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Suggested Citation:"Appendix A: References." Institute of Medicine. 2014. Nationwide Response Issues After an Improvised Nuclear Device Attack: Medical and Public Health Considerations for Neighboring Jurisdictions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18347.
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Page 93
Suggested Citation:"Appendix A: References." Institute of Medicine. 2014. Nationwide Response Issues After an Improvised Nuclear Device Attack: Medical and Public Health Considerations for Neighboring Jurisdictions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18347.
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Page 94
Suggested Citation:"Appendix A: References." Institute of Medicine. 2014. Nationwide Response Issues After an Improvised Nuclear Device Attack: Medical and Public Health Considerations for Neighboring Jurisdictions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18347.
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Page 95
Suggested Citation:"Appendix A: References." Institute of Medicine. 2014. Nationwide Response Issues After an Improvised Nuclear Device Attack: Medical and Public Health Considerations for Neighboring Jurisdictions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18347.
×
Page 96
Suggested Citation:"Appendix A: References." Institute of Medicine. 2014. Nationwide Response Issues After an Improvised Nuclear Device Attack: Medical and Public Health Considerations for Neighboring Jurisdictions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18347.
×
Page 97
Suggested Citation:"Appendix A: References." Institute of Medicine. 2014. Nationwide Response Issues After an Improvised Nuclear Device Attack: Medical and Public Health Considerations for Neighboring Jurisdictions: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18347.
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Page 98

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A References AMR (American Medical Response). 2011. Overview of AMR–FEMA national emergency medical services contract. http://www.amr.net/Files/PDFs/DRT- Companies/AMR-FEMA-contract-overview.aspx (accessed May 19, 2013). ASPR (Office of the Assistant Secretary for Preparedness and Response). 2012. ASPR response playbooks. http://www.phe.gov/preparedness/planning/ playbooks/Pages/default.aspx (accessed May 19, 2013). Barnett, D. J., C. B. Thompson, N. A. Errett, N. L. Semon, M. K. Anderson, J. L. Ferrell, J. M. Freiheit, R. Hudson, M. M. Koch, M. McKee, A. Mejia- Echeverry, J. Spitzer, R. D. Balicer, and J. M. Links. 2012. Determinants of emergency response willingness in the local public health workforce by ju- risdictional and scenario patterns: A cross-sectional survey. BMC Public Health 12:164. doi: 10.1186/1471-2458-12-164. Becker, S. M. 2007. Communicating risk to the public after radiological inci- dents. BMJ 335(7630):1106–1107. Becker, S. M. 2011. Learning from the 2011 Great East Japan Disaster: Insights from a special radiological emergency assistance mission. Biosecurity and Bioterrorism 9(4):394–404. doi: 10.1089/bsp.2011.0084. Bromet, E. J. 2012. Mental health consequences of the Chernobyl disaster. Journal of Radiological Protection 32(1):N71–N75. doi: 10.1088/0952- 4746/32/1/N71. Caro, J. J., E. G. DeRenzo, C. N. Coleman, D. M. Weinstock, and A. R. Knebel. 2011a. Resource allocation after a nuclear detonation incident: Unaltered standards of ethical decision making. Disaster Medicine and Public Health Preparedness 5(Suppl 1):S46–S53. doi: 10.1001/dmp.2011.14. Caro, J. J., C. N. Coleman, A. R. Knebel, and E. G. DeRenzo. 2011b. Unaltered ethical standards for individual physicians in the face of drastically reduced resources resulting from an improvised nuclear device event. Journal of Clinical Ethics 22(1):33–41. 93

94 NATIONWIDE RESPONSE ISSUES AFTER AN IND ATTACK Casagrande, R., N. Wills, E. Kramer, L. Sumner, M. Mussante, R. Kurinsky, P. McGhee, L. Katz, D. M. Weinstock, and C. N. Coleman. Using the model of resource and time-based triage (MORTT) to guide scarce resource alloca- tion in the aftermath of a nuclear detonation. Disaster Medicine and Public Health Preparedness 5(Suppl 1):S98–S110. doi: 10.1001/dmp.2011.16. CDC (Centers for Disease Control and Prevention). 2012. Health Effects Mes- sage Testing: Detonation of Improvised Nuclear Device. Washington, DC: Cen- ters for Disease Control and Prevention. http://emergency.cdc.gov/radiation /pdf/Health%20Message%20Testing-Detonation%20of%20an%20Improvised %20Nuclear%20Device.pdf (accessed May 19, 2013). CDC. 2013. Acute radiation syndrome: A fact sheet for physicians. http://www.bt.cdc.gov/radiation/arsphysicianfactsheet.asp (accessed May 17, 2013). Coleman, C. N., D. M. Weinstock, R. Casagrande, J. L. Hick, J. L. Bader, F. Chang, J. B. Nemhauser, and A. R. Knebel. 2011. Triage and treatment tools for use in a scarce resources-crisis standards of care setting after a nu- clear detonation. Disaster Medicine and Public Health Preparedness 5(Suppl 1):S111–S121. doi: 10.1001/dmp.2011.22. Coleman, C. N., C. Hrdina, R. Casagrande, K. D. Cliffer, M. K. Mansoura, S. Nystrom, R. Hatchett, J. J. Caro, A. R. Knebel, K. S. Wallace, and S. A. Adams. 2012. User-managed inventory: An approach to forward- deployment of urgently needed medical countermeasures for mass-casualty and terrorism incidents. Disaster Medicine and Public Health Preparedness 6(4):408–414. doi: 10.1001/dmp.2012.46a. DHS (Department of Homeland Security). 2008. National Response Frame- work. Washington, DC: Department of Homeland Security. http://www. fema.gov/pdf/emergency/nrf/nrf-core.pdf (accessed March 5, 2013). Dodgen, D., A. E. Norwood, S. M. Becker, J. T. Perez, and C. K. Hansen. 2011. Social, psychological, and behavioral responses to a nuclear detonation in a U.S. city: Implications for health care planning and delivery. Disaster Med- icine and Public Health Preparedness 5(Suppl 1):S54–S64. doi: 10.1001/ dmp.2011.12. EPA (Environmental Protection Agency). 1992. Manual of Protective Action Guides and Protective Actions for Nuclear Incidents. Washington, DC: En- vironmental Protection Agency. http://www.epa.gov/radiation/docs/er/400- r-92-001.pdf (accessed March 5, 2013). Farese, A. M., D. B. Casey, R. M. Vigneulle, N. R. Siegel, R. F. Finn, J. A. Klover, W. G. Smith, J. P. McKearn, and T. J. MacVittie. 2001. A sin- gle dose of pegylated leridistim significantly improves neutrophil recovery in sublethally irradiated rhesus macaques. Stem Cells 19(6):514–521. Farese, A. M., M. V. Cohen, B. P. Katz, C. P. Smith, A. Gibbs, D. M. Cohen, and T. J. MacVittie. 2013. Filgrastim improves survival in lethally irradiat- ed nonhuman primates. Radiation Research 179(1):89–100. doi: 10.1667/RR3049.1.

APPENDIX A 95 FEMA (Federal Emergency Management Agency). 2008. Planning guidance for protection and recovery following radiological dispersal device and impro- vised nuclear device incidents. 73 FR 149, pp. 45029–45048. http://www. gpo.gov/fdsys/pkg/FR-2008-08-01/pdf/E8-17645.pdf (accessed May 28, 2013). FEMA. 2013a. NIMS and the Incident Command System. http://www.fema. gov/txt/nims/nims_ics_position_paper.txt (accessed February 14, 2013). FEMA. 2013b. Improvised Nuclear Device Response and Recovery: Communi- cating in the Immediate Aftermath. http://www.fema.gov/media-library /assets/documents/33036 (accessed August 6, 2013) Garrett, A., Y. S. Park, and I. Redlener. 2009. Mitigating absenteeism in hospital workers during a pandemic. Disaster Medicine and Public Health Prepar- edness 3(2):141–147. Hrdina, C. M., C. N. Coleman, S. Bogucki, J. L. Bader, R. E. Hayhurst, J. D. Forsha, D. Marcozzi, K. Yeskey, and A. R. Knebel. 2009. The “RTR” med- ical response system for nuclear and radiological mass-casualty incidents: A functional TRiage-TRansport-TReatment medical response model. Pre- hospital Disaster Medicine 24(3):167–178. IOM (Institute of Medicine). 2009. Assessing Medical Preparedness to Respond to a Terrorist Nuclear Event: Workshop Summary. Washington, DC: The National Academies Press. IOM. 2012. Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response. Washington, DC: The National Academies Press. Jenkins. B. 2008. Will Terrorists Go Nuclear? New York: Prometheus Books. Kaufman, K. 2011. Development of a Multi-Agency Radiation Response Plan. NACCHO Preparedness Brief. July. Edition 57. http://www.naccho.org/ topics/emergency/upload/StoryfromtheField_July2011.pdf (accessed May 1, 2013). Kelen, G. D., C. K. Kraus, M. L. McCarthy, E. Bass, E. B. Hsu, G. Li, J. J. Scheulen, J. B. Shahan, J. D. Brill, and G. B. Green. 2006. Inpatient dispo- sition classification for the creation of hospital surge capacity: A multiphase study. Lancet 368(9551):1984–1990. McBurney, R., et al. 2010. A Plan for Incorporating Local Volunteer Radiation Professionals into Existing Health Volunteer Programs to Assist in Popula- tion Monitoring. http://www.crcpd.org/Homeland_Security/RRVC_Final Report.pdf (accessed May 1, 2013). Meit, M., I. Redlener, T. W. Briggs, M. Kwanisai, D. Culp, and D. M. Abram- son. 2011. Rural and suburban population surge following detonation of an improvised nuclear device: A new model to estimate impact. Disaster Medicine and Public Health Preparedness 5(Suppl 1):S143–S150. doi: 10.1001/dmp.2011.20.

96 NATIONWIDE RESPONSE ISSUES AFTER AN IND ATTACK Murrain-Hill, P., C. N. Coleman, J. L. Hick, I. Redlener, D. M. Weinstock, J. F. Koerner, D. Black, M. Sanders, J. L. Bader, J. Forsha, and A. R. Knebel. 2011. Medical response to a nuclear detonation: Creating a playbook for state and local planners and responders. Disaster Medicine and Public Health Preparedness 5(Suppl 1):S89–S97. doi: 10.1001/dmp.2011.13. National Center for PTSD. 2006. Psychological First Aid. http://www.ptsd. va.gov/professional/manuals/manual-pdf/pfa/PFA_V2.pdf (accessed March 4, 2013). National Commission on Children and Disasters. 2010. 2010 Report to the Pres- ident and Congress. AHRQ Publication No. 10-M037. Rockville, MD: Agency for Healthcare Research and Quality. NCRP (National Council on Radiation Protection and Measurements). 2005. Key Elements of Preparing Emergency Responders for Nuclear and Radio- logical Terrorism. Commentary No. 19. http://www.ncrponline.org/ Publications/Commentaries/Comm19press.html (accessed May 17, 2013). NCRP. 2010. Responding to a Radiological or Nuclear Terrorism Incident: A Guide for Decision Makers. Report No. 165. http://www.ncrppublications. org/reports/165 (accessed May 17, 2013) New York Times. 2005. Katrina’s Diaspora. October 2. http://www.nytimes. com/imagepages/2005/10/02/national/nationalspecial/20051002diaspora_ graphic.html (accessed May 29, 2013). Nuclear Detonation Response Communications Working Group. 2010. Nuclear Detonation Preparedness: Communicating in the Immediate Aftermath. http://www.remm.nlm.gov/NuclearDetonationPreparedness.pdf (accessed May 17, 2013). Operation Shared Burden. 2012. After-Action Report and Improvement Plan. Michigan Region 2S. Detroit, MI: Medical Bio-defense Network. OSTP (Office of Science and Technology Policy). 2010. Planning Guidance for Response to a Nuclear Detonation, Second Edition. http://www.epa.gov/ rpdweb00/docs/er/planning-guidance-for-response-to-nuclear-detonation-2- edition-final.pdf (accessed February 10, 2013). Rambhia, K. J., R. E. Waldhorn, F. Selck, A. K. Mehta, C. Franco, and E. S. Toner. 2012. A survey of hospitals to determine the prevalence and charac- teristics of healthcare coalitions for emergency preparedness and response. Biosecurity and Bioterrorism 10(3):304–313. doi: 10.1089/bsp.2012.0022. RITN (Radiation Injury Treatment Network). 2010. Acute radiation syndrome treatment guidelines. http://www.ritn.net/WorkArea/DownloadAsset.aspx? id=2147483696 (accessed February 26, 2013). Satterthwaite, P. S., and C. J. Atkinson. 2012. Using “reverse triage” to create hospital surge capacity: Royal Darwin Hospital’s response to the Ashmore Reef disaster. Emergency Medical Journal 29(2):160–162. doi:10.1136/ emj.2010.098087.

APPENDIX A 97 Schuster, M. A., B. D. Stein, L. Jaycox, R. L. Collins, G. N. Marshall, M. N. Elliott, A. J. Zhou, D. E. Kanouse, J. L. Morrison, and S. H. Berry. 2001. A national survey of stress reactions after the September 11, 2001, terrorist at- tacks. New England Journal of Medicine 345(20):1507–1512. Slovic, P. (ed.). 2001. The Perception of Risk. London: Earthscan Publications Ltd. Talbott, E. O., A. O. Youk, K. P. McHugh-Pemu, and J. V. Zborowski. 2003. Long-term follow-up of the residents of the Three Mile Island accident area: 1979–1998. Environmental Health Perspectives 111(3):341–348. Tippett, V. C., K. Watt, S. G. Raven, H. A. Kelly, M. Coory, F. Archer, and K. Jamrozik. 2010. Anticipated behaviors of emergency prehospital medical care providers during an influenza pandemic. Prehospital and Disaster Medicine 25(1):20–25. U.S. Senate Committee on Government Affairs. 2001. Hearing on FEMA’s Role in Managing Bioterrorist Attacks and the Impact of Public Health Concerns on Bioterrorism Preparedness. July 23. http://www.upmchealthsecurity.org/ wesite/resources/To%20USG/Testimony_Briefings/2001/20010723femarole. pdf (accessed May 28, 2013). Vandre, R. H., J. Klebers, F. M. Tesche, and J. P. Blanchard. 1993. Electromag- netic pulse (EMP), Part I: Effects on field medical equipment. Military Medicine 158(4):233–236. Waselenko, J. K., T. J. MacVittie, W. F. Blakely, N. Pesik, A. L. Wiley, W. E. Dickerson, H. Tsu, D. L. Confer, C. N. Coleman, T. Seed, P. Lowry, J. O. Armitage, and N. Dainiak. 2004. Strategic National Stockpile Radiation Working Group. Medical management of the acute radiation syndrome: Recommendations of the Strategic National Stockpile Radiation Working Group. Annals of Internal Medicine 140(12):1037–1051.

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Our nation faces the distinct possibility of a catastrophic terrorist attack using an improvised nuclear device (IND), according to international and U.S. intelligence. Detonation of an IND in a major U.S. city would result in tens of thousands to hundreds of thousands of victims and would overwhelm public health, emergency response, and health care systems, not to mention creating unprecedented social and economic challenges. While preparing for an IND may seem futile at first glance, thousands of lives can be saved by informed planning and decision making prior to and following an attack.

In 2009, the Institute of Medicine published the proceedings of a workshop assessing the health and medical preparedness for responding to an IND detonation. Since that time, multiple federal and other publications have added layers of detail to this conceptual framework, resulting in a significant body of literature and guidance. However, there has been only limited planning effort at the local level as much of the federal guidance has not been translated into action for states, cities and counties. According to an informal survey of community preparedness by the National Association of City and County Health Officials (NACCHO), planning for a radiation incident ranked lowest in priority among other hazards by 2,800 local health departments.

The focus of Nationwide Response Issues After an Improvised Nuclear Device Attack: Medical and Public Health Considerations for Neighboring Jurisdictions: Workshop Summary is on key response requirements faced by public health and health care systems in response to an IND detonation, especially those planning needs of outlying state and local jurisdictions from the detonation site. The specific meeting objectives were as follows:

- Understand the differences between types of radiation incidents and implications of an IND attack on outlying communities.

-Highlight current planning efforts at the federal, state, and local level as well as challenges to the implementation of operational plans.

-Examine gaps in planning efforts and possible challenges and solutions.

-Identify considerations for public health reception centers: how public health and health care interface with functions and staffing and how radiological assessments and triage be handled.

-Discuss the possibilities and benefits of integration of disaster transport systems.

-Explore roles of regional health care coalitions in coordination of health care response.

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