A wide spectrum of scenarios may lead to radiation incidents and the liberation of radioactive material. In the case of a terrorist attack by a "dirty bomb"

there is a risk of mechanical and thermal trauma

external irradiation

superficial contamination and incorporation of radioactive material. The first treatment priority must be given to the care of trauma patients with life-threatening injuries

as the health effects of radiation occur with latency. Radionuclide incorporation will lead to a longer-lasting irradiation from inside the body

associated with a higher risk of stochastic radiation effects（e.g.

occurrence of tumors） in the long run. It must be expected that victims with potentially incorporated radionuclides will far outnumber trauma patients. The elimination of radionuclides can be enhanced by the administration of decorporation agents such as（Ca） Diethylenetriaminepentaacetic acid（DTPA） or Prussian blue

reducing the radiological burden of the body. There is still no consensus whether decorporation treatment should be started immediately based only on a suspicion of radionuclide incorporation（"urgent approach"） or if the results of internal dosimetry confirming the necessity of a treatment should be awaited

accepting the delay caused by the measurements and computations（"precautionary approach"）. As the therapeutic effectiveness may be substantially decreased if treatment initiation is delayed only by several days

depending on the radionuclide

the physicochemical properties of the compounds involved and the route of absorption

we favor an "urgent approach" from a medical point of view. In doubt

it seems justified to treat victims by precaution

as the adverse effects of the medication seem minimal. However

in the case of a high number of victims

an "urgent treatment approach" may require a large number of daily doses of antidotes

and therefore

adequate investments in preparedness and antidote stockpiling are necessary.