First Aid brushup - Particular Hazards: Dirty Bombs

There has been a lot of attention lately on the North Korean nuclear weapons test.  First aiders might find useful a brushup concerning a more 'down to earth' atomic hazard: the risk posed by a "dirty bomb".

The risk

A "dirty bomb" (sometimes called a 'radiological dispersal device') combines conventional explosives with radioactive material (for example, certain types of medical and industrial waste).  This combination is unnerving but should not be exaggerated: a dirty bomb is not a nuclear device.  A nuclear weapon, like that tested by North Korea, splits atoms to cause a catastrophic explosion and widespread radioactive contamination.  A dirty bomb is simply a conventional device with contaminants added.

Identification. 

An explosion is proverbially hard to miss, but radioactive material is unlikely to be obvious unless (for example) the debris contain material with a hazardous goods label.

Image from here

Ideally emergency responders will be equipped to detect radiation in the area of an explosion and will be able to relay suitable warnings.  It is probably not worthwhile obtaining one’s own Geiger counter or similar advice: the United States' Nuclear Regulatory Commission warns that “many of the Geiger counters available commercially are uncalibrated and worthless”.




The Centres for Disease Control advise that radiation injuries may be indicated by the skin becoming red and swollen and the casualty complaining of nausea, vomiting and diarrhoea.  However, they caution that the low radiation levels expected from a dirty bomb situation are unlikely to cause symptoms.

Management

Blast Injuries

Where people have been injured in the explosion itself may require first aid for blast trauma.

Radiation Exposure

Casualties who have not suffered blast injuries but who may have been exposed to radioactive material should be encouraged to avoid any obvious clouds of smoke or dust, and to breathe through tissues or cloth to avoid inhaling radioactive particles.  They should not touch detritus in the area of the explosion which may be contaminated.  For the avoidance of doubt, unpackaged food or water in the area of the explosion may have become contaminated and should not be eaten.  However, food in sealed containers should be safe as long as the outside of the container is washed before it is opened.

Shelter

Casualties should be encouraged to take shelter inside a building of which the doors and windows can be closed, and to avoid public transport.  Once inside the building they should move to an inner room if possible, and limit exposure to radioactive particles which may be outside by closing the doors and windows and shutting off ventilation, heating or air conditioning which draws air in from outside.

Decontamination

It would be prudent for casualties (once indoors) to take off any clothing which may have become contaminated and to put it in a sealed plastic bag along with the cloth or similar item through which they were breathing (the clothing can be examined by an expert to estimate the casualty’s degree of exposure to radiation).  As soon as possible they should wash thoroughly to remove radioactive particles from the skin and hair.

Medication

Anti-radiation medications (for example, potassium iodide) may not be helpful and medical guidance should be sought.

Acknowledgement

This post was prepared using information from the websites of the United States' Nuclear Regulatory Commission, the Centres for Disease Control and the Nuclear Energy Institute.