Assessment of biodosimetry methods for a mass-casualty radiological incident: Medical response and management considerations

Julie M. Sullivan, Pataje G S Prasanna, Marcy B. Grace, Lynne K. Wathen, Rodney L. Wallace, John F. Koerner, C. Norman Coleman

Research output: Contribution to journalArticle

Abstract

Following a mass-casualty nuclear disaster, effective medical triage has the potential to save tens of thousands of lives. In order to best use the available scarce resources, there is an urgent need for biodosimetry tools to determine an individual's radiation dose. Initial triage for radiation exposure will include location during the incident, symptoms, and physical examination. Stepwise triage will include point of care assessment of less than or greater than 2 Gy, followed by secondary assessment, possibly with high throughput screening, to further define an individual's dose. Given the multisystem nature of radiation injury, it is unlikely that any single biodosimetry assay can be used as a standalone tool to meet the surge in capacity with the timeliness and accuracy needed. As part of the national preparedness and planning for a nuclear or radiological incident, the authors reviewed the primary literature to determine the capabilities and limitations of a number of biodosimetry assays currently available or under development for use in the initial and secondary triage of patients. Understanding the requirements from a response standpoint and the capability and logistics for the various assays will help inform future biodosimetry technology development and acquisition. Factors considered include: type of sample required, dose detection limit, time interval when the assay is feasible biologically, time for sample preparation and analysis, ease of use, logistical requirements, potential throughput, point-of-care capability, and the ability to support patient diagnosis and treatment within a therapeutically relevant time point.

Original languageEnglish (US)
Pages (from-to)540-554
Number of pages15
JournalHealth Physics
Volume105
Issue number6
DOIs
StatePublished - Dec 2013
Externally publishedYes

Fingerprint

Mass Casualty Incidents
Triage
Point-of-Care Systems
Surge Capacity
Radiation Injuries
Disasters
Physical Examination
Limit of Detection
Radiation

Keywords

  • biodosimetry
  • cytogenetics
  • dose assessment
  • emergency planning

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Health, Toxicology and Mutagenesis
  • Epidemiology

Cite this

Sullivan, J. M., Prasanna, P. G. S., Grace, M. B., Wathen, L. K., Wallace, R. L., Koerner, J. F., & Coleman, C. N. (2013). Assessment of biodosimetry methods for a mass-casualty radiological incident: Medical response and management considerations. Health Physics, 105(6), 540-554. https://doi.org/10.1097/HP.0b013e31829cf221

Assessment of biodosimetry methods for a mass-casualty radiological incident : Medical response and management considerations. / Sullivan, Julie M.; Prasanna, Pataje G S; Grace, Marcy B.; Wathen, Lynne K.; Wallace, Rodney L.; Koerner, John F.; Coleman, C. Norman.

In: Health Physics, Vol. 105, No. 6, 12.2013, p. 540-554.

Research output: Contribution to journalArticle

Sullivan, JM, Prasanna, PGS, Grace, MB, Wathen, LK, Wallace, RL, Koerner, JF & Coleman, CN 2013, 'Assessment of biodosimetry methods for a mass-casualty radiological incident: Medical response and management considerations', Health Physics, vol. 105, no. 6, pp. 540-554. https://doi.org/10.1097/HP.0b013e31829cf221
Sullivan, Julie M. ; Prasanna, Pataje G S ; Grace, Marcy B. ; Wathen, Lynne K. ; Wallace, Rodney L. ; Koerner, John F. ; Coleman, C. Norman. / Assessment of biodosimetry methods for a mass-casualty radiological incident : Medical response and management considerations. In: Health Physics. 2013 ; Vol. 105, No. 6. pp. 540-554.
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