New Study In AMA Disaster Journal: In An Urban Nuclear Attack, Loss Of Medical Resources Would Hinder Medical Response For Victims

Main Category: Aid / Disasters
Also Included In: Bio-terrorism / Terrorism
Article Date: 13 Nov 2007 - 3:00 PST

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A nuclear attack on a major U.S. metropolitan city with hundreds of thousands of casualties is unthinkable - but government reports persistently indicate that terrorists intend just such a deliberate attack. What can a city do to prepare for this nightmare scenario? That's the topic of a new study in the American Medical Association's (AMA) Disaster Medicine and Public Health Preparedness journal. The study outlines steps a city can take to better prepare for a nuclear attack that would devastate its health care system, leaving tens of thousands of burn victims in need of urgent care.

"After a nuclear attack, the surviving health care community would be faced with an unprecedented burden of care for burn victims," according to author Cham E. Dallas, PhD, director of the Institute for Health Management and Mass Destruction Defense at the University of Georgia. "This burden would be compounded by the loss of hospitals, doctors, nurses and other health professionals."

The study, "Prediction Modeling to Determine the Adequacy of Medical Response to Urban Nuclear Attack," analyzes the effects that a 20- and 550- kiloton nuclear detonation would have on the cities of Los Angeles and Houston. Authors Dr. Cham Dallas and William C. Bell, PhD, used a variety of known data to create models to calculate the number of burn victims expected in both cities.

"The number of people affected by a 550-kiloton nuclear weapon detonated in Los Angeles or Houston is staggering," Dr. Dallas said.

According to their model, a 550-kiloton attack in downtown Los Angeles would result in 786,000 burn victims with about 185,000 likely to survive. In Houston, a similar attack would produce 257,579 burn casualties with only about 59,000 likely to survive.

The study outlines four necessary improvements for cities to consider to better prepare for an urban nuclear attack:

- An expansion of medical personnel who are trained in burn care, including non-physicians.
- Proper planning for displaced populations who will need shelter, food, water, clothing, basic health care and safety.
- Pre-positioning of secure stockpiles of narcotics for use in mass burn care.
- The creation of regional mobilization systems, such as air transport, to move medical resources and personnel in the event of a nuclear attack.

"It is imperative that cities consider the catastrophic health consequences of a nuclear attack and create plans that will account for such an extreme challenge," Dr. Dallas concluded.

Additional articles in the November issue of the AMA Disaster Medicine and Public Health Preparedness journal are:

- "Regional Health System Response to the 2007 Greensburg, Kansas, EF5 Tornado," by Elizabeth Ablah, PhD, MPH.
- "Assessing the Integration of Health Center and Community Emergency Preparedness and Response Planning," by Nicole V. Wineman, MA, MPH, MBA.
- "Postexposure Immunization and Prophylaxis of Bloodborne Pathogens Following a Traumatic Explosive Event: Preliminary Recommendations," by Italo Subbarao, DO, MBA.
- "Measuring Humanitarian Emergencies," by Richard Garfield, RN, DrPH.
- "The New International Health Regulations: Consideration for Global Public Health Surveillance," by John S. Brownstein, PhD.

American Medical Association

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