Citing recent concerns about North Korea and other groups ramping up their involvement in making and using radioactive material, John White, CNMT, Chair of the North Texas Radiation Response Group, updated the Eagles U.S Medical Directors Consortium on what would/could happen if a nuclear device was detonated in a large metropolitan center. Areas of prime focus will include: “¢ Need for water and other substance needs — for months; “¢ Shelter for hundreds of thousands of people; “¢ Special trash and sanitation concerns; “¢ Need to place children in alternative education facilities if their schools are contaminated; “¢ Psychological and law enforcement issues, particiularly when the population is displaced and hungry; Rioting will be a concern; “¢ Children separated from their parents; and “¢ Employees who “abandon” their jobs or profession to care for their quarantined children or due to stress and grief. He advised the Eagles and their EMS agencies and providers to get the Planning Guidance for Response to Nuclear Detonation, available free online. www.epa.gov/radiation/docs/er/planning-guidance-for-response-to-nuclear-detonation-2-edition-final.pdf. White told the Eagles that, “We know the bad guys want to get hold of nuclear material and devices.” The three concern that were discussed were: “¢ Nuclear power plant explosion “¢ Nuclear device “¢ Dirty bomb — with all material release rapidly He also recommended that EMS systems and communications centers download the free HOTSPOT – plume physics program: https://narac.llnl.gov/HotSpot/HotSpot.html. He urged those in attendance to keep hard/paper copies of these reference materials on hand and in supervisor vehicles because warned on electromagnetic pulses that will occur in the event of a nuclear release will incapacitate computers, vehicle electronic systems and other key devices we have become dependent on for emergency incident management. He noted that there will be significant demands on systems, particularly when affected agencies and residents will be unable to enter nuclear-affected areas for years. Take-away messages included: 1. Prepare/train your EMS personnel; 2. Meet with your local/regional meterologists; 3. Locate your Radiation resource personnel (A Health Physicist — Radiation Safety Officer; Nuclear Medicine Physicians and Technologists); and 4. Have pre-prepared messages ready for release prior to an incident occurs.