Radiation injury mechanism of action

Improvised Nuclear Devices and Stolen Nuclear Weapons 

Detonation of an improvised or stolen nnclear weapon by terrorists is the worst-case radiological attack scenario (5). Althongh difficnlt to construct, due to requirements for sophisticated engineering and expertise, an improvised nuclear device could produce a yield similar to the Hiroshima bomb, with release or radiation, blast, thermal pulses, and radioactive fallout (1). At a minimum, a small nuclear detonation could cause damage equal or exceeding the September 11 attacks in New York City. Even if the nuclear detonation were unsuccessful, the conventional explosion associated with the device could cause significant environmental contamination with the nuclear weapons material, such as plutonium or uranium (1). 

Certainly, the technical expertise to develop crude devices, including improvised nuclear devices, exists worldwide (4). Whereas terrorist attacks with SRDs and RDDs would cause a limited number of casualties, attacks with improvised or sophisticated nuclear weapons, if used in a populated area, have the potential for mass casualties and disruption. The Joint Commission on Accreditation of Healthcare Organizations has already directed hospitals to plan and prepare for a terrorist attack involving nuclear weapons, specifically asking them to (2)  

Depending on the incident, radioactive material cause radiation exposure in one or more (any combination) of three ways (1,2)  

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