Exploring Medical and Public Health Preparedness for a Nuclear Incident Proceedings of a Workshop (2019) / Chapter Skim
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7 Capability-Building Challenges and Opportunities: Building Response Capability
7 Capability-Building Challenges and Opportunities: Building Response Capability
Pages 111-120
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From page 111... ...
• The Strategic National Stockpile holds several medical coun termeasures relevant to a potential nuclear scenario, including cytokines, nausea medications, pain medications, sedatives, and burn kits. Accessing patient areas to maximize distribution of medical countermeasures would likely be a major challenge in any nuclear incident response.
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From page 112... ...
LARGE-SCALE TESTING FOR ACUTE RADIATION SICKNESS AFTER A NUCLEAR INCIDENT Amesh Adalja, senior scholar, Center for Health Security, Johns opkins Bloomberg School of Public Health, described a previously pub H lished "thought experiment" that described a potential solution to test ing millions of survivors following a nuclear incident for acute radiation sickness (ARS) : the formation of a public–private partnership with two major national laboratory chains -- Quest and LabCorp -- to test and iden tify individuals at risk for ARS (Adalja et al., 2011)
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From page 113... ...
Moreover, the CBC test is automated and is a common task at laboratories and hospitals across the country, meaning the CBC test for ALC is a potentially scalable solution. Keeping in mind the likely reality that local medical infrastruc ture would be destroyed by a nuclear incident, Adalja said that he and colleagues approached the two major national laboratory chains about the feasibility of their role in this scenario.
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From page 114... ...
First, he listed products held for radia tion injuries: • Cytokines, including Neupogen, Neulasta, and Leukine • Nausea medications, including ondansetron • Pain medications, including morphine and Oxycodone • Antibiotics, including levofloxacin and amoxicillin • Antivirals, including acyclovir • Antifungals, including voriconazole Adams also discussed SNS countermeasures used for burn and blast injuries, including electrolyte replacement (saline) , wound care products, laceration repair kits, topical ointments, eye care kits, and burn care kits.
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From page 115... ...
o ROLE OF THE U.S. DEPARTMENT OF VETERANS AFFAIRS IN A NUCLEAR INCIDENT In the field of public health emergency response for nuclear incidents, the Comprehensive Emergency Management Program (CEMP)
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From page 116... ...
Couig discussed challenges to VA's emergency preparedness. She said the aging health professional workforce -- more than two-thirds of VA nurses are over the age of 45 -- could prove to be problematic because ad vanced age could limit some individuals' capability to respond to a nuclear incident.
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From page 117... ...
Expanding on the Hiroshima example, James admitted that medical systems in the United States and elsewhere likely do not have the capacity to care for all the casual ies in the short term following an event, but he emphasized that they t do have the ability to decrease the potential number of casualties before a nuclear incident occurs through the evolution of a more prepared citizenry. A prepared citizenry is an informed citizenry, he said, and this requires b etter public education about the potential threat.
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From page 118... ...
The decision points ensure that leadership, over the course of a long-term response, can accurately address key topics such as public information, crisis standards of care, waste management, population relocation, and remediation, among other topics, he said. NRIA also allowed for the creation of an interagency Nuclear Radiological Incident Task Force (NRITF)
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From page 119... ...
Adalja suggested that satellite laboratories could play a role as the national chains already have a footprint in many small towns and the companies employ many phlebotomists who would be able to par ticipate in a mass CBC test drive. Strategic National Stockpile William Blakely of the Armed Forces Radiobiology Research Institute asked Adams about the use of diagnostic tools and devices in the SNS, includng blood cell counts, needles, tubes for bioassay fecal collection, i nasal swabs, and other products.
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From page 120... ...
Hanfling agreed that crisis standards of care is not a fully actionable concept yet, but it is worth further exploration by the National Academies and other bodies to identify barriers to implementation and possible methods to overcome them. John Dreyzehner, commissioner, Tennessee Department of Health, also agreed that crisis standards of care is a topic that requires further discussion; separately, he also urged others to consider crisis standards of privacy during a mass medical emergency, citing the Las Vegas shooting as a frustrating example of a time when privacy laws prevented practitioners from relaying important information to victims' family members.
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