Emergency War Surgery NATO Handbook: Part I: Types of Wounds and Injuries: Chapter VII: Mass Causalties in Thermonuclear Warfare

General

United States Department of Defense

Nuclear weapons range in size from very small (not many times larger in total energy yield than the largest conventional bombs), to immensely large (the so-called thermonuclear or hydrogen devices), with yields in the megaton range. Total energy yield of nuclear weapons are rated in terms of equivalent amounts of TNT. Therefore, a weapon with a 20-kiloton yield has the same total energy output as 20,000 tons of TNT. A 1.0-megaton weapon has the energy output of 1,000,000 tons of TNT. Energy is released by nuclear detonations in three forms: thermal radiation, blast, and ionizing radiation. The relative-casualty causing potential of each depends primarily upon three factors: the yield of the weapon, the environmental conditions in which the detonation occurs, and the distribution of troops in the target area. The thermal output may be the most significant casualty producer, particularly for the larger weapons; however, blast will produce nearly as many casualties, and blast and thermal injuries together will account for most of the casualties under almost all circumstances. Radiation, either at the time of detonation or later from fallout, will be responsible for significant numbers of delayed casualties.

Radiation-associated injuries pose many new challenges to medical management. Many organ systems are affected by radiation, often compounding problems produced by conventional injuries. These challenges are magnified by the very real potential of nuclear weapons to produce very large numbers of casualties instantaneously. Thus, new concepts of mass-casualty medicine that utilize simplified and standardized regimens will be required to accomplish what is now done by labor and resource-intensive means.

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Operational Medicine 2001

Health Care in Military Settings

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