FM 4-02.283 TREATMENT OF NUCLEAR AND RADIOLOGICAL CASUALTIES (December 2001) - page 5

 

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FM 4-02.283 TREATMENT OF NUCLEAR AND RADIOLOGICAL CASUALTIES (December 2001) - page 5

 

 

FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
LEVEL 2
Assumptions: Critical to lethal radiation exposure, but 100 percent mortality when combined with
this severity of burn injury; litter patient; central neurological deficits will be indicative of extreme radiation
doses. Additional radiation effects include: apprehension and agitation; n/v 100 percent; fatigue and
weakness 100 percent; mortality 50 percent within 24 hours.
Treatment: Comfort measures only; 100 percent morphine IV/IM as needed for pain, 100 percent
injectable antiemetic medication; reassurance; 100 percent routine ground/air transport.
LEVEL 3
Assumptions: Critical to lethal radiation exposure, but 100 percent mortality when combined with
this severity of burn injury; litter patient; central neurological deficits will be indicative of extreme radiation
doses. Additional radiation effects include: apprehension and agitation; n/v 100 percent; fatigue and
weakness 100 percent.
Treatment: EMT: Patients are all expectant. LAB: Draw one blood specimen per patient for
biodosimetry (red top [clot] [keep refrigerated]), CBC with differential for radiation exposure.
OR: None.
WARDS: ICU: None.
ICW: None.
MCW: 100 percent of patients arriving at Level 3; expectant patients only;
IM pain medications (morphine) as needed. Patients admitted to MCW: Mortality 100 percent by five days.
C-41
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
GLOSSARY
Section I. ABBREVIATIONS AND ACRONYMS
ABCA American, British, Canadian and Australian
ACD acid-citrate dextrose
ADM atomic demolition munition
AFMAN United States Air Force Manual
ALARA as low as reasonably achievable
ALCM air launched cruise missile
AMEDDC&S Army Medical Department Center and School
ANC absolute neutrophil count
ARS acute radiation syndrome
ATC air transportable clinic
ATH air transportable hospital
atm atmospheres (of pressure)
BAS battalion aid station
BDO battle dress overgarment
BEIR V Biological Effects of Ionizing Radiations, 5th Consensus Summary
BID bis in die (twice a day)
BP blood pressure
Bq Becquerel
BSA body surface area
BUN blood urea nitrogen
BW biological warfare
Glossary-1
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
C Celsius/carbon
C/kg-air coulombs per kilogram in air
CaDTPA calcium diethylenetriaminepentaacetic
acid
CaEDTA calcium ethylenediaminetetraacetate
cal calorie
CAM chemical agent monitor
CBC complete blood count
CBF cerebral blood flow
cc cubic centimeter(s)
CD-ROM compact disk–read-only memory
CFU colony-forming units
cGy centiGray
cGy/hr centiGray per hour (0.01 Gy = 1 rad)
ChRS chronic radiation syndrome
Ci curie
cm centimeter(s)
CMV cytomegalovirus
CNS central nervous system (syndrome)
Co cobalt
CONUS continental United States
CRS Cutaneous Radiation Syndrome
CRTS casualty receiving and treatment ship
CSCU Combat Stress Control Unit
CSF colony stimulating factor(s)
Glossary-2
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
CSH combat support hospital
cSv centiSievert (0.01 Sv = 1 rem)
CT computed tomography
CV cardiovascular
CV/CVN aircraft carrier designation
CW chemical warfare
DA Department of the Army
DECON decontamination
DIA Defense Intelligence Agency
DMPS
2,3-dimercapto-1-propanesulfonic acid
DMSA meso-2,3-dimercaptosuccinic acid
DNA deoxyribonucleic acid
DNBI disease and nonbattle injury
DOD Department of Defense
DODI Department of Defense Instruction
DOE Department of Energy
DTPA diethylenetriaminepentaacetic acid (pentetic acid)
DU depleted uranium
D/W dextrose in water
E energy
Ebq exabecquerel (1018Bq)
EDTA ethylenediaminetetraacetic acid (edetic acid)
Glossary-3
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
EMG electromyography
EMP electromagnetic pulse
EMT emergency medical treatment
ER enhanced radiation
erg electroretinogram
ETI early transient incapacitation
ETI-PD early transient incapacitation and performance decrement
Ev electron volt
F Fahrenheit
FAST forward area surgical team
FDA Food and Drug Administration
FFP fresh frozen plasma
FM field manual
FSMC forward support medical company
FST forward surgical team
FSU former Soviet Union
GBq Giga Bequerel
G-CSF granulocyte-colony stimulating factor(s)
GI gastrointestinal
GLCM ground-launched cruise missile
gm gram(s)
GM-CSF granulocyte macrophage-colony stimulating factor
Glossary-4
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
gm/dl gram/deciliter
GTX granulocyte transfusions
GU genitourinary
GVHD graft-versus-host disease
Gy gray (1 Gy = 100 rads)
H hydrogen
HA heavy armor
HCT hematocrit
He helium
HE high explosive
HEPA high efficiency particulate air
HEU highly enriched uranium
HLA human leukocyte antigen
HOB height of burst
HQDA Headquarters, Department of the Army
HREC health record
hrs hours
HSS health service support
I iodine/Interservice
IAEA International Atomic Energy Agency
ICBM intercontinental ballistic missile
ICRP International Council on Radiation Protection
Glossary-5
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
ICU intensive care unit
ICW intermediate care ward
IFN interferon
Ig immunoglobulin
IL Interleukin
IM intramuscular
IND improvised nuclear devices
IU international unit
IV intravenous(ly)
JRCAB Joint Readiness Clinical Advisory Board
K potassium
K103
potassium iodate
kBq thousand becquerels
KE kinetic energy
kg kilogram(s)
km kilometer(s)
kPa kilopascals
KT kiloton(s)
l
liter
LAB laboratory diagnostic tests
LBRM long range ballistic missile (intercontinental ballistic missile [ICBM])
LD lethal dose
Glossary-6
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
LET linear energy transfer
LIHOPO a hydroxypridizone ligand
LLR low-level radiation
LR laboratory report
m mass
MASCAL mass casualty
MASF mobile aeromedical staging facility
MBq Mega Becquerel
mCi millicurie
mcg microgram
MCRP Marine Corps Reference Publication
MCW minimal care ward
MD doctor of medicine
MES medical equipment sets
mg milligram(s)
MGDF/Tpo megakaryocyte growth and development factor/thrombopoietin
mGy milligray (0.001 Gy; 10 mGy = 1 rad)
ml milliliter(s)
mm millimeter(s)
mm3
cubic millimeter
mo month
MOLLE modular lightweight load-carrying equipment
MOPP mission-oriented protective posture
Glossary-7
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
MOX mixed oxide
mph miles per hour
mrad millirad
MRBM medium range ballistic missile
mrem millirem
MRI magnetic resonance imaging
mSv milliSievert (0.001 Sv; 10 mSv = 1 rem)
MT megaton
MTF medical treatment facility
MUPS medically unexplained physical symptoms
MW megawatt
Na sodium
NATO North Atlantic Treaty Organization
NAVMED P US Navy Medical Publication
NBC nuclear, biological, and chemical
NCRP National Council on Radiation Protection
NDI nondestructive inspection
NIGA neutron-induced ground activity
nm nanometer
NPO nil per os (nothing by mouth)
NRC Nuclear Regulatory Commission
NTRP Navy Tactical Reference Publication
n/v nausea/vomiting
Glossary-8
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
n/v/d nausea/vomiting/diarrhea
NVD night vision device
NW nuclear warfare
O2 oxygen
ODS Operation Desert Storm
OEG operational exposure guidance
OR operating room
OSHA Occupational Safety and Health Act
PAF platelet activating factor
PBq pico Becquerel
PBSC peripheral blood stem cell
PBSCT peripheral blood stem cell transplantation
PCC prematurely condensed chromosome
PCR polymerase chain reaction
PD performance decrement
pg picograms
PHS Public Health Service
PIES proximity, immediacy, expectancy, simplicity (mnemonic for treatment of psychiatric casualties)
PMN polymorphonuclear neutrophil
PO per os (by mouth)
PO2
plutonium oxide
ppm parts per million
Glossary-9
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
PPW patient protective wrap
PR per rectum
PRBC peripheral red blood cell
prn pro re nata (for the emergency, as needed)
psi pounds per square inch
PTSD post-traumatic stress disorder
PTX pentoxifylline
Pu plutonium
PVNTMED preventive medicine
PWR pressurized water reactor
q quaque (every)
QD quaque die (every day)
QF quality factor
QID quater in die (four times a day)
QSTAG Quadripartite Standardization Agreement
R roentgen
Ra radium
rad radiation absorbed dose
RADIAC radiation detection, identification, and computation
RBC red blood cell
RBE relative biological effectiveness
R&D research and development
Glossary-10
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
RDD radiological dispersal device
REAC/TS Radiation Emergency Assistance Center/Training Site
rem roentgen equivalent in man/mammal
RES radiation exposure status
Rn radon
RNA ribonucleic acid
RPL radiophotoluminescent
RTD return to duty
Rx a medical prescription
SAT serum-agglutinating titers
SD skin dose
sec second(s)
SI systems international
SLBM submarine launched ballistic missile
SNM special nuclear material
SOP standard operating procedure(s)
SQ subcutaneous
SRBM short range ballistic missile
SSB single-strand break(s)
STANAG Standardization Agreement
Sv Sievert (SI unit of roentgen dose equivalent)
TB Treatment Brief(s)
Glossary-11
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
TBq Tera Bequerel
TCDO tetrachlorodekaoxide
TDM trehalose dimycolate
TID ter in die (three times a day)
TG Technical Guide
TGF-beta transforming growth factor beta
ThO thorium oxide
TLAM/N Tomahawk land attack missile/nuclear
TLD thermo-luminescent dosimeter
TMP trimethoprim
TNF tumor necrosis factor
TNT trinitrotoluene
TO theater of operations
TPN total parenteral nutrition
TSH thyroid-stimulating hormone
TSST-1
toxic shock syndrome toxin-1
µ microns
µCi microcurie
µg microgram
µl
microliter
U uranium
UO2
uranium oxide
US United States
Glossary-12
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
USACHPPM US Army Center for Health Promotion and Preventative Medicine
USAF United States Air Force
USAMRIID United States Army Medical Research Institute for Infectious Diseases
USTRANSCOM United States Transportation Command
UTC unit type code (United States Air Force)
VA Department of Veterans Affairs
VS vital signs
vWf von Willenbrand factor, clotting factor 8
WHO World Health Organizations
WMD weapons of mass destruction
WMDT wartime medical decontamination team
WR radiation weighting factor
yr year
ZnDTPA zinc diethylenetriaminepentaacetic acid
Section II. DEFINITIONS
acute radiation syndrome a combination of clinical syndromes occurring in stages, during a period of
hours to weeks after exposure, as radiation injury to various tissues and organs is expressed.
agranulocytosis a complex of symptoms characterized by marked decrease in the number of granulocytes
and by lesions of the throat and other mucous membranes, of the gastrointestinal tract, and of the skin.
airburst an explosion of a bomb or projectile above the surface as distinguished from an explosion on
contact with the surface or after penetration.
Glossary-13
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
alpha particle a positively charged particle ejected from the nucleus of a radioactive atom, being a high-
speed ionized atom of helium. A stream of these particles constitutes alpha rays.
aplasia lack of development of an organ or tissue, or of the cellular products from an organ or tissue.
atomic number the number of protons in an atomic nucleus.
beta particle an electron emitted from an atomic nucleus during beta decay.
bioassay sampling indirect means of measuring contamination in body tissue or fluids from which body
burden is extrapolated.
blast wave a pulse of air in which the pressure increases sharply at the front propagated by the explosion.
bremsstrahlung the process by which a beta particle emits an x-ray photon during its interaction with an
atomic nucleus.
carcinogenesis the development of cancer; various malignant growths that manifest invasiveness and a
tendency to metastasize to another location.
cataractogenesis the development of cataracts; opacity of the lens causing blindness.
cerebral anoxia absence of an oxygen supply to the brain despite adequate perfusion of the tissue by blood.
congestion excessive or abnormal accumulation of blood in a tissue or organ.
critical mass the minimum amount of fissile material capable of supporting a chain reaction under
precisely specified conditions.
critical organ body organ with an affinity for a particular substance and in which that substance
concentrates.
cytokine a nonantibody protein released by one cell population that acts as an intercellular mediator on
another cell population(s). Synthetic cytokines are metabolically active in pico-molar concentrations.
decontamination the process of making any person, object, or area safe by absorbing, destroying,
neutralizing, making harmless, or removing chemical or biological agents, or by removing radioactive
material clinging to or around it.
delayed fallout radioactive fallout that returns to earth later than 24 hours after a nuclear detonation;
usually ascends into the stratosphere and is distributed worldwide.
desquamation the shedding of epithelial elements, chiefly of the skin, in scales or small sheets; exfoliation.
Glossary-14
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
deterministic effect one that occurs after a certain dose threshold, with the severity of the effect
determined by the dose; example: cataractogenesis.
dose rate a measure of the amount of ionizing radiation an individual is exposed to, per unit of time;
commonly expressed in units of gray (or rads) per hour.
dynamic pressure pressure resulting from some medium in motion, such as the air following the shock
front of a bast wave.
early fallout radioactive fallout that returns to earth within 24 hours after a nuclear detonation; also
referred to as local fallout.
edema the presence of abnormally large amounts of fluid in the intercellular tissue.
exposure a measure of the number of ionizations produced by gamma or x-rays in a volume of air;
expressed in units of roentgen.
fallout the precipitation to Earth of radioactive particulate matter from a nuclear cloud; also applied to the
particulate matter itself.
fireball the luminous sphere of hot gases which forms a few millionths of a second after detonation of a
nuclear weapon and immediately starts expanding and cooling.
fission the process whereby the nucleus of a heavy element splits into (generally) two nuclei of lighter
elements, with the release of substantial amounts of energy.
fission products a general term for the complex mixture of substances produced as a result of nuclear
fission.
flash burn a burn caused by excessive exposure of the skin to thermal radiation.
free-in-air-dose radiation that would be measured in air at a certain point. Military tactical dosimeters
measure free-in-air-doses.
gamma rays high energy electromagnetic radiation emitted from atomic nuclei during a nuclear reaction.
Gamma rays and very high energy X-rays differ only in origin. X-rays do not originate from atomic nuclei
but are produced in other ways.
granulocyte any cell containing granules in its cytoplasm, especially a leukocyte (neutrophil, basophil, or
eosinophil).
granulocytopenia agranulocytosis; a symptom complex consisting of a marked decrease in the number of
circulating white blood cells, with lesions of the throat and mucous membranes.
Glossary-15
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
hematopoietic pertaining to, or effecting, the formation of blood cells.
hemorrhage the escape of blood from the vessels; hemorrhages, classified according to size: petechiae
(pinpoint) or ecchymoses (larger than 1 centimeter in diameter).
hyperpyrexia a highly elevated body temperature.
hypotension abnormally low blood pressure.
induced radiation radiation produced as a result of exposure to radioactive materials, particularly the
capture of neutrons.
ingestion pathway route for internalization of radioactive contaminants; the pathway most accessible for
decontamination.
inhalation pathway primary pathway for internalization of radioactive contaminants.
ionization the process of stripping electrons from their atomic orbits by radiation.
isotope one of two or more atoms whose nuclei have equal numbers of protons but different numbers of
neutrons.
late effect a biological effect that occurs long after radiation exposure ends; example: cancer.
lymphocyte a mononuclear leukocyte; chiefly a product of lymphoid tissue and participates in humoral and
cell-mediated immunity.
malformation a birth defect; an abnormal structure or form; example: small head.
morbidity the ratio of sick to well individuals in a community; the sick rate.
mortality the ratio of people who die to those who survive irradiation; the death rate.
nadir the point at which a blood count drops to, or closest to zero, before beginning to increase.
neutron an electrically neutral or uncharged particle of matter existing along with protons in the atoms of
all elements except the isotope of hydrogen with the mass of 1.
neutropenia a decrease in the number of neutrophilic leukocytes in the blood.
nosocomial pertaining to or originating in a hospital.
Glossary-16
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
nuclear material traditionally, uranium or plutonium used to produce a nuclear detonation via the fission
or fusion process. The fuel is compressed into a given volume to cause supercriticality. The major products
include blast effects, heat, nuclear radiation, and fallout.
nucleated blood cell a blood cell that contains a nucleus, to include white cells and reticulocytes.
nucleon a proton or neutron as part of an atomic nucleus.
nuclide all nuclear species, both stable (about 270) and unstable (about 500), of the chemical elements, as
distinguished from the two or more nuclear species of a single chemical element which are called “isotopes.”
orbital excitation change in energy level of an orbital electron that occurs when the energy lost by the
incident radiation is insufficient to cause ionization.
overpressure the pressure resulting from the blast wave of an explosion. It is referred to as “positive”
when it exceeds atmospheric pressure and “negative” during the passage of the wave when resulting
pressures are less than atmospheric pressure.
pathognomonic specifically distinctive or characteristic of a disease or pathologic condition; a sign or
symptom on which a diagnosis can be based.
perceived threat a threat that is experienced by a person subjectively and out of proportion to the real
threat or physical danger.
phagocytosis the engulfing of microorganisms, other cells, and foreign particles by phagocytes.
pressor tending to increase blood pressure.
prodrome a premonitory symptom or precursor; a symptom indicating the onset of a disease.
Prussian blue ferric ferrocyanide; a chemical that is not absorbed by the gastrointestinal system and is an
effective means to reduce the body’s uptake of cesium, thallium, and rubidium; approved as an
investigational new drug by the United States Food and Drug Administration with the license held by
Radiation Emergency Assistance Center/Training Site.
radioactive cloud an all-inclusive term for the cloud of hot gases, smoke, dust, dirt, and debris from a
weapon and the environment. The cloud is carried aloft in conjunction with the rising fireball produced by
the detonation of a nuclear weapon.
radioactive contamination radioactive material in an undesirable location such as on structures, areas,
objects, or personnel.
Glossary-17
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
radionuclide a radioactive nuclide; one that disintegrates with the emission of particulate or
electromagnetic radiations.
rainout radioactive material in the atmosphere brought down by precipitation.
relative biological effectiveness the ratio of the number of rads of gamma (or X) radiation of a certain
energy which will produce a specified biological effect to the number of rads of another radiation required to
produce the same effect is the relative biological effectiveness of the latter radiation.
reproductive death the loss of the ability to reproduce. Many organs must have cells that can reproduce
to function. Thus, even though injured cells may remain biologically viable, reproductive death may cause
irreversible organ damage.
scavenging the selective removal of material from the radioactive cloud by inert substances, such as
precipitation, introduced into the fireball.
sepsis the presence of pathogenic microorganisms (bacteria) or their toxins in the blood or other tissues.
septicemia systemic disease associated with the presence and persistence of pathogenic microorganisms
or their toxins in the blood.
skin permeability the rate at which the skin absorbs a liquid; expressed as a coefficient. The lower a
substance’s coefficient, the greater the rate of absorption.
Specific ionization number of ion pairs per unit distance formed along the path of a particle, often
expressed as ion pairs per centimeter.
stochastic effect an effect that has no-dose threshold and for which the severity of the effect is not dose-
related, although its probability is; example: carcinogenesis
stratosphere the layer of the atmosphere above the troposphere in which the change of temperature with
height is relatively small.
subsurface burst the explosion of a nuclear weapon beneath the surface of the earth.
syndrome a set of symptoms that occur together.
synergistic acting together to enhance the effect of another force or agent.
thermal radiation the heat and light produced by a nuclear explosion. Electromagnetic radiations emitted
from a heat or light source as a consequence of its temperature; it consists essentially of ultraviolet, visible,
and infrared radiations.
Glossary-18
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
total parenteral nutrition by injection through some route other than the alimentary canal.
washout the removal of radioactive particles from a nuclear cloud by precipitation when the nuclear cloud
is below a rain or snow cloud.
weapon debris (nuclear) the residue of a nuclear weapon after it has exploded; that is, materials used for
the casing and other components of the weapon, plus unexpended plutonium or uranium, together with fission
products.
wound contamination the presence of a radioactive substance in a wound, whether an abrasion, puncture,
or laceration; condition in which the loss of intact skin increases the risk that the contaminant will be
absorbed.
Glossary-19
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
REFERENCES
Joint Publications
Joint Pub 3-11. Joint Doctrine for Operations in Nuclear, Biological, and Chemical (NBC) Environments.
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Joint Pub 3-12. Doctrine for Joint Nuclear Operations.
15 December 1995.
Joint Pub 3-12.1. Doctrine for Joint Theater Nuclear Operations.
9 February 1996.
NATO STANAGs
These agreements are available on request using DD Form 1425 from Standardization Document Order
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ABCA QSTAG
This agreement is available on request using DD Form 1425 from Standardization Document Order Desk,
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1263. Common Principles and Procedures for Critical Aspects of the Medical and Dental Treatment of
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29 May 1992.
(Reprinted with basic including Change 1,
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44-151V1V2V3. 1 February 1996.
FM 8-285. Treatment of Chemical Agent Casualties and Conventional Military Chemical Injuries.
NAVMED P-5041; AFJMAN 44-149; FMFM 11-11. 22 December 1995.
References-1
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
Department of Defense Publications
The Militarily Critical Technologies List, Part II: Weapons of Mass Destruction Technologies, Office of
the Under Secretary of Defense for Acquisition and Technology, Washington, D.C., February 1998.
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FM 8-10-1. The Medical Company—Tactics, Techniques, and Procedures. 29 September 1994.
FM 8-10-6. Medical Evacuation in a Theater of Operations—Tactics, Techniques, and Procedures.
14 April 2000.
FM 8-10-7. Health Service Support in a Nuclear, Biological, and Chemical Environment. 22 April 1993.
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FM 21-11. First Aid For Soldiers.
27 October 1988.
(Reprinted with basic including Change 1—2,
4 December 1991.)
US Army Center for Health Promotion and Preventive Medicine Publication
Technical Guide 238. Radiological Sources of Potential Exposure and/or Contamination. Draft, June 1999.
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Bellamy, Ronald F., and Zajtchuk, Russ. Conventional Warfare: Ballistic, Blast, and Burn Injuries.
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Cerveny, T. Jan, and Walker, Richard I. Medical Consequences of Nuclear Warfare.
(Textbook of
Military Medicine Series, Part I, Warfare, Weaponry, and the Casualty, Volume 2.) Office of The
Surgeon General, Textbook of Military Medicine Publications. Washington, DC: Borden
Institute, 1989.
References-2
FM 4-02.283/NTRP 4-02.21/AFMAN 44-161(I)/MCRP 4-11.1B
Oak Ridge Institute for Science and Education. Reference Manual for Medical Planning and Care in
Radiation Accidents. September 2000.
O’Maonaigh, H., and Thaul, S. Potential Radiation Exposure in Military Operations. Institute of Medi-
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Upton, Arthur C., Chairman. Health Effects of Exposure to Low Levels of Ionizing Radiation: BEIR V,
1990. National Academy Press, 1990.
Voelz, George L., Chairman. Management of Persons Accidentally Contaminated With Radionuclides.
National Council on Radiation Protection (NCRP) and Measurements Report No. 65, 1979.
Wyngaarden, J.B., and Smith, L.H., Editors. Cecil Textbook of Medicine. W.B. Saunders Company,
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Federation of American Scientists. Nuclear Forces Guide (December 2000).
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Sandia Lab News (19 January 1995).
Gilmore, James III, Chairman. First Annual Report to The President and The Congress of the Advisory
Panel to Assess Domestic Response Capabilities for Terrorism Involving Weapons of Mass
Destruction, I. Assessing the Threat. The RAND Corporation (1999).
Gray, Cleve J., and Tiwari, Jaya. US Nuclear Weapons Accidents. Center for Defense Informa-
tion (January 1999).
Harley, Naomi H., Foulkes, Ernest C., Hilborne, Lee H., Hudson, Arlene, and Anthony, C. Ross. A
Review of the Scientific Literature as It Pertains to Gulf War Illnesses, Volume
7, Depleted
Uranium. The RAND Corporation (1999).
International Atomic Energy Agency. Report on the Preliminary Fact Finding Mission Following the
Accident at the Nuclear Fuel Processing Facility in Tokaimura, Japan. Vienna: International
Atomic Energy Agency (November 1999).
Métivier, Dr. Henri (France) (Chair, Editing Committee). Chernobyl—Ten Years On Radiological and
Health Impact. An Assessment by the NEA Committee on Radiation Protection and Public Health,
OECD Nuclear Energy Agency (November 1995).
Non-Proliferation Center, Director of Central Intelligence. Unclassified Report to Congress on the
Acquisition of Technology Relating to Weapons of Mass Destruction and Advanced Conventional
Munitions (February and August 2000).
References-3

 

 

 

 

 

 

 

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