Dirty bomb
Background
- Also known as "Radiological Dispersal Device"[1]
- Consists of radioactive material packaged into non-nuclear (conventional) bomb[1]
- No nuclear fusion/fission occurs
- Detonation causes injuries from conventional explosion and also spreads radioactive material, causing radiation injuries and cancer
- Radioactive material spread locally via blast, and carried more distantly via aerosolized or particulate "plumes"
- Multiple radioisotopes from various sources (e.g. nuclear fuel waste, medical radiography, etc) could be employed
- Most injuries and deaths will be caused by blast injuries, not radiation injury[2]
- Triage of patients by radiation dose received is important and should be coordinated with disaster response officials.
Clinical Features
- See Blast injury and Acute radiation syndrome
Differential Diagnosis
Mass casualty incident
- Radiation exposure (disaster)
- Dirty bomb
- Bioterrorism
- Chemical weapons
- Mass shooting
- Natural Disaster (e.g. Hurricane, Earthquake, Tornado, Tsunami, etc)
- Unintentional large-scale incident (e.g. building collapse, train derailment, etc)
- Major pandemic
- Explosions
Evaluation
- Determined by injuries
- If Acute radiation syndrome suspected, establishing baseline with CBC and CMP is appropriate.
Management
- Priority is treatment of blast injuries and burns
- ED treatment of Acute radiation syndrome is primarily supportive
Disposition
- Most patients require admission.
See Also
References
- ↑ 1.0 1.1 Rosoff H, von Winterfeldt D. A risk and economic analysis of dirty bomb attacks on the ports of Los Angeles and Long Beach. Risk Anal. 2007 Jun;27(3):533-46.
- ↑ Chin FK. Scenario of a dirty bomb in an urban environment and acute management of radiation poisoning and injuries. Singapore Med J. 2007 Oct;48(10):950-7.