A Decision Makers Guide: Medical Planning and Response for a Nuclear Detonation

A Decision Makers Guide: Medical Planning and Response for a Nuclear Detonation

A Decision Makers Guide: Medical Planning and Response for a Nuclear Detonation (PDF - 4.98 MB)

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Successful detonation of an improvised nuclear device (IND) would be a catastrophic event, causing an unprecedented number of injuries and lives lost, as well as economic, political, and social disruption. However, an effective medical response and an infrastructure prepared to protect itself from fallout could save tens of thousands of lives. Since 2001, all levels of government, academic institutions, and professional organizations have done significant work to enhance our ability to prepare for and respond to a nuclear detonation. The following manual is intended to simplify and translate the necessary protective actions and medical response modalities in order to make them more accessible and easier to translate into practice. The approach of this manual is to provide a common baseline application for various allied response disciplines (to include senior operational responders, emergency managers, public health advisors, and municipal, State, and Federal executives and elected officials). This manual will enhance mutual understanding of the basics of nuclear response.


This Manual will assist preparedness efforts and decision making by providing readily accessible information that quickly describes critical scientific and medical aspects of a nuclear incident as well as the response organization and resources anticipated to be required or available during a response. It is intended to offer a checklist of decision-provoking questions and reference guide for essential information to assist with the development of appropriate actions in response to a nuclear detonation. The subject matter includes basic principles about radiation, measurement, health effects, protective actions, critical public messaging, response strategies, medical management and countermeasures, and preparedness for a nuclear detonation.


The Manual is intended for use by planners, administrators, emergency managers, government officials, and other upper-level policy and decision-makers in Federal, State, local, tribal, and territorial public health and health-sector agencies and institutions. As an informational resource and practical tool, the guide presents essential background information that provides the “why” behind the critical issues and decisions that must be made in the complex response to the medical and public health consequences of a nuclear detonation. This manual is not intended to provide granular, encyclopedic content or instruction. Each “Section” is a rapid resource for awareness and understanding of key concepts and immediate concerns. Detailed reference information is accessible through the linked “Guide” reference sources. The summaries found in the Manual Sections and the associated details found in the Guides are essential to understanding an integrated systems approach to medical response that includes all municipal, state and federal responders, managers and key decision-makers.

The Manual is a companion to the journal manuscript published in 2012 PubMed: Medical Planning and Response for a Nuclear Detonation: a Practical Guide and is an update to the previously published Version 1.

Accessible Version of IND Decision Maker Guide (PDF – 5.04 MB)

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