DOC, D 101.2: JM46/6 JUN 26 1991 Op % py SCIENCES, ARMY US FORT SAM HOUSTON, TEXAS 78234 MEDICAL ASPECTS OF NUCLEAR WEAPONS AND THEIR EFFECTS ON MEDICAL OPERATIONS SUBCOURSE MED447 JUNE 1990 DEVELOPMENT This subcourse is approved for resident and correspondence course instruction. It reflects the current thought of the Academy and conforms to printed Depart- ment of the Army doctrine as closely as currently possible. Development and progress render such doctrine continuously subject to change. The education specialist responsible for revision of this edition was James F. Legendre, AUTOVON 471-3873 or commercial phone (512) 221-3873; Commandant, Academy of Health Sciences, ATTN: HSHA-TCC, Fort Sam Houston.Texas 78234-6100. The subject matter expert responsible for content accuracy of this edition was the NBC Science Branch of the Preventive Medicine Division, AUTOVON 471-6011 or area code 512-221-6011, Academy of Health Sciences, ATTN: HSHA-IPM, Fort Sam Houston, Texas 78234-6100 The editorial assistant for this edition of the subcourse was John L. Mc ntosh. I ADMINISTRATION For comments or questions regarding enrollment, student records, or shipment of subcourses, contact the Extension Services Division, Monday through Friday beteeen 0730 and 1230 hours, Central Time, at AUTOVON 471-6877. Toll—free numbers are: in Texas, 1—800—292—5867 (extension 6877); outside Texas, 1—800—531—1114 (extension 6877); Commandant, Academy of Health Sciences, ATTN: HSHA-IES, Fort Sam Houston, Texas 78234-6199. CLARIFICATION OF TRAINING LITERATURE TERMINOLOGY When used in this publication, words such as "he," "him," "his," and "men" are intended to include both the masculine and feminine genders, unless specifically stated otherwise or when obvious in context. I AND BOOKSTACKS CENTRAL CIRCULATION The person borrowing this material is re- stbpheoencsLhiaatbrelsgetefdDoaratietmsisrnteianmmeupwemadlfbeoerelrooefwtu$r7Yn5o.ub0e0fmoatroyer each non-returned or lost item. «jj«^ TABLE OF ^.ft, ^...a.ion, o*r d*efacMemen«t•o"f li«brary J* ~ J' Lesson 1tohf,..IlU,lniinvfoeoirsrsia„tnuyddeonafr.e...p.rnoot.e,ctILefdcrbaryyA~rteicl*e io^d"*j£ " ,a,e Page Law and Procedure. TO RENEW, CAU 1217) 333-8400. INTRODUCTION University of Illinois library at Urbana-Champaign i i i REVIEW OF NUCLEAR WEAPON EFFEC", m Section I. Principles of Nuc -2 Section II. Nuclear Blast.... apr o z -13 Section III. Thermal and Initi -29 Section IV. Residual Ionizing -32 Exerc ises -44 23282 IONIZING RADIATION INJURY -2 Exerc ises MAY 2 5 2004 -14 COMPARATIVE EFFECTS OF NUCLEAR V RADIATION DOSE AND DECAY CALCUL/ MANAGEMENT OF MASS CASUALTIES Section Comparative Effect I. Weapons 2 Section II. Residual Radiation Calcu lat ions. ... 3 Sect ion III. Management of Mass When renewing by phone, write new due date , below previous due date. Exerc ises !9 | COMMAND GUIDANCE ON IRRADIATED PERSONNEL AND NUCLEAR ACCIDENTS AND INCIDENTS Sect ion Command Guidance on Irradiated — I . Personne 4-1 4-7 4-2 Sect ion II. Nuclear Accidents and Incidents. 4-8—4-12 4-13 Exerc ises 4-19 MEDICAL OPERATIONS IN FALLOUT Sect ion Background 5-1——5-8 5-2 Sect ion Problem Si tuat ion 5-9 5-24 5-12 I I Exerc ises 5-29 APPENDIX A (GR 76-332-100) A-1 GLOSSARY OF TERMS) G-1 EXAMINATION EXAM-1 MED447 DEVELOPMENT This subcourse is approved for resident and correspondence course instruction. It reflects the current thought of the Academy and conforms to printed Depart- ment of the Army doctrine as closely as currently possible. Development and progress render such doctrine continuously subject to change. The education specialist responsible for revision of this edition was James F. Legendre, AUTOVON 471-3873 or commercial phone (512) 221-3873; Commandant, Academy of Health Sciences, ATTN: HSHA-TCC, Fort Sam Houston.Texas 78234-6100. The subject matter expert responsible for content accuracy of this edition was the NBC Science Branch of the Preventive Medicine Division, AUTOVON 471-6011 or area code 512-221-6011, Academy of Health Sciences, ATTN: HSHA-IPM, Fort Sam Houston, Texas 78234-6100 The editorial assistant for this edition of the subcourse was John L. Mc ntosh. I ADMINISTRATION For comments or questions regarding enrollment, student records, or shipment of subcourses, contact the Extension Services Division, Monday through Friday beteeen 0730 and 1230 hours, Central Time, at AUTOVON 471-6877. Tol I—free numbers are: in Texas, 1—800—292—5867 (extension 6877); outside Texas, 1—800—531—1114 (extension 6877); Commandant, Academy of Health Sciences, ATTN: HSHA-IES, Fort Sam Houston, Texas 78234-6199. CLARIFICATION OF TRAINING LITERATURE TERMINOLOGY When used in this publication, words such as "he," "him," "his," and "men" are intended to include both the masculine and feminine genders, unless specifically stated otherwise or when obvious in context. TABLE OF CONTENTS Lesson Paragraph Page NTRODUCT ON I I i i i REVIEW OF NUCLEAR WEAPON EFFECTS 1 — Section I. Principles of Nuclear Weapons 1-1—1-7 1-2 Section II. Nuclear Blast 1-8—1-15 1-13 Section III. Thermal and Initial Radiation 1-16—1-17 1-29 Section IV. Residual Ionizing Radiation 1-18 1-22 1-32 Exerc ises 1—44 — 2 IONIZING RADIATION INJURY 2-1 2-11 2-2 Exercises 2—14 3 COMPARATIVE EFFECTS OF NUCLEAR WEAPONS; RESIDUAL RADIATION DOSE AND DECAY CALCULATIONS, AND MANAGEMENT OF MASS CASUALTIES Section I. Comparative Effects of Nuclear — Weapons 3-1 3-5 3-2 Section II. Residual Radiation Dose and Decay — Ca I cu I at ions 3-6—3-1 1 3-8 Section III. Management of Mass Casualties 3-12 3-18 3-20 Exerc ises 3-29 4 COMMAND GUIDANCE ON IRRADIATED PERSONNEL AND NUCLEAR ACCIDENTS AND INCIDENTS Section I. Command Guidance on Irradiated — Personne 4-1—4-7 4-2 I Section II. Nuclear Accidents and Incidents.... 4—8 4—12 4—13 Exercises 4-19 5 MEDICAL OPERATIONS IN FALLOUT — Sect ion I . Background 5—1—5—8 5—2 Section II. Probl em S tuat ion 5-9 5-24 5-12 i Exerc ses 5-29 i APPENDIX A (GR 76-332-100) A-1 GLOSSARY OF TERMS) G-1 EXAM NAT ON EXAM-1 I I MED447 i LIST OF FIGURES F gure Page i 1-1 Distribution of energy 1-16 3-1 ABC-M1 rad ac ca cu ator 3-11 i I I 3—2 Decay of radioactive fallout 3—12 3—3 Normalizing survey data 3—13 3—4 Dose absorbed by personnel 3—14 5—1 Simplified fallout predictor, field construction (not drawn to scale) 5-1 1 LIST OF TABLES Table Page — Compar ison of effects of psi —19 1 1 1 2—1 Radiation dose effect relationship 2-5 3-1 Casualty criteria for personnel exposed to prompt effects... 3-2 3—2 Comparison of weapon effects (airbursts) 3—3 3—3 Emergency medical treatment procedures 3—28 4—1 Physical effectiveness required to perform typical combat tasks 4-3 4-2 Acute dose 4-10 4-3 Operations exposure guide 4—11 MED447 i i CORRESPONDENCE COURSE OF THE ACADEMY OF HEALTH SCIENCES, U.S. ARMY SUBCOURSE MED447 MEDICAL ASPECTS OF NUCLEAR WEAPONS AND THEIR EFFECTS ON MEDICAL OPERATIONS INTRODUCTION Nuclear weapons may have a tremendously devastating effect, but by no means are they the ultimate in weapons. In fact, much can be done to defend aga nst these weapons and still ma nta n some ab ty to cont nue mi tary as i i i i I i i I i well as national operational functions. Of course, this is more true for those effects which we have classified and you know as residual, when compared to the immediate or prompt effects. Survival of large population segments, which have survived the prompt effects, can be ensured by proper shelter from fallout or the residual effects. Because the post—attack environment requires an aspect of nuclear medical responsibility be employed in medical services and the other residual reserves to obtain optimum results, a knowledge of the operational characteristics and post—attack tasks must be absorbed prior to the event and capabilities developed and exercised for medical support. On the integrated battlefield, the Army Medical Department will be expected to continue medical support operations and to treat large numbers of nuclear casualties despite the enormous capabilities of nuclear weapons to wreak havoc upon and within military units and personnel. This expectation alone forebodes a tremendous undertaking. In addition, attention must be given to another aspect of the nuclear medical responsibility, which, in the final analysis, may be every bit as important a contribution to the support of the Army's combat mission. This is the time—honored responsibility of the medical officer for advising the commander on all medical problems pertaining to the health of his command. Ionizing radiation is important to the military commander because of its effect on people. This means that the commander should, does, and will look to his surgeon for advice on the effects of radiation exposure. But because of the insidious nature of these radiation effects, and limitations in the present knowledge of radiation effects and associated technology, radiation guidance becomes an exceedingly challenging responsibility for the surgeon and h is staff . Conservation of manpower, without question, will be of great concern in any mass casualty situation, and especially so, in a nuclear situation. The basic problem that the medical service faces in planning for mass casualty situations is not the type of injuries to be expected, or a lack of experi- ence, or dispersion of the units, but rather the large numbers of casualties requiring treatment that will occur at almost the same instant. One phase of the problem visualized at this time is the training of the individual soldier to take care of himself (self-aid) and of his associates (buddy—aid) until medical assistance can be made available. Another phase of the problem lies MED447 i i i in the decisions made by the commander in his consideration of the casualties and the tactical situation. The commander must constantly weigh the ever increasing health hazards against the demands of the tactical situation. This is a difficult problem for any commander but the more he knows and has thought of his potential problems in a possible mass casualty situation, the better his decisions will be when faced with the actual situation. This subcourse is directed toward the medical effects of nuclear weapons; command guidance on irradiated personnel; medical management of mass casualties with a view toward minimizing manpower damage and preventing unnecessary loss of personnel capable of continuing their military mission; effective command, control, and employment of medical units in the post- attack environment; and actions to be taken by the military, in this case, specifically the medical units, in order to preclude and defend against the tremendous residual effects of nuclear warfare. The ability to perform under such conditions can be attained through effective command, control, and employment of the medical units after the nuclear explosion. This subcourse consists of 5 lessons and an examination. The lessons are: Lesson 1, Review of Nuclear Weapon Effects. Lesson 2, Ionizing Radiation Injury. Lesson 3, Comparative Effects of Nuclear Weapons; Residual Radiation Dose and Decay Calculations; and Management of Mass Casualties. Lesson 4, Command Guidance on Irradiated Personnel and Nuclear Accidents and Incidents. Lesson 5, Medical Operations in Fallout. Exami nat on i You will be awarded 21 credit hours for the successful completion of this subcourse. Text and materials furnished: Subcourse MED447, May 1990. Map Helotes, 1:50,000, Sheet 6243 II, series V782, Edition 1-DMATC, Stock No. V782X62532. Overlay, Simplified Fallout Predictor. Calculator Set, Radiac, ABC-M1 (printed on inside of rear cover). No other materials are required. YOU MAY RETAIN THE STUDY MATERIALS. MED447 iv . No mail—in answer sheets are provided for the lessons in this subcourse because you are to grade your own lessons. The lesson exercises and solutions for all lessons are contained in this booklet. You are encouraged to complete the subcourse esson—by— esson. I I You will submit your examination answer sheet to the Academy for grading. WE SUGGEST THAT YOU FOLLOW THESE STUDY PROCEDURES: — Read and study each lesson assignment carefully. — REFER TO THE GLOSSARY EXPLAINING THE MANY ACRONYMS AND SPECIFIC TERMS FOUND THROUGHOUT THE LESSONS. — Read again through the text material, completing unanswered exercises and correcting others as needed. — When you have completed the exercises to your satisfaction, compare your answers to the ones on the solution sheet located at the end of the lesson. Check the references for your incorrect answers. — After you have successfully completed one lesson go on to the next and repeat the above procedures. — Complete the examination answer sheet and mail it to us for grading. The grade you make on the examination will be your rating for the subcourse — No postage is required. A Student Comment Sheet is located in the back of this booklet. It is to be returned with your examination answer sheet. As you study the subcourse you may wish to make notes of suggestions or criticisms and write them on the comment sheet after you have completed the examination. MED447 Digitized by the Internet Archive in 2012 with funding from University of Illinois Urbana-Champaign http://archive.org/details/medicalaspectsofOOacad