This publication focuses on the medical management of individuals involved in radiation emergencies, especially those who have been exposed to high doses of ionizing radiation. Its primary objective is to provide practical information, to be used for treatment decisions by medical personnel during a radiation emergency. It also addresses general and specific measures for the medical management of individuals who have been internally contaminated with radionuclides. This publication is complementary to other publications developed by the IAEA in the medical area of radiation emergencies.

Although radiation accidents are rare and often complex in nature, they are of great concern not only to the patient and involved medical staff, but to the media and public as well. Yet there are few if any comprehensive publications on the medical management of radiation accidents. Medical Management of Radiation Accidents provides a complete refe

This text from the British Institute of Radiology provides an international standard for the evaluation of radiation-induced health impairments, which should make a useful contribution to the harmonization and standardization of the Medical Management of Radiation Accidents.

Stereotactic body radiation therapy (SBRT) has emerged as an important innovative treatment for various primary and metastatic cancers. This book provides a comprehensive and up-to-date account of the physical/technological, biological, and clinical aspects of SBRT. It will serve as a detailed resource for this rapidly developing treatment modality. The organ sites covered include lung, liver, spine, pancreas, prostate, adrenal, head and neck, and female reproductive tract. Retrospective studies and prospective clinical trials on SBRT for various organ sites from around the world are examined, and toxicities and normal tissue constraints are discussed. This book features unique insights from world-renowned experts in SBRT from North America, Asia, and Europe. It will be necessary reading for radiation oncologists, radiation oncology residents and fellows, medical physicists, medical physics residents, medical oncologists, surgical oncologists, and cancer scientists.

Does radiation medicine need more regulation or simply better-coordinated regulation? This book addresses this and other questions of critical importance to public health and safety. The issues involved are high on the nation's agenda: the impact of radiation on public safety, the balance between federal and state authority, and the cost-benefit ratio of regulation. Although incidents of misadministration are rare, a case in Pennsylvania resulting in the death of a patient and the inadvertent exposure of others to a high dose of radiation drew attention to issues concerning the regulation of ionizing radiation in medicine and the need to examine current regulatory practices. Written at the request from the Nuclear Regulatory Commission (NRC), Radiation in Medicine reviews the regulation of ionizing radiation in medicine, focusing on the NRC's Medical Use Program, which governs the use of reactor-generated byproduct materials. The committee recommends immediate action on enforcement and provides longer term proposals for reform of the regulatory system. The volume covers: Sources of radiation and their use in medicine. Levels of risk to patients, workers, and the public. Current roles of the Nuclear Regulatory Commission, other federal agencies, and states. Criticisms from the regulated community. The committee explores alternative regulatory structures for radiation medicine and explains the rationale for the option it recommends in this volume. Based on extensive research, input from the regulated community, and the collaborative efforts of experts from a range of disciplines, Radiation in Medicine will be an important resource for federal and state policymakers and regulators, health professionals involved in radiation treatment, developers and producers of radiation equipment, insurance providers, and concerned laypersons.

Looseleaf version also available (ISBN 9780117540774). On cover: Fire and Rescue Service operational guidance. GRAs - generic risk assessments. This series only applies to England. Dated January 2011

In recent years, wound care has gained increasing recognition as a distinct medical specialty. An understanding of the complex mechanisms involved in wound healing facilitates efficient assessment and treatment of patients with wounds, and skin necrosis can be considered the starting point in the entire healing process. This book is the first to discuss skin necrosis as a symptom related to a broad range of pathologies. Richly illustrated, it primarily provides therapeutic strategies and treatment algorithms for different clinical contexts. All chapters were written by renowned specialists in their respected fields and include detailed sample cases and essential take-home messages. In light of the highly interdisciplinary nature of wound management, Skin Necrosis offers an invaluable resource for wound care practitioners and health care professionals across the fields of surgery, dermatology, internal medicine, and nursing.

Mass Casualty events may occur as a result of natural or human-caused disasters or after an act of terrorism. The planning and response to disasters and catastrophes needs to take into consideration the distinction between progressive and sudden events. Insidious or slowly progressive disasters produce a large number of victims but over a prolonged time period, with different peaks in the severity of patients presenting to the hospital. For example, radiation events will produce a large number of victims who will present days, weeks, months, or years after exposure, depending on the dose of radiation received. The spread of a biological agent or a pandemic will produce an extremely high number of victims who will present to hospitals during days to weeks after the initial event, depending on the agent and progression of symptoms. On the other hand, in a sudden disaster, there is an abrupt surge of victims resulting from an event such as an explosion or a chemical release. After the sarin gas attack in a Tokyo subway in 1995, a total of 5500 victims were injured and required medical attention at local hospitals immediately after the attack. The car bomb that exploded near the American Embassy in Nairobi, Kenya, killed 213 people and simultaneously produced 4044 injured patients, many requiring medical care at local hospitals. The Madrid train bombing in March 2004 produced more than 2000 injured victims in minutes, overwhelming the city’s healthcare facilities. More than 500 injured patients were treated at local hospital after the mass shooting in Las Vegas. Finally, earthquakes may produce a large number of victims in areas in which the medical facilities are partially or completely destroyed. Sudden events bring an immediate operational challenge to community healthcare systems, many of which are already operating at or above capacity. The pre-hospital as well as hospital planning and response to sudden mass casualty incidents (SMCI’s) is extremely challenging and requires a standard and protocol driven approach. Many textbooks have been published on Disaster Medicine; although they may serve as an excellent reference, they do not provide a rapid, practical approach for management of SMCI’s. The first edition of “Mass Casualty Incidents: The Nuts and Bolts of Preparedness and Response for Acute Disasters” dealt exclusively with sudden mass casualty incidents. The second edition will expand its focus and include planning and response for insidious and protracted disasters as well. This new book is designed to provide a practical and operational approach to planning, response and medical management of sudden as well as slow progressive events. The target audience of the second edition will be health care professionals and institutions, as well as allied organizations, which respond to disasters and mass casualty incidents. Parts I and II are essentially the first edition of the book and consist of planning of personnel, logistic support, transport of patients and equipment and response algorithms. These 2 parts will be revised and updated and include lessons learned from major mass shootings that occurred recently in the United States and other parts of the world Part III will describe the planning process for progressive disasters and include response algorithms and checklists. Part IV will handle humanitarian and mental health problems commonly encountered in disaster areas. Part V will deal with team work and communication both critical topics when handling catastrophes and mass casualty incidents. This new book will be a comprehensive tool for healthcare professionals and managers and should perform demonstrably better in sales and downloads. It will be of value at the pre-hospital as well as the hospital level, to plan and respond to the majority of catastrophes and mass casualty incidents.

Radiation Pathology is an up-to-date compendium of the effects of ionizing radiation on human tissues. It will be of great value to radiation oncologists, pathologists, and other professionals. The early chapters deal with basic science: physics, radiobiology, genetics, etc. The circumstances of human exposures (therapeutic, accidental, warfare) are then considered in the light of extensive epidemiological data. Acute radiation syndromes and radiation cardiogenesis are described in detail, including recent information on mechanisms of oncogenesis. For the benefit of readers who are not radiation oncologists, two chapters outline the current uses of radiation in therapy and in diagnosis, including the various applications of radionuclides. The bulk of the text deals with radiopathology and its morphologic expression. An overview orients the reader and classifies the main types of lesions. The chapters on specific organs or organ systems are consistently divided into sections to facilitate rapid retrieval of information on: normal structure, tolerance doses, experimental studies, morphology and pathogenesis, and clinical manifestations. The authors' lucid, well-organized descriptions will inform radiation oncologists about the types of injury to be expected, and will guide pathologists in making differential diagnoses.

On 21 June 1990 a fatal radiological accident occurred at an industrial irradiation facility at Soreq, Israel. An operator entered the irradiation room by circumventing safety systems and was acutely exposed, with an estimated whole body dose of 10-20 Gy. The accident, like earlier accidents at similar irradiators, was the consequence of the contravention of operating procedures. An IAEA review team investigated the causes of the accident. This report presents its findings and recommendations and describes the clinical management of the patient, particularly of the haematological phase. The medical treatment included the use of emerging therapies with haematopoietic growth factor drugs which may rescue the overexposed patient, albeit in this case only temporarily. The report is intended for regulatory authorities responsible for the regulation and inspection of irradiators, operating organizations and physicians who may need to treat overexposed patients.