Radiology Department, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH, USA.
Clin-EPR, LLC, Lyme, NH, USA.
Radiat Prot Dosimetry. 2023 Sep 18;199(14):1539-1550. doi: 10.1093/rpd/ncad022.
Following large-scale radiation events, an overwhelming number of people will potentially need mitigators or treatment for radiation-induced injuries. This necessitates having methods to triage people based on their dose and its likely distribution, so life-saving treatment is directed only to people who can benefit from such care. Using estimates of victims following an improvised nuclear device striking a major city, we illustrate a two-tier approach to triage. At the second tier, after first removing most who would not benefit from care, biodosimetry should provide accurate dose estimates and determine whether the dose was heterogeneous. We illustrate the value of using in vivo electron paramagnetic resonance nail biodosimetry to rapidly assess dose and determine its heterogeneity using independent measurements of nails from the hands and feet. Having previously established its feasibility, we review the benefits and challenges of potential improvements of this method that would make it particularly suitable for tier 2 triage. Improvements, guided by a user-centered approach to design and development, include expanding its capability to make simultaneous, independent measurements and improving its precision and universality.
在大规模辐射事件发生后，大量的人可能需要防护剂或治疗辐射损伤。这就需要有方法根据剂量及其可能的分布对人员进行分类，以便仅将救生治疗用于那些能从中受益的人。利用简易核装置袭击大城市后受害者的估计数，我们说明了一种两级分类方法。在第二层，首先去除大多数不会受益于护理的人后，生物剂量测定应提供准确的剂量估计，并确定剂量是否不均匀。我们举例说明了使用体内电子顺磁共振指甲生物剂量测定法来快速评估剂量并使用来自手部和脚部的指甲的独立测量来确定其不均匀性的价值。在先前已经确定其可行性之后，我们回顾了改进该方法的益处和挑战，这将使其特别适合二级分类。以用户为中心的设计和开发方法为指导的改进包括扩展其同时进行独立测量的能力，并提高其精度和通用性。
