Australian clinical guidelines for radiological event

The Australian Health Protection Committee oversees national health protection priorities in: communicable disease outbreaks; chemical, biological or radiological incidents; mass casualty incidents; and deployment of Australian health teams overseas. The Australian Clinical Guidelines for a Radiological Event to complement existing national guidelines on chemical agents, anthrax, and smallpox. Other prompts included the need to revise the ARPANSA Guidance Manual, Medical Management of Individuals Involved in Radiation Accidents, 2000, and the requirement for specific therapeutic information regarding the indications and use of radiological decorporation agents held as part of the National Medical Stockpile. Matters identified by clinicians requiring specific guidance included: basic understanding of radiation; an approach to dose assessment; specific thresholds for initiating decorporation and other therapy; the role of gastric lavage, as contemporary practice considers this ineffective for other toxicological indications. rationale for, and detailed description of pulmonary lavage; advice on prenatal exposure to radiation; protocols for biodosimetry and other laboratory analysis. The objective was to produce a plain language guidance document for Australian clinicians on the diagnosis and management of radiation injury. It was to be based on evaluation of existing Australian documents, a literature review and consultation of appropriate specialists. Content areas included human health effects of radiation, scenario-based risk assessment and risk management, pre-hospital and hospital systems of care, management of specific injury types, radionuclide pathophysiology and decorporation protocols, biodosimetry options, individual psychological support 'and public health information, and Australian responsibilities under the Radiation Emergency Medical Preparedness and Assistance Network, of the World Health Organization. The range of resources utilised in preparing the guidelines, and the process of development and review will be described.