Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response, Washington, DC, USA.
Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD, USA.
Int J Radiat Biol. 2022;98(5):873-877. doi: 10.1080/09553002.2021.2013573. Epub 2021 Dec 13.
An effective response for a mass-casualty incident requires understanding the relevant basic science and physical impact; detailed preparedness among jurisdictions; and clear, sequential response planning, including formal operational exercises, logistics, interagency, and public-private coordination, rapid activation of resilience, and continual improvement from lessons learned and new knowledge. This ConRad 2021 meeting report describes steps for civilian medical and public health response planning for a nuclear detonation; the utility of this type of planning for broader application; and extension of this planning to the international community.
A nuclear detonation requires a response within minutes to what will be a large-scale disaster complicated by radiation, including some elements that are similar to a broad range of incidents. The response could be further complicated if multiple incidents occur simultaneously. Required are detailed planning, preparedness and scripting for an immediate operational response, addressing clinical manifestations of evolving radiation illness, and flexibility to adapt to a rapidly changing situation. This need translates into the use of just-in-time information; effective, credible communication; situational awareness on a global scale; and a template upon which to apply capabilities in a multi-sector response. This effort is greatly facilitated using a 'playbook' approach, the basics of which are presented.
大规模伤亡事件需要有效应对，这要求了解相关的基础科学和物理影响；各司法管辖区有详细的准备；以及明确、有序的响应规划，包括正式的操作演练、后勤、机构间和公私协调、快速激活弹性，以及从经验教训和新知识中不断改进。本 2021 年 ConRad 会议报告描述了民用医疗和公共卫生部门针对核爆炸的响应规划步骤；这种规划在更广泛的应用中的效用；以及将这种规划扩展到国际社会。
核爆炸需要在几分钟内做出响应，因为这将是一场规模庞大的灾难，其复杂性包括辐射等因素，其中一些因素与广泛的事件类似。如果同时发生多个事件，响应可能会更加复杂。需要详细规划、准备和编写即时操作响应脚本，以应对不断发展的辐射病的临床表现，并具备适应快速变化局势的灵活性。这种需求转化为即时信息的使用；有效、可信的沟通；全球范围内的态势感知；以及在多部门响应中应用能力的模板。使用“剧本”方法可以极大地促进这项工作，本文介绍了其基本原理。
