title: Infrastructure to support ultra high throughput biodosimetry screening after a radiological event.
abstract: OBJECTIVE
  After a large-scale radiological event, there will be a pressing need to assess, within a few days, the radiation doses received by tens or hundreds of thousands of individuals. This is for triage, to prevent treatment locations from being overwhelmed, in what is sure to be a resource limited scenario, as well as to facilitate dose-dependent treatment decisions. In addition there are psycho-social considerations, in that active reassurance of minimal exposure is a potentially effective antidote to mass panic, as well as long-term considerations, to facilitate later studies of cancer and other long-term disease risks.
  
  
  METHODS
  As described elsewhere in this issue, we are developing a Rapid Automated Biodosimetry Tool (RABiT). The RABiT allows high throughput analysis of thousands of blood samples per day, providing a dose estimate that can be used to support clinical triage and treatment decisions.
  
  
  RESULTS
  Development of the RABiT has motivated us to consider the logistics of incorporating such a system into the existing emergency response scenarios of a large metropolitan area. We present here a view of how one or more centralized biodosimetry readout devices might be incorporated into an infrastructure in which fingerstick blood samples are taken at many distributed locations within an affected city or region and transported to centralized locations.
  
  
  CONCLUSIONS
  High throughput biodosimetry systems offer the opportunity to perform biodosimetric assessments on a large number of persons. As such systems reach a high level of maturity, emergency response scenarios will need to be tweaked to make use of these powerful tools. This can be done relatively easily within the framework of current scenarios.
authors.affiliation: Radiological Research Accelerator Facility, Columbia University, Irvington, NY 10533, USA. gyg2101@columbia.edu
authors.forename: Guy
authors.initials: G
authors.lastname: Garty
authors.forename: Andrew
authors.initials: A
authors.lastname: Karam
authors.forename: David J
authors.initials: DJ
authors.lastname: Brenner
mesh_terms: D001681:Biological Assay / Q000379:methods*; D019058:Community Networks / Q000458:organization & administration; D004189:Disaster Planning / Q000458:organization & administration*; D006801:Humans; D054527:Mass Casualty Incidents / Q000517:prevention & control*; D008403:Mass Screening / Q000379:methods*; D011832:Radiation Injuries / Q000175:diagnosis* / Q000517:prevention & control*; D011834:Radiation Monitoring / Q000379:methods*; D018788:Radioactive Hazard Release; D014481:United States