Nuclear medical expertise delivered by telemedicine in a 'dirty bomb' exercise.

Management of victims in a 'dirty bomb' incident requires communication between the physicians directly involved and experts in radiation medicine. Telemedicine is an excellent tool to support doctors--who may not have specific training in radiation medicine--in handling radiation casualties. We have successfully used telemedicine in an exercise of the Federal Police in Germany. Experts in radiation medicine were provided by the Bundeswehr Institute of Radiobiology. Simple PC-based videoconferencing equipment was used with a 128 kbit/s ISDN line. To facilitate a standardized approach, a new questionnaire for radiation accidents was developed and tested during the exercise. A special camera was used for capturing skin images. Advice for patient treatment and strategies for safeguarding personnel and the environment during the exercise was provided almost immediately.