Proposed “Exposure And Symptom Triage” (EAST) Tool to Assess Radiation Exposure After a Nuclear Detonation

John L. Hick, Judith L. Bader, C. Norman Coleman, Armin J. Ansari, Arthur Chang, Adela Salame-Alfie, Dan Hanfling, John F. Koerner

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


One of the biggest medical challenges after the detonation of a nuclear device will be implementing a strategy to assess the severity of radiation exposure among survivors and to triage them appropriately. Those found to be at significant risk for radiation injury can be prioritized to receive potentially lifesaving myeloid cytokines and to be evacuated to other communities with intact health care infrastructure prior to the onset of severe complications of bone marrow suppression. Currently, the most efficient and accessible triage method is the use of sequential complete blood counts to assess lymphocyte depletion kinetics that correlate with estimated whole-body dose radiation exposure. However, even this simple test will likely not be available initially on the scale required to assess the at-risk population. Additional variables such as geographic location of exposure, sheltering, and signs and symptoms may be useful for initial sorting. An interdisciplinary working group composed of federal, state, and local public health experts proposes an Exposure And Symptom Triage (EAST) tool combining estimates of exposure from maps with clinical assessments and single lymphocyte counts if available. The proposed tool may help sort survivors efficiently at assembly centers near the damage and fallout zones and enable rapid prioritization for appropriate treatment and transport. (Disaster Med Public Health Preparedness. 2017;page 1 of 10)

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalDisaster Medicine and Public Health Preparedness
StateAccepted/In press - Jul 31 2017


  • nuclear weapons
  • radiation injuries
  • triage

PubMed: MeSH publication types

  • Journal Article


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