Gastrointestinal effects may include nausea and vomiting on the first day. A two-week “latent period” may ensue in which symptoms disappear but then reappear in milder form. Generally, the more severe the symptoms in the beginning, the slower the process of recovery. Individuals with these levels of radiation dosages are excellent candidates for recovery.
Individuals with dosages in this range can display symptoms ranging from mild to severe. Nausea, vomiting, diarrhea, lack of appetite, etc., are the most obvious characteristics. The more severe the symptoms, the higher the radiation dosage absorbed may be assumed. Again, there may be a latent period of a week or perhaps only several days. Higher dosages produce skin hemorrhages, bleeding in the mouth and urine, and, with dosages above 200 rems, a loss of hair. A swelling of the throat is not uncommon. In the 600+ rem stage, high uncontrollable fevers may be present, as well as emaciation. Death in these cases is probable in 80 to 100 percent of the cases. Judgments as to the extent of medical services to be provided are therefore advised.
Gastrointestinal symptoms are the most obvious: extreme vomiting, diarrhea, nausea, prostration, ataxia (loss of motor control), and difficulty in breathing. Individuals displaying these symptoms will almost certainly die within several days to two weeks. You are not likely to see individuals with such severe symptoms. All subjects arriving in a coma or comalike state should immediately be referred to medical authorities for handling.
Undoubtedly, these guidelines are not complete, nor are they intended to be inflexible. However, the immediate need to process large numbers of incoming civilians is crucial in order to assure adequate distribution of medical supplies and attention, food and clothing, shelter, and relocation services.
MESSAGE BY COURIER
SIGNED RECEIPT MANDATORY
TO ALL DIRECTORS, CIVILIAN AND MILITARY MEDICAL FACILITIES IN THE CONTINENTAL UNITED STATES
FROM U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, CENTERS FOR DISEASE CONTROL (CDCHDQ) ATLANTA
10 FEBRUARY 1989
Pursuant to the War Emergency Act (23 CFR 586, Sections 18-35) and Executive Order 15, you are hereby instructed to implement at once the emergency triage procedures necessary for the treatment of war victims. This action is taken in view of the catastrophic numbers of victims requiring medical attention and the overall burden on existing facilities. The unavailability of adequate numbers of trained personnel and supplies, presently and for the immediate future, poses a major health hazard. The unprecedented nature of the emergency facing this nation mandates the immediate implementation of selection procedures for treatment. Communities can expect severe resistance, but you are reminded that the first task facing this nation is that of survival; existing facilities, personnel, and supplies must be directed to those populations with the greatest probability of survival.
Therefore, as of 1200 hours, 10 February 1989, you are instructed to triage victims according to the following requirements:
1.0 GENERAL INJURIES (Non-radiation-induced)
Mild to Severe: Injuries of this nature, such as burns, fractures, contusions, etc., may be treated as conditions allow.
Severe to Critical: Treatment should be limited to victims with greatest possibilities of recovery. Medical supplies should be limited accordingly.
Severely Critical: No treatment desirable.
2.0 RADIATION-INDUCED INJURIES
Treatment should be accorded on the basis of radiation dosage absorbed. Whole-body measurements should be taken whenever possible: in cases where this cannot be done, interviews should attempt to ascertain proximity to radiation zones and duration of exposure. The following schedule should then be utilized:
| 0 to 100 REMS | No treatment necessary. |
| 100 to 200 REMS | Treatment limited to radiation symptoms such as flash burns, nausea, vomiting, etc. No other treatment desirable. |
| 200 to 450 REMS | Medical assistance most valuable here. At upper levels (350+), chances of recovery with medical attention are 50 percent. |
| 450+ REMS | No treatment desirable. |
It is not known at this time whether radiation injuries are more severe in cases where radiation is absorbed all at once or cumulatively.
Your government is aware of the implications of this order.
Steps are being taken by appropriate military authorities to provide assistance to you in implementation of triage instructions. You will be provided with further information as soon as it is available. You will be instructed as soon as possible regarding the cessation of triage requirements.
Hector Espinoza, Aztlan Leader
[ENTRY IN TO AZTLAN: RUMOR TO REALITY. Officially, Aztlan starts in Monahans. The actual border, however, was not encountered until we reached the former town of Van Horn, now called Ciudad de Reforma.
The Texas & Western Bus Company stops on this side of the big white gate that has been erected across I-20. When we arrived at the border, we found that we were expected. Governor Parker had sent a special message to the Foreign Minister of Aztlan, apparently right after our interview.
Despite the differences between Texas and the new country, this letter smoothed our passage and enabled us to gain access to the highest Aztlan authorities. Once in El Paso, Aztlan’s capital, we found that the real power in the country is centered around the Foreign Minister, who has obtained recognition from most of Latin America, Spain, and a number of African countries. Even more important, he has obtained much friendly help from Japan.
There is no reason, really, to introduce Senior Espinoza. He speaks very well for himself.]
