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Seems everyone online is focused on prepping for a nuclear war these days. Shows the stupidity of humanity that this is even a thing but it is, so I thought I’d share the contents of my radiological medical response kit. There are plenty of excellent sources out there covering the other issues around this topic but get a hard copy of Nuclear War Survival Skills. There is a free download is the 1987 version. There is a 2012 updated version for purchase but I do feel some books require owning as hard copies and this is one of them.
My kit started in 2008 before I became a prepper after attending a compulsory Canadian Government conference for a few days on the Medical Emergency Treatment for Exposures to Radiation (METER) . I am sure some of you have had more recent training and I’d love to read about USA and UK equivalent training. The course enrolment in 2008 was managers of trauma hospitals and emergency services and included a dirty bomb table top exercise. It was fascinating stuff and great speakers. I am including some more recent information from the Ontario Government Radiation Response Plan.
I did not use FEMA for this article but this slide show is interesting if you want more background of a general nature on Medical Management of Radiologic Casualties
I am including some directions to take materials and over the counter medications to limit radiation dosing but you should only take these on medical advice and under medical supervision. No self-treatment even in the apocalypse!
Treating a Casualty
Read More: Generic Procedures for Medical Response During a Nuclear or Radioactive Emergency.
I am not going through the types and methods of exposure, or the protective materials/clothing/masks. Look that information up but there are a few things the average person might overlook. I am giving the general ideas here and some will not work in a nuclear war but work great if it was a dirty bomb or power plant incident so adapt as required.
If treating an exposed casualty keep them outside an established Cold Zone (an area where outside material, clothing, foot wear never enters. The area of treatment is a Hot Zone so protect yourself as best you can while there. Try to avoid treating for prolonged periods near the casualty as they might be radioactive enough to give you a lethal dose. Have your Cold Zone at least 5 metres (About 20 feet) away from any casualties and preferably with a concrete wall in between. Alter this if contamination is everywhere but even if they have driven to you still remember they might be a radioactive source internally or externally.
Decontamination is supposed to occur after treatment of any regular injuries but honestly I would decontaminate first to avoid exposing yourself while treating. Minimum here is double gloves and plastic suit with duct tape sealing the arms and legs. An NBC mask would be great but goggles and a N95 mask might be all you have. None of these supplies should be reused if possible or left anywhere near the Cold Zone after use. Be checked or check yourself every 5-10 minutes to make sure your gear is intact. Approach the casualty with the wind to your back if possible. Remove all their clothes by cutting gently to avoid making anything airborne and dispose away from the casualty and the Cold Zone.
Water is not recommended for decontamination but likely it will be all you can find to achieve removal of visible and invisible external contamination. Pour clean water over them and hose them down if you can. Try to make sure this water runs away from the Cold Zone and think about any drains it might enter. If you have enough consider using wet wipes rather than water and will you have enough clean water anyway for this sort of thing in a nuclear war? The goal is to remove anything visible and then hopefully wash off any invisible sources of radiation. This will not make them safe to enter the Cold Zone as they might have absorbed, ingested, and/or inhaled radioactive material and remain deadly to you. A few hours to a day will tell as they will show obvious signs they are going to die. If you can keep them outside the Cold Zone for at least 24 hours and a week would be good but again depends on who it is and circumstances locally.
Treat injuries but place Cold Zone equipment in minimal amounts on doubled clean tarps not the ground. Remember not to kneel down or rest against walls or the casualty. Ideally the casualty should be doing all of these interventions themselves with you shouting encouragement and throw gear to them. If you have to move them then place them on a thick clean tarp and a sheet and literally wrap them up entirely to avoid contact for the transport.
They are contaminated until a Geiger counter says they are not or several days have gone by and they are showing no major progressive radiation illness. Until then treat them as if they are radiative to you. Do not forget this ever. As the hours and days go by the threat of this lessens but it does not take much source material to kill.
Radiation Sickness
Occurs a few hours to several weeks after exposure and are mainly the signs and symptoms from dead stem cells that you will see. Of interest if you have seen Threads or any film it takes 2-4 days before you see gastric signs. Diarrhea and abdominal pain take about 48 hours for most lethal doses to appear so being fine a day afterwards means nothing for survival. Gastric symptoms lead to a horrible death in about ten days so if they get to two weeks it looks good but… it takes 30 to 60 days before you know they will not die from blood failure. The earlier lack of appetite, nausea, vomiting (persistent), and lack of energy occur the more likely it is the casualty will die.
The most useful sign is their consciousness as it gets hit hard early by lethal and high radiation. It can kill in 24-48 hours but expect drowsiness and feeling very ill even in none lethal exposures. Diarrhoea is always a bad sign for survival and remember that poop might well be radioactive so keep away from it and keep it away from your Cold Zone.
Bleeding and vomiting and diarrhea can all occur within minutes of high level exposure. Interestingly a type of pneumonia can occur after about 50 days and pulmonary fibrosis can occur about a year afterwards. Carry a few N95 or similar masks with you everywhere you go as inhaling is the easiest way to become contaminated in a nuclear incident.
Treatment
This gets complex but basics are needed such as an antiemetic (Gravol). Antipyretic such as Tylenol but do not use Aspirin as they are likely to bleed and this really won’t help that. Keep hydrated and warm. Treat other injuries as best you can. Use ciprofloxacin and/or cephalosporin antibiotics and consider also using Vancomycin (Gram Positive antibiotic) and Amphotericin B (anti-fungal). You will need a Doctor to prescribe these but Vets have these and there are sources available to treat your tropical fish that might help in a pinch. Antivirals (acyclovir) are good but there is no information on using HIV treatments for Acute Radiation Sickness but if available I would consider it. The casualty is going to feel really ill from this therapy but worth a try if available and if not obviously dying.
Cutaneous Syndrome
Typically a hand or foot might develop this even if there are no signs of systemic Acute Radiation Sickness. Of note the First Aider is at high risk from this if the casualty has high doses. This is basically a really bad burn that swells and then develops tissue death. Treat with removal of dead tissue, ingesting steroids, eating lots of protein, and avoiding nicotine (vasoconstrictor). Pain killers will be nice here as it is agony so consider early amputation if loss of the area is clear.
My Radioactive Medical Response Kit
Most radioactive elements are not easily absorbed by the bowels but Iodine, Tritium, and Cesium are 100% absorbed. Strontium is about 30% absorbed while most other elements about 10%. This is an ongoing issue in a radioactive environment so consider using double bag clean soil and secure water barrels to construct your Fall Out shelter with and using these for food production later on after clear vegetation and soil from your garden (this is arguable as might put you at risk of inhaling)
Metamucil. High fiber intake promotes bowel clearance to flush out any ingested radioactive materials. Start as soon as you think there is a radiation issue. Vegans clear the bowel in less than 24 hours and meat eaters about five days.
Use Potassium Iodide tablets to block radioactive iodine from being absorbed by the thyroid gland in the neck. Ontario Government gave me free ones but I’d go for 14 days supply for all members of the group and a 28 day supply for all people under the age of 25. Make sure they are not allergic to iodine (shell fish) and it only works if taken before exposure and only helps the thyroid not the entire body. A 130mg tablet provides protection after six hours and last about 36 hours. One tablet for adults a day and half a tablet ages 3-18. Under 3 years give a quarter of a tablet. Under one month an eight of a tablet. Only used if intake of radioactive Iodine is likely. 130mg of Potassium Iodide is equivalent to 170mg of Potassium Iodate.
Drink fresh water in large quantities (3-4 litres a day) as it helps flush some elements out and you need to be hydrated if you get sick. Urinate outside the Shelter and think about drainage away from the Shelter. Not likely to be radioactive but no point doing all this and overlooking the portable toilet in the shelter that is emptied every week. The goal is to reduce all radioactive exposure as far as possible and for as long as possible.
Barium Sulphate (not commonly available but see if you can get a friendly ICU nurse to get you a supply). Not an enema but the oral version as it is really good at binding to Strontium and excreting it via the bowels. Your poop will by clay like and you should consider it to be radioactive. Use one oral dose of 300mg but repeat is ingestion reoccurs. I’d basic this on where the food is from and if your poop is normal again but honestly do not eat or drink anything that is not from your stores to avoid this fate. It causes constipation so a mild laxative added to the Metamucil is a good move.
Use Prussian Blue by mouth as it is absorbed in the bowel instead of Cesium, Thallium, and Thorium which is then pooped out. Your poop is highly radioactive in this case. Use about 3gm per day for a minimum of 30 days. It is not absorbed by the body and is relatively harmless. It will cause constipation and your poop will turn blue. If used, maintain a high potassium diet as it rips this out of you as well and that can easily kill you.
Maalox or similar. You want colloidal Aluminum Phosphate or Aluminum Hydroxide (antacids). Hard to find these days as the anti-aluminum movement due to Alzheimer’s risks means many brands no longer contain Aluminum. Read the label. Use about a 2.5 gm dose once a day for five days. It binds to the radioactive elements in the bowel allowing you to excrete them in your poop .
Sodium Bicarbonate. This helps depleted or enriched uranium leave the body by the kidney. I can only find intravenous doses but it seems a spoonful a day for a week might help if you can stomach it. The dose is two tablets every four hours until three days after there are no symptoms but tablets might be hard to find. Use pure sodium bicarbonate powder and check the label for additives.
You might consider charcoal ingestion but this is not recommended for radioactive contamination as it does not do much to block absorption and can lead to vomiting and then aspiration of radioactive material into your lungs which is a far worse issue than in the bowels.
I also have the ability to stop all treatment humanely. Well that is my kit and the background to it. Enjoy!