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Understanding and Responding to Mass Casualty Radiation Incidents

ASTRO's Role in Radiation Disaster Management

After the tragic events of September 11, 2001, ASTRO recognized a need to involve radiation oncologists and other medical personnel in emergency preparedness measures in the event of a nuclear/radiologic attack or disaster. Because radiation oncologists are the physicians most thoroughly trained to understand the effects of radiation exposure on healthy and malignant cells, ASTRO felt that it was appropriate that our members become one of the principal resources in this effort. To that end, ASTRO worked with the American College of Radiology and the American Association of Physicists in Medicine to create a radiological terrorism primer to serve as an educational tool for radiation oncology and radiology professionals. The primer, Disaster Preparedness for Radiology Professionals, summarizes information on preparing for a radiation emergency, handling contaminated persons, dose assessment and radiation exposure health effects.

Key Resource

Radiation Event Medical Management (REMM). REMM provides guidance for physicians and allied professionals about clinical diagnosis and treatment during mass casualty radiological/nuclear events. REMM provides just-in-time, evidence-based, usable information with sufficient background and context to make complex issues understandable to those without formal radiation medicine expertise. Additionally, this web-based information is also downloadable in advance, so that it would be available during an event if the internet is not accessible.


Centers for Disease Control and Prevention (CDC): https://emergency.cdc.gov/radiation/

Radiation Emergency Assistance Center/Training Site (REAC/TS): https://orise.orau.gov/reacts/index.html

Federal Emergency Management Agency (FEMA): https://www.fema.gov/radiological-emergency-preparedness-program

Department of Health and Human Services, Assistant Secretary for Preparedness and Response (HHS/ASPR): https://www.phe.gov/about/pages/default.aspx

Radiation Injury Treatment Network (RITN): https://ritn.net/

Public health and medical preparedness for a nuclear detonation: the nuclear incident medical enterprise. Coleman CN, Sullivan JM, Bader JL, Murrain-Hill P, Koerner JF, Garrett AL, Weinstock DM, Case C Jr, Hrdina C, Adams SA, Whitcomb RC, Graeden E, Shankman R, Lant T, Maidment BW, Hatchett RC. Health Phys. 2015 Feb;108(2):149-60. doi: 10.1097/HP.0000000000000249. PMID:25551496

The medical decision model and decision maker tools for management of radiological and nuclear incidents. Koerner JF, Coleman CN, Murrain-Hill P, FitzGerald DJ, Sullivan JM. Health Phys. 2014 Jun;106(6):645-51. doi: 10.1097/HP.0000000000000053. PMID: 24776895

Emergency medical preparedness for radiological/nuclear incidents in the United States.
Coleman CN, Lurie N. J Radiol Prot. 2012 Mar;32(1):N27-32. doi: 10.1088/0952-4746/32/1/N27. Epub 2012 Mar 6. PMID: 22395159

Development of a statewide hospital plan for radiologic emergencies. Dainiak N, Delli Carpini D, Bohan M, Werdmann M, Wilds E, Barlow A, Beck C, Cheng D, Daly N, Glazer P, Mas P, Nath R, Piontek G, Price K, Albanese J, Roberts K, Salner AL, Rockwell S. Int J Radiat Oncol Biol Phys. 2006 May 1;65(1):16-24. PMID: 16618574

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