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Radiological Dispersal Devices (RDDs) Radiological Exposure Devices (REDs) Nuclear Explosions: Weapons, Improvised Nuclear Devices A Decision Makers Guide: Medical Planning and Response for a Nuclear Detonation Damage Zones After a Nuclear Detonation & "Zoned Approach" to the Response Radiation Triage, Treat, and Transport System (RTR) after a Nuclear Detonation: Venues for the Medical Response Damage Zones, Radiations Zones and Likely Rescue Activities After a Nuclear Detonation: Table Damage Zones after a Nuclear Detonation: Idealized Map Time Sequenced Size of Dangerous Fallout Zone and 0.01 R/Hour Boundary After a Hypothetical 10kT Nuclear Detonation at Ground Level Electromagnetic Pulse (EMP) Following a Nuclear Detonation Fallout from a Nuclear Detonation: Description and Management Nuclear Power Plant / Nuclear Reactor Incidents Radionuclides Likely to be Found in Nuclear Reactors and Spent Fuel Some Characteristics of Different Nuclear Reactor Designs Monitoring Radionuclides in Drinking Water and Food: Routinely and After a Release Transportation Incidents Involving Radiation Radiological vs. Nuclear Incident Discovering an Incident Identify Types of Radiation Incidents Describing an Incident: Definition, Severity, Phases, Timeline Initial Incident Activities Initial On-site Activities Control Incident Perimeter Identify Radiation Types and Isotopes Measure Levels of Radiation Continuously Protective Action Guides for the Public for RDD and IND Incidents Use Personal Dosimeter Radiation Control Zones and Perimeters Recommended by Various Agencies for Responding to Radiological Emergencies Personal Protective Equipment (PPE) in a Radiation Emergency Personal Protective Equipment (PPE) Classification Systems PPE Classification System from OSHA and EPA National Fire Protection Association (NFPA) Protective Ensemble Classes PPE Image Gallery: Dermal Protective Equipment - Civilian PPE Image Gallery: Respiratory Protective Equipment - Civilian PPE Image Gallery: Dermal Protective Equipment - Military PPE Image Gallery: Respiratory Protective Equipment - Military Mission Oriented Protective Posture (MOPP) Gear: Military PPE PPE: Operational Impact, Requirements, and Administrative Costs Level of Risk to First Responders in a Radiation Emergency NCRP Commentary No. 19: Key Elements of Preparing Emergency Responders for Nuclear and Radiological Terrorism - Notes on Recommended PPE Guidance OSHA/NIOSH Interim Guidance - April 2005 - Notes on PPE Selection Matrix for Emergency Responders OSHA/NIOSH Interim Guidance - August 30, 2004 - Notes on PPE Selection Matrix for Emergency Responders: Radiological Dispersal Device (RDD) Emergency Worker Exposure Guidelines in the Early Phase National Council on Radiation Protection and Measurements (NCRP) Radiation Protection Guidelines: Control of Radiation Dose in the Control Zones International Atomic Energy Agency (IAEA) Emergency Worker Turn-back Dose Guidance Conference of Radiation Control Program Directors, Inc. (CRCPD) Turn-back Exposure Rates and Dose Guidelines International Commission on Radiological Protection (ICRP) Guidance for Occupational Exposure Explaining Protective Actions and Protective Action Guides (PAGs) Exposure Pathways and Protective Actions Three Phases of the Response to an RDD or IND Triage Guidelines Triage Category and Cytokine Use after a Nuclear Detonation Nuclear Detonation Scarce Resources Project Working Group Publications 4 New Videos Explaining the Scarce Resources Project Triage and Medical Guidance Triage Category and Cytokine Use after a Nuclear Detonation (Interactive tool) Triage Category and Cytokine Use after a Nuclear Detonation (Printable cards) (PDF -664 KB) Triage Category and Cytokine Use after a Nuclear Detonation Help Definitions of Trauma Categories Descriptions of Myeloid Cytokine Categories Definitions of Medical Resource Availability Response Resource Availability and Crisis Standards of Care START Adult Triage Algorithm JumpSTART Pediatric Triage Algorithm SALT Mass Casualty Triage Algorithm, Adapted for a Very Large Radiation Emergency Establishing Patient Handling Flow Transport Victims of Radiation Emergencies Hospital Activities Other Audiences First Responders in the Field Mental Health Professionals Hospital Staff Nurses Public Information Officers Radiation Safety Officers Planners: Preparedness and Response Incident Command System and Hospital (Emergency) Incident Command System Trainers: Practices and Drills Public Health Officers Legal Advisors Senior Leaders Veterinarians Medical Examiners / Coroners Public Health Emergency Researchers Volunteers About This Site What Are the Goals of This Site? Who Produced This Site? Disclaimers List of Consultants Sign Up for REMM Email Updates Contact Us: Provide Site Feedback Download REMM to Your Computer Installing REMM on Mac System Requirements (e.g., Allow Pop-ups) Multimedia Library: Animations, Illustrations, Photos Radiation Incidents: Multimedia Library How Radiation Emergencies are Discovered Identify Types of Radiation Incident Terminology to Describe Radiation Incidents Recovery Continuum Timelines and Tasks - Illustration Three Phases of the Response to an RDD or IND Expected Timeline of IND Detonation - Illustration Dirty Bomb: Radiological Dispersal Device Using Explosive - Illustration Dispersal of Radioactive Material by Aircraft - Illustration Radiological Dispersal Device (RDD) Response Guidance Planning for the First 100 Minutes: Document and Videos Video: Meeting the Needs of First Responders Hidden Sealed Radioactive Source (Radiological Exposure Device) in Train Car - Illustration Difference between Dirty Bomb and Fission Bomb - Illustration RDD: Diagram of Recommended Protective Action Zones after a Hypothetical RDD Explosion Nuclear Explosion: Mushroom Cloud Nuclear Power Plant / Nuclear Reactor Emergencies Nuclear Power Plant Emergency Planning Zones RDD: Radioactive Dispersal from an Experimental RDD Explosion RDD: Diagram of Hypothetical Dispersal Possibilities Video: Emergency Response to Transportation Accident Involving Radioactive Material Nuclear Explosion: Mushroom Cloud Approximate Prompt and Delayed Fallout Effects from a 10 kT Detonation - Illustration Time Sequenced Size of Dangerous Fallout Zone and 0.01 R/Hour Boundary After a Hypothetical 10kT Nuclear Detonation at Ground Level Video: Demonstration of the Rapidly Shrinking Dangerous Fallout Zone after an IND Detonation Radiation Triage, Treat, and Transport System (RTR) after a Nuclear Detonation: Venues for the Medical Response Estimated fallout pattern from nuclear air burst Factors That Affect Fallout How blast injuries cause trauma Flash Blindness Retinal Burn Video: Nuclear Detonation Effects Video: Nuclear Detonation Fallout Fallout from a Nuclear Detonation: Description and Management Fallout: Relative Rate Decline of Radioactivity after Nuclear Explosion Fallout Shrinks Over Time Due to Radioactive Decay - Illustration Computer Model Example of Fallout/Goundshine at 2 hours after Detonation of Nuclear Device - Illustration Computer Model of Effects of a 10kT Ground Nuclear Detonation: 2 Hours Post Detonation - Illustration Zones of Damage after Nuclear Explosion: Generalized Damage Zones after a Nuclear Detonation: Idealized Map Thermal skin burns: Example after nuclear blast How Buildings Provide Shielding from a Nuclear Explosion How Nuclear Explosions Affect Dwellings: Examples Selecting a safe room after an IND detonation Size of the Incident and Potential Affected Areas How Energy Is Dispersed after Nuclear Explosion: Approximate Video: Saving Lives After a Nuclear Detonation Fallout from a Nuclear Detonation: Description and Management Key Public Messages after an Improvised Nuclear Device Detonation - Illustration Video: Saving Lives After a Nuclear Detonation Radiation Basics: Multimedia Library Video: Biological Effects of Radiation Electromagnetic Radiation: Ionizing and Non-ionizing Ionization - Animations Video: Four types of ionizing radiation Video: Illustration of Fission Atomic Number and Atomic Mass Decay Rate/Half-Life of Radioisotopes - Illustrations Video: Radiological Basics Alpha Radiation - Animation Beta and Gamma Radiation - Animation Neutron - Illustration Dose Rate Effect of Radiation Exposure - Illustration Differences between Contamination and/or Exposure Types of Ionizing Radiation and Shielding Required - Illustration Factors that Decrease Radiation from Exposure - Illustration Radiation Shielding - Illustration Radiation Shielding - Animation Video: Time, Distance, Shielding Becquerel - Animation Various Units of Dose - Animations Understanding the Basics About Radiation Radiation Detection and Survey Devices 8 Categories of Radiation Dosimeters for Dose and Exposure Monitoring and Worker Safety Video: Radiation Survey Instruments Video: Radiological Dosimetry PPE Image Gallery: Respiratory Protective Equipment - Civilian PPE Image Gallery: Respiratory Protective Equipment - Military PPE Image Gallery: Dermal Protective Equipment - Civilian PPE Image Gallery: Dermal Protective Equipment - Military Exposure (ARS): Multimedia Library Radiation Exposure - Whole Body - Animation Radiation Exposure - Partial Body - Animation Differences between Contamination and/or Exposure Time/Dose Effects in Acute Radiation Syndrome (ARS) Time Phases of Acute Radiation Syndrome (ARS) Lethality as a Function of Dose and LD50/60 - Illustration Time to Onset of Vomiting and Dose - Illustration Dose Estimator for Exposure: 3 Biodosimetry Tools Managing Acute Radiation Syndrome (ARS) Radiation Exposure: Diagnose and Manage Acute Radiation Syndrome (ARS) Video Tutorial: Exposure - Diagnose/Manage Acute Radiation Syndrome Dose Estimator for Exposure: 3 Biodosimetry Tools Triage Category and Myeloid Cytokine Use after a Nuclear Detonation Managing Acute Radiation Syndrome (ARS) Radiation Exposure + Contamination: Diagnose and Manage Cytokines for Treatment of Acute Exposure to Myelosuppressive Doses of Radiation: Hematopoietic Subsyndrome of Acute Radiation Syndrome (H-ARS) Use of Blood Products in a Radiation Emergency Targeted Physical Examination Following a Nuclear Detonation Hospital Approach to Patients Presenting after a Nuclear Detonation Types of Ionizing Radiation and Shielding Required - Illustration Factors that Decrease Radiation from Exposure - Illustration Radiation Shielding - Illustration Radiation Shielding - Animation Lymphocyte Depletion Kinetics Graph - Illustration Radiation Effects on Blood Counts (1) - Illustration Radiation Effects on Blood Counts (2) - Illustration Radiation Effects on Blood Counts (3) - Illustration Chromosome Aberrations: Dicentric Chromosomes - Illustration Chromosome Aberrations: Dicentric Chromosomes - Illustration Conventional Lymphocyte Metaphase-Dicentric Assay - Illustration Scoring of Dicentrics Thermal skin burns: Example after nuclear blast Cutaneous Radiation Syndrome Simulated RED on Skin Illustrating Dose Attenuation Video Tutorial: Exposure - Diagnose/Manage Acute Radiation Syndrome Video Tutorial: Nuclear Detonation Scarce Resources Triage Tool Implementing the Scarce Resources Project Guidance: Video Teaching Tools Video Tutorial: Manage 4 Subsyndromes of Acute Radiation Syndrome Video Tutorial: Dose Estimator for Exposure Video Tutorial: Time/Dose Effects in ARS Video Tutorial: Time Phases of Acute Radiation Syndrome Exposure and Symptom Triage (EAST) Tool Contamination/Decontamination: Multimedia Library External Radiation Contamination - Full Body - Animation External Radiation Contamination: Partial Body - Animation Wound Contamination with Radioactive Shrapnel - Animation Internal Radiation Contamination via Respiratory Tract Internal Radiation Contamination via Digestive Tract Wound Contamination with Radioactive Dust - Animation Internal Exposure to Iodine-131 Through Ingestion - Illustration Incorporation of Radioisotopes into Cells and Organs - Illustration Differences between Contamination and/or Exposure Radiation Contamination: Diagnose and Manage Video Tutorial: Contamination - Diagnose/Manage Managing Internal Radiation Contamination Radiation Exposure + Contamination: Diagnose and Manage Prussian Blue Hospital Approach to Patients Presenting after a Nuclear Detonation Video: Decontamination of Children Video: Emergency Response to Transportation Accident Involving Radioactive Material Use of Shower for External Decontamination - Illustration Decontamination Using Water from Fire Trucks Photos of Decontamination Facilities and Procedures Video: Decontamination & Dressdown at a Transportation Accident involving Radioactive Material Video: Pre-hospital Practices for Handling a Radiologically Contaminated Patient Radiation Detection and Survey Devices 8 Categories of Radiation Dosimeters for Dose and Exposure Monitoring and Worker Safety Video: Radiation Survey Instruments Video: Radiological Dosimetry How to Perform a Survey for Radiation Contamination PPE Image Gallery: Respiratory Protective Equipment - Civilian PPE Image Gallery: Respiratory Protective Equipment - Military PPE Image Gallery: Dermal Protective Equipment - Civilian PPE Image Gallery: Dermal Protective Equipment - Military Video: Decontamination & Dressdown at a Transportation Accident involving Radioactive Material Radiation Safety: Multimedia Library Types of Ionizing Radiation and Shielding Required - Illustration Factors that Decrease Radiation from Exposure - Illustration Radiation Shielding - Illustration Radiation Shielding - Animation Radiation Detection and Survey Devices 8 Categories of Radiation Dosimeters for Dose and Exposure Monitoring and Worker Safety Video: Radiation Survey Instruments Video: Radiological Dosimetry How to Perform a Survey for Radiation Contamination Becquerel - Animation Various Units of Dose - Animations Understanding the Basics About Radiation Video: Radiological Dosimetry Protective Actions and Protective Action Guides Key Public Messages after an Improvised Nuclear Device Detonation - Illustration Video: Saving Lives After a Nuclear Detonation Protective Actions and Protective Action Guides Radiation Control Zones and Perimeters Recommended by Various Agencies for Responding to Radiological Emergencies RDD: Diagram of Recommended Protective Action Zones after a Hypothetical RDD Explosion Definition of Radiation Area Boundaries for Responding to a Radiological Dispersal Device (RDD) Zones of Damage after Nuclear Explosion: Generalized Approximate Prompt and Delayed Fallout Effects from a 10 kT Detonation - Illustration Nuclear Power Plant Emergency Planning Zones Video: Meeting the Needs of First Responders Damage Zones after a Nuclear Detonation: Idealized Map Time Sequenced Size of Dangerous Fallout Zone and 0.01 R/Hour Boundary After a Hypothetical 10kT Nuclear Detonation at Ground Level Video: Demonstration of the Rapidly Shrinking Dangerous Fallout Zone after an IND Detonation IAEA Recommendation for Generic Areas to be Established by First Responders National Council on Radiation Protection and Measurements (NCRP) Radiation Protection Perimeter Guidelines How Buildings Provide Shielding from a Nuclear Explosion Selecting a safe room after an IND detonation Key Public Messages after an Improvised Nuclear Device Detonation - Illustration Radiation Dose Comparisons - Illustration Video: Saving Lives After a Nuclear Detonation Understanding Shipping Labels and Placards for Radioactive Materials Video: Radioactive Material Shipping Packages Video: Emergency Response to Transportation Accident Involving Radioactive Material Video: Decontamination & Dressdown at a Transportation Accident involving Radioactive Material Video: Pre-hospital Practices for Handling a Radiologically Contaminated Patient Triage and Transport: Multimedia Library START Adult Triage Algorithm JumpSTART Pediatric Triage Algorithm SALT Mass Casualty Triage Algorithm, Adapted for a Very Large Radiation Emergency Hospital Approach to Patients Presenting after a Nuclear Detonation Triage Category and Myeloid Cytokine Use after a Nuclear Detonation Video Tutorial: Nuclear Detonation Scarce Resources Triage Tool Radiation Triage, Treat, and Transport System (RTR) after a Nuclear Detonation: Venues for the Medical Response Radiation Triage, Treat, and Transport System (RTR) after a Nuclear Detonation: Venues for the Medical Response Radiation Triage, Treat, and Transport System (RTR) after a Nuclear Detonation: Venues for the Medical Response Implementing the Scarce Resources Project Guidance: Video Teaching Tools Exposure and Symptom Triage (EAST) Tool Differences between Contamination and/or Exposure Radiation Exposure: Diagnose and Manage Acute Radiation Syndrome (ARS) Radiation Contamination: Diagnose and Manage Radiation Exposure + Contamination: Diagnose and Manage Video: Emergency Response to Transportation Accident Involving Radioactive Material Video: Decontamination & Dressdown at a Transportation Accident involving Radioactive Material Video: Pre-hospital Practices for Handling a Radiologically Contaminated Patient Video Library Video Tutorial: Exposure - Diagnose/Manage Acute Radiation Syndrome Video Tutorial: Dose Estimator for Exposure Video Tutorial: Manage 4 Subsyndromes of Acute Radiation Syndrome Video: Illustration of Fission Video: Biological Effects of Radiation Video: Four types of ionizing radiation Video Tutorial: Contamination - Diagnose/Manage Video Tutorial: Time/Dose Effects in ARS Video Tutorial: Time Phases of Acute Radiation Syndrome Video: Radiological Basics Video: Time, Distance, Shielding Video Tutorial: Mobile REMM App Video Tutorial: Contamination - Diagnose/Manage Video: Emergency Response to Transportation Accident Involving Radioactive Material Video: Pre-hospital Practices for Handling a Radiologically Contaminated Patient Video: Decontamination & Dressdown at a Transportation Accident involving Radioactive Material Video: Decontamination of Children Video: Radioactive Material Shipping Packages Video: Radiation Survey Instruments Video: Radiological Dosimetry Video: Nuclear Detonation Effects Video: Nuclear Detonation Fallout Video: Demonstration of the Rapidly Shrinking Dangerous Fallout Zone after an IND Detonation Video: Saving Lives After a Nuclear Detonation Video Tutorial: Nuclear Detonation Scarce Resources Triage Tool Implementing the Scarce Resources Project Guidance: Video Teaching Tools Exposure and Symptom Triage (EAST) Tool Patient Management Choose Appropriate Algorithm: Evaluate for Contamination and/or Exposure Differences between Contamination and/or Exposure Medical Countermeasures Countermeasures: Exposure Countermeasures: Internal Contamination Contamination: Diagnose/Manage Management Modifiers for Contamination Algorithm Decontamination Procedures Standard Precautions Managing Internal Contamination Isotopes of Interest: Properties, Treatment, and Fact Sheets Radiation Countermeasures for Treatment of Internal Contamination Countermeasures: Internal Contamination Caveats about Radiation Countermeasures for Treatment of Internal Contamination Total Body Radiation Survey with Modified Hospital Nuclear Medicine Equipment Swab Each Nostril Separately to Help Estimate Level of Internal (Lung) Contamination Ca-DTPA/Zn-DTPA Calcium Calcium Gluconate Dimercaprol Penicillamine Potassium Iodide (KI) Follow-up for Patients Exposed to I-131 Potassium Phosphate, Dibasic Propylthiouracil Prussian Blue Sodium Alginate Sodium Bicarbonate Exposure: Diagnose/Manage Acute Radiation Syndrome Diagnosis Frequency of Serial CBCs with Differential and Platelet Count Radiation Effects on Blood Counts (1) Radiation Effects on Blood Counts (2) Radiation Effects on Blood Counts (3) Dose Reconstruction Targeted Physical Examination Dose Estimator (Biodosimetry Tools) Explaining Biodosimetry About Time to Onset of Vomiting About Lymphocyte Depletion Kinetics About Dicentric Chromosome Assays About the REMM Dose Estimator for Exposure Management Management Modifiers for Exposure Algorithm Acute Radiation Syndrome (ARS) Manage Subsyndromes of Acute Radiation Syndrome Countermeasures: Exposure Hematopoietic Subsyndrome Treatment Cytokines for Treatment of Acute Exposure to Myelosuppressive Doses of Radiation: Hematopoietic Subsyndrome of Acute Radiation Syndrome (H-ARS) Hematopoietic Stem Cell Transplant Guidelines for Use of Antiemetics Time Phases of ARS Time/Dose Effects in ARS Cutaneous Radiation Syndrome Simulated Radiological Exposure Device (RED) on Skin Illustrating Dose Attenuation Gallery of Clinical Photographs Exposure + Contamination Management Modifiers for Exposure + Contamination Algorithm No Contamination or Exposure Multi-organ Injury, Multi-organ Dysfunction Syndrome, Multi-organ Failure: A New Hypothesis about Whole Body Radiation Effects Collection of Data Sample Data Elements that Could be Collected at a Community Reception Center after an IND Detonation Strategic National Stockpile Management Modifiers Burn Triage and Treatment: Thermal Injuries Radiation + Trauma (Combined Injury) Mass Casualty Psychological Issues At-Risk / Special Needs Populations Tools and Guidelines Dose Estimator (Biodosimetry Tools) Template for Adult/Pediatric Orders in a Radiation Incident Use of Blood Products Follow-up Instructions for Individuals Involved in a Radiological/Nuclear Incident Population Monitoring Management of the Deceased Develop a Radiation Response Plan Equip an Emergency Department for Decontamination Recovery / Resilience after an Incident How to Volunteer Top 10 Items for Radiation Emergencies Print Algorithms & Tables Reference/Data Center Training and Education Dictionary of Radiation Terms Multimedia Library: Animations, Illustrations, Photos Emergency Contacts Abbreviations Understanding Radiation Basics REMM Bibliography Books, Handbooks, Pamphlets, Pocket Guides Software Tools Government Entities with Radiation Information for Healthcare Providers International Agencies with Radiation Information for Healthcare Providers Professional Societies with Radiation Information for Healthcare Providers Radiation Safety Preparedness and Planning Medical Management of Radiation Injury Radiation Biodosimetry Isotopes of Interest, Countermeasures for Internal Contamination Contamination, Decontamination Nuclear Detonation Incidents RDD Incidents Nuclear Reactor Incidents Late Effects of Ionizing Radiation History of Radiation Incidents Algorithms and Interactive Tools Patient Management Algorithms Evaluate for Contamination and/or Exposure Contamination: Diagnose/Manage Exposure: Diagnose/Manage Acute Radiation Syndrome Exposure + Contamination No Contamination or Exposure Triage Algorithms START Adult Triage Algorithm JumpSTART Pediatric Triage Algorithm SALT Mass Casualty Triage Algorithm, Adapted for a Very Large Radiation Emergency Exposure and Symptom Triage (EAST) Tool to Assess Radiation Exposure After a Nuclear Detonation Incident Management Algorithms Discovering an Incident Identify Types of Radiation Incidents Establish Patient Handling Flow Prototype for Zones to Handle Staff/Patients in Medical Facility at Mass Casualty Incident Interactive Tools Dose Estimator (Biodosimetry Tools) Manage Subsyndromes of Acute Radiation Syndrome Quick Links Top 10 Items for Radiation Emergencies What's New on REMM Emergency Contacts Patient Management Algorithms Dose Estimator for Exposure Dictionary Isotopes of Interest Countermeasures: Internal Contamination Countermeasures: Exposure Decontamination Procedures Acute Radiation Syndrome (ARS) Hematopoietic Subsyndrome Cutaneous Radiation Syndrome Manage ARS Subsyndromes Time/Dose Effects in ARS Time Phases of ARS Strategic National Stockpile Scarce Resources Triage Tool Multimedia Library: Animations, Illustrations, Photos Print Algorithms & Tables Download REMM Download Mobile REMM