US Army Reserve Officer Introduces ‘Medical Care in a Radioactive Environment’ to NATO Members | Article

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U.S. Army Capt. Eliot Fletcher (left), commander of the 491st Medical Support Area, or MCAS, discusses Tactical Operations Center operations and medical management of radiation patients with its executive officer, 1st Lt. Bonita Rutkowski (center), and platoon leader, 1st Lt. Aaron Presley, during Exercise “Guardian Response” at Camp Atterbury, Ind., in April 2022.
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An army reserve officer presents








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U.S. Army Capt. Eliot Fletcher prepares to perform chemical, biological, radiological and nuclear triage with the 491st Medical Care Area Support during a simulated radiological incident in Sloan, Nevada. in January 2022.
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During his presentation at the Interallied Confederation of Medical Reserve Officers event August 3, 2022 in Athens, Greece, U.S. Army Reserve Capt. Eliot Fletcher, commander of the 491st Medical Area Support of Santa Fe, New Mexico discussed the topic of radiation exposure in an environment of heightened global threat.

The CIOMR Junior Medical Reserve Officers Workshop provided North Atlantic Treaty Organization and Partner Nation Junior Medical and Medical Support Officers with a professional development program in a multinational environment, focusing on the NATO medical planning, civil-military negotiation training and medical planning for the operation within a chemical, biological, radiological and nuclear environment.

Fletcher, an Army biochemist, has a doctorate in genetics and conducted his postdoctoral research in radiation biology. His knowledge of radioactive environments and the treatment of radiation injuries makes him an ideal candidate to present at the conference.

“The issue of operating in a radioactive environment is more critical today than it has been since the end of the Cold War,” Fletcher said. “Since the Russian Federation invaded Ukraine in February, there has been increased rhetoric around the use of nuclear weapons and an increased risk of a radiological incident.”


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U.S. Army Capt. Eliot Fletcher, commander of the 491st Medical Area Support, U.S. Army Reserve, presents information on warfare in a radiological environment during the Interallied Confederation of Officers of medical reserve on August 3, 2022 in Athens, Greece.
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U.S. Army Capt. Eliot Fletcher, commander of the 491st Medical Support Area, U.S. Army Reserve (fifth from right), joins the U.S. delegation participating in the Changing of the Guard in Athens, Greece, for the Interallied Confederation of Medical Reserve Officers in August. , 2022.
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Fletcher explained how ionizing radiation damages DNA and the body’s ability to repair damaged DNA and continue normal cell function. (Ionizing radiation provides enough energy to disrupt the normal structure of surrounding materials, such as living tissue. Tissue damage occurs when DNA repair is overwhelmed). A person’s typical exposure to background radiation is 2.4 millisieverts, or mSv per year, and at 100 mSv there is a slightly increased risk of cancer.

Fletcher then examined the biology of radiation through five historical exhibits. Hiroshima and Nagasaki both experienced extremely high exposure due to the use of nuclear weapons.

“Detonating a bomb high enough that the fireball does not actually hit the Earth’s surface is called an air blast. Conversely, a nuclear bomb that explodes at surface level, on land or in water, is perceived as an explosion on the surface,” Fletcher said.

Both explosions were surface explosions, dragging debris into the air, resulting in radioactive fallout. These explosions resulted in the exposure of a large number of people to high levels of radiation. To this day, thousands of people are still being followed for high rates of cancer. The survivors had a significantly elevated rate of cancer, while their offspring showed no signs of increased abnormalities and no detected elevation in mutation rate.

The study of the Chernobyl disaster in 1986 (due to the shutdown of a reactor causing the explosion of reactor 4) and the Fukushima nuclear accident in 2007 (due to an earthquake and a subsequent tsunami damaging cooling systems and resulting in partial meltdown of reactors and release of radiation) focusing on increased health problems, acute radiation illnesses and potential for cancer as a function of distance from the epicenter and radiation exposure levels.

“The lessons learned from these radiological/nuclear incidents are directly related to the effects of specific doses of radiation on biology. They also taught us how difficult it is to track people exposed to radiation and determine their exact dose,” Fletcher said. “This highlights the importance of being able to track the amount of radiation a soldier is exposed to in order to treat that person specifically.”

Fletcher concluded the presentation by drawing attention to the invaluable data obtained from radiation during space travel and its applicability to the battlefield. Radiation protection in space is crucial, as some radiation particles can penetrate the skin, damage cells and DNA, and/or cause acute radiation sickness. However, unlike most environments, it is impossible to escape space radiation while traveling in space. Similarly, in a radioactive combat zone, it may not be possible to quickly escape from a radioactive environment.

“The Russian invasion of Ukraine has brought to the fore at least two concerns, 1) an increased global threat of a radiological disaster and 2) rapid entry and exit will be difficult in large-scale operations. two concerns are combined, it creates an environment for the warfighter in which we need to begin to prepare to fight and operate for potentially extended periods of time in a radiological environment,” Fletcher said.

Fletcher was awarded the CIOMR JMROW “Best Overall Presentation” award and will pursue a position as a technical adviser with the NATO CBRN Task Force.

Fletcher’s unit, the 491st MCAS, is currently assigned to the Command and Control CBRN Response Element-A, or C2CRE-A, mission. Under the direction of the Secretary of Defense, the Military CBRN Response Enterprise will conduct CBRN response operations in the United States and its territories or outside the continental United States to support civil authorities in response to CBRN incidents in order to save lives and minimize human suffering.

The 491st MCAS conducts quarterly training exercises to hone decontamination tactics and techniques and identify and treat acute radiation syndrome and chronic radiation sickness. Since 2019, the unit has trained at Exercise Guardian Response at Muscatatuck Urban Training Center, Indiana, conducting a CBRN disaster in a controlled environment.

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