Medical implications of enhanced radiation weapons

During the 1960s through 1980s the United States and several other nations developed, and even considered deploying, enhanced-radiation warheads (ERWs). The main effect of ERWs (sometimes called "neutron bombs"), as compared to other types of nuclear weapons, is to enhance radiation casualties while reducing blast and thermal damage to the infrastructure. Five nations were reported to have developed and tested ERWs during this period, but since the termination of the "Cold War" there have been no threats of development, deployment, or use of such weapons. However, if the technology of a quarter of a century ago has been developed, maintained, or even advanced since then, it is conceivable that the grim possibility of future ERW use exists. The type of destruction, initial triage of casualties, distribution of patterns of injury, and medical management of ERWs will be shown to significantly differ from that of fission weapons. Emergency response planners and medical personnel, civilian or military, must be aware of these differences to reduce the horrible consequences of ERW usage and appropriately treat casualties.