FMST Student Manual - 2008 Web Edition*

Nuclear Reaction: A reaction that alters the energy, composition, or structure of an atomic nucleus.

Nuclear Bomb:  An explosive weapon of great destructive power delivered form the rapid release of energy in fission of heavy atomic nuclei. 

2.  HISTORY OF NUCLEAR WARFARE:

High Altitude Burst

Characteristics

Detonation of a weapon at an altitude above 100,000 ft

Fireball is much larger and expands much more rapidly than a surface or subsurface burst

Ionizing radiation can travel for hundreds of miles before being absorbed

Causes severe disruption in communication and leads to an electromagnetic pulse (EMP), which can significantly degrade or destroy electronic and critical medical equipment

Air Burst

Characteristics

An explosion in which a weapon is detonated at an altitude below 100,000 feet but high enough that the fireball does not contact the surface of the earth

Airbursts may cause considerable damage; thermal burns to exposed skin may be produced many kilometers away from the burst.

Eye injuries may be produced at even a much greater distance than that of thermal burns.

Tactically, airbursts are the most likely to be used against ground forces. 

Surface Burst

Characteristics

An explosion in which a weapon is detonated on or slightly above the surface of the earth so that the fireball actually touches the land or water surface.

The area affected by the blast, thermal radiation, and initial nuclear radiation will be less extensive than an air burst of similar yield

It produces the greatest amount of fallout over a much larger area than that which is affected by blast and thermal radiation 

Subsurface Burst

Characteristics

An explosion in which the point of detonation is beneath the surface of land or water

Cratering of the ground will generally result

If the subsurface burst does not penetrate the surface, the only other hazard will be from ground or water shock

If the burst is shallow enough to penetrate the surface, blast, thermal and initial nuclear radiation effects will be present, but less than a surface burst of comparable yield

If the burst penetrates the surface, fallout will be heavy 

Figure 1. Types of Nuclear Blasts

4.  COMMON TYPES OF NUCLEAR INJURIES

Two Types of Blast Injuries:

Although there are many effects of a standard blast (see block 4 “Blast Injuries”) the following information divides the types of injuries that may result from a nuclear explosion into two types, primary and secondary.

Primary Blast Injury (Direct) - these types of injuries are caused by the direct action of the shock wave on the human body after the detonation of a nuclear device.

Injuries occur immediately after detonation due to over pressure from rapid the expansion of air.

If the patient is in close proximity to ground zero, the initial blast wave is usually lethal.

Sub lethal exposures to the initial blast wave can result in damage to bones, muscles, lungs, gastrointestinal system and ruptured eardrums.

Secondary Blast Injury (Indirect) - these injuries are caused by indirect wind forces greater than several kilometers per hour seconds after the primary detonation of a nuclear device.

Injuries occur as a result of collapsing buildings, flying timber and other debris impacting the body or physical displacement of the body against objects or structures.

More injuries are caused by indirect blast wind drag forces than by the shock wave.

Treatment of Blast Injuries from a Nuclear Attack:

Blunt trauma - blunt trauma with nuclear detonation will be anywhere from mild to severe.  Injuries occur as a result of debris put into motion from blast and its following winds.  Injuries such as fractures, spinal injury, head and torso blunt trauma, and penetrating injuries should be expected.  Care for these injuries as you would in a non-contaminated environment.

- 100% oxygen, positive pressure if needed.

Thermal Injuries from a Nuclear Attack

Thermal radiation emitted by a nuclear detonation causes two types of burns:

Flash Burns (Direct)

Flash Burns results from thermal radiation (infrared) emanating from the fireball of a nuclear explosion.  Exposed skin and extremities facing the explosion will be burned  

Flame Burns (Indirect)

Flame burns are caused by exposure to fires from the environment, particularly from ignition of clothing.  This could be the predominant cause of burns depending on the number of and characteristics of flammable objects in an environment. 

Eye Injuries: The initial thermal pulse from nuclear detonation can cause eye injuries in the form of flash blindness and retinal scarring

Flash blindness results from looking in the general direction but not directly at a brilliant flash of intense light energy.  It is a condition in which a flash of light swamps the eyes and depletes the pigmentation from the retinal receptors.  Flash blindness is a temporary condition that usually last for several seconds but not more than two minutes when exposure occurs during daylight. The blindness will be followed by a darkened after image that lasts for several minutes. If exposure occurs at nighttime, blindness can last from 15 to 30 minutes before full nighttime adaptation occurs.

Retinal Scarring develops from a burn to the retina from looking directly at the fireball.  It is a relatively uncommon injury, but can cause blind spots and permanent blindness. 

6.   SIGNS AND SYMPTOMS OF RADIATION EXPOSURE