title: Assessing surge capacity for radiation victims with marrow toxicity.
abstract: Hematologists/oncologists would provide essential care for victims of a catastrophic radiation incident, such as the detonation of an improvised nuclear device (IND). The US Radiation Injury Treatment Network (RITN) is a voluntary consortium of 37 academic medical centers, 8 blood donor centers, and 7 umbilical cord banks focused on preparedness for radiation incidents. The RITN conducted 2 tabletop exercises to evaluate response capability after a hypothetical IND detonation in a U.S. city. In the 2008 exercise, medical centers voluntarily accepted 1757 victims at their institutions, a small fraction of the number in need. In the 2009 exercise, each center was required to accept 300 victims. In response, the centers outlined multiple strategies to increase bed availability, extend staff and resources, and support family and friends accompanying transferred victims. The exercises highlighted shortcomings in current planning and future steps for improving surge capacity that are applicable to various mass casualty scenarios.
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02115, USA. DavidM_Weinstock@dfci.harvard
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Davids
authors.forename: Cullen
authors.initials: C
authors.lastname: Case
authors.forename: Raymond
authors.initials: R
authors.lastname: Hornung
authors.forename: Nelson J
authors.initials: NJ
authors.lastname: Chao
authors.forename: John P
authors.initials: JP
authors.lastname: Chute
authors.forename: C Norman
authors.initials: CN
authors.lastname: Coleman
authors.forename: Daniel
authors.initials: D
authors.lastname: Weisdorf
authors.forename: Dennis L
authors.initials: DL
authors.lastname: Confer
authors.forename: David M
authors.initials: DM
authors.lastname: Weinstock
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D001771:Blood Banks; D001855:Bone Marrow Diseases / Q000209:etiology / Q000601:surgery*; D016026:Bone Marrow Transplantation; D002648:Child; D004189:Disaster Planning / Q000458:organization & administration*; D005312:Fetal Blood; D006301:Health Services Needs and Demand; D006742:Hospital Bed Capacity; D006801:Humans; D007373:Interinstitutional Relations; D054527:Mass Casualty Incidents; D054043:Nuclear Weapons; D016544:Patient Simulation; D018788:Radioactive Hazard Release; D033581:Stem Cell Transplantation; D023481:Terrorism; D014218:Triage; D014481:United States