Emergency medical preparedness for radiological/nuclear incidents in the United States.

The Office of the Assistant Secretary for Preparedness and Response in the Department of Health and Human Services develops health and medical response plans for all hazards--natural and human caused. While a nuclear power plant (NPP) incident will take time to evolve, a terrorist incident will have 'no-notice' so that extensive preparation and planning are essential. For radiological/nuclear (rad/nuc) incidents we have developed and continue to refine detailed plans and tools for medical responders for a nuclear detonation and a radiological dispersal device, which also serve for any type of rad/nuc incident. The plans are based on the best available basic science with the goal of providing planners and responders with just-in-time information and tools. There is much in common across the range of hazards, so that the products developed for rad/nuc incidents have helped overall preparedness. A major consideration in the development of new diagnostics, medical treatment and countermeasures for radiation injury is that of 'dual utility' with potential for routine medical use for cancer care. Participation and collaboration among nations helping the Japanese response to the Fukushima earthquake, tsunami and NPP disaster demonstrated the benefit of preparation and ongoing worldwide cooperation among experts.