗服务提供系统中的各个成员，包括医疗急救人员、医院首诊医生和医疗机构支持人员，如清洁工、医院管理人员和安全人员，都缺乏与辐射相关的培训。这种知识的缺乏可能导致这些群体在核爆炸或其他重大辐射事件后无法做出适当的反应，并限制医疗反应和恢复工作的有效性。通过向每个群体提供其完成工作所需的信息，可以提高反应的效果。本文提出了一种可持续的培训策略，将课程传播到必要的社区。它将医疗服务提供系统的成员分为四个层次，并确定了每个层次的任务以及执行这些任务所需的辐射相关知识。通过向现有培训结构提供额外的模块教育，将放射性污染控制与日常专业实践联系起来，并通过即时培训来增强这些系统，该策略为医疗社区成员在放射性或核危机期间提高应对能力创造了一个可持续的机制，从而减少死亡人数，减轻伤害，并提高社区的弹性。
