· Hospital units are very susceptible to the thermal effect of a nuclear detonation. Tents will not provide protection against the thermal pulse. If the thermal effect (fire) is an impending threat, patients and personnel in tentage must move to trenches, bunkers, or other nonflammable areas.
· Protection factors that can reduce the overall radiation exposure rate for hospital personnel and patients are--
· Time. Reducing the exposure time to the radiation reduces the overall exposure proportionally (cut the time of exposure in half and the overall exposure is cut in half). EXAMPLE: An exposure time of 60 minutes to a dose rate of 100 centigray (cGy) is cut in half (30 minutes) to an exposure rate of 50 cGy.
· Distance. Increasing the distance from the radiation source reduces the exposure in an inverse square relationship (double the distance factor by 2 decreases the exposure factor by 4).
· Shielding. Placing material between personnel and patient and the radiation source decreases the dose (the reduction factor is dependent on the type of radiation and the density of the shielding material). Placement of sandbags (two feet wide) around the hospital tents and shelters provides adequate shielding for protection from gamma and x-ray radiation; the thicker the sandbag stacks the greater the protection factor. Tent material is a good shield for alpha particles and adequate shielding from beta particles. See Appendix H for field expedient shielding techniques.
(3) _Biological._ The most likely use of a biological agent (such as anthrax) is releasing the agent as an aerosol. While such agents may produce large numbers of casualties, initially patients may be seen at the MTF in small numbers, but the number of patients will rapidly increase within a few hours to days. When a trend is identified, the enemy use of a biological agent is suspected. General protective measures are the same as for any infectious disease; specific protective measures are used once the vector or method of transmission has been identified. Designating a single hospital to care for these patients (from a patient care or disease transmission standpoint) may not be necessary. However, if the agent is communicable, consolidating them all at one facility maximizes the use of limited assets and aids in limiting the spread of the disease. Protective measures against biological attack are the same as those for chemical agents when bombs, sprays, or gases are used; see (4) below. The difficulty in rapidly identifying biological agents may force the use of protective measures for longer periods of time. Faced with this situation, a careful evaluation of the mask-only posture is necessary before implementing any level of MOPP. See FM 8-284 for additional information on prevention, protection, and treatment of biological casualties.