title: Health care system planning for and response to a nuclear detonation.
abstract: The hallmark of a successful response to a nuclear detonation will be the resilience of the community, region, and nation. An incident of this magnitude will rapidly become a national incident; however, the initial critical steps to reduce lives lost, save the lives that can be saved with the resources available, and understand and apply resources available to a complex and dynamic situation will be the responsibility of the local and regional responders and planners. Expectations of the public health and health care systems will be met to the extent possible by coordination, cooperation, and an effort to produce as consistent a response as possible for the victims. Responders will face extraordinarily stressful situations, and their own physical and psychological health is of great importance to optimizing the response. This article illustrates through vignettes and supporting text how the incident may unfold for the various components of the health and medical systems and provides additional context for the discipline-related actions outlined in the state and local planners' playbook.
authors.affiliation: Hennepin County Medical Center, University of Minnesota, Minneapolis, MN 55415, USA. john.hick@hcmed.org
authors.forename: John L
authors.initials: JL
authors.lastname: Hick
authors.forename: David M
authors.initials: DM
authors.lastname: Weinstock
authors.forename: C Norman
authors.initials: CN
authors.lastname: Coleman
authors.forename: Dan
authors.initials: D
authors.lastname: Hanfling
authors.forename: Stephen
authors.initials: S
authors.lastname: Cantrill
authors.forename: Irwin
authors.initials: I
authors.lastname: Redlener
authors.forename: Judith L
authors.initials: JL
authors.lastname: Bader
authors.forename: Paula
authors.initials: P
authors.lastname: Murrain-Hill
authors.forename: Ann R
authors.initials: AR
authors.lastname: Knebel
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration*; D004189:Disaster Planning; D004632:Emergency Medical Services / Q000458:organization & administration*; D006801:Humans; D033242:Minors; D054043:Nuclear Weapons; D011634:Public Health; D011832:Radiation Injuries / Q000628:therapy; D018788:Radioactive Hazard Release; D012040:Regional Health Planning; D014187:Transportation of Patients; D014218:Triage; D014481:United States; D035862:Vulnerable Populations