Triage tools to cope with radiological or nuclear event
Two approaches facilitate the triage under RN conditions, namely dose estimation and effect prediction. Radiation exposure along a causal pathway (black arrow) leads to certain effects such as the acute radiation syndrome (ARS). Physical measurements, clinical parameter (e.g. vomiting or diarrhea) or biological changes such as DIC (dicentric chromosomal aberrations) or gene and protein expression changes can be used for both, dose estimation (blue arrows) and/or effect prediction (red arrows).
In the case of radiological or nuclear events (RN), radiation exposed individuals might require either early intensive therapy, early radionuclide decorporation treatment or psychological support. It is also important to identify individuals who got no exposure. The sorting of and allocation of treatment to patients (triage) in large scale RN scenarios is challenging.
This manuscript describes established concepts to facilitate triage in RN situations. They are either based on exposure/dose estimation or on disease prediction. The contribution of these concepts or triage purposes is critically examined and some outlook on future developments and requirements are provided. An important example is the development of new generation tools to use in the field.