As part of the C.W. Bill Young Cell Transplantation Program (Program), contractors must have an emergency response process. Additionally, the Program has created a specialized group, the Radiation Injury Treatment Network® (RITN). The RITN was developed to respond to a potential disaster resulting in mass casualties with marrow toxic injuries from ionizing radiation exposure or other hazardous material (such as sulfur mustard). The marrow creates new blood-forming cells each and every day. If the marrow is injured and cannot do this, a person may need a bone marrow or umbilical cord blood transplant. Many of the casualties with radiation injury from such an incident will be salvageable but require outpatient and/or inpatient care.
Recognizing this, theNational Marrow Donor Program® (NMDP), US Navy, Office of Naval Research and American Society for Blood and Marrow TransplantationTM (ASBMT) collaboratively developed RITN, which comprises of medical centers with expertise in the management of bone marrow failure, stem cell donor centers and umbilical cord blood banks across the US.
The RITN goals include:
After a marrow toxic incident resulting in mass casualties, RITN centers may be asked to:
The RITN has developed and offers to those who are interested web based training related to radiological disaster preparedness; all are accessible through www.RITN.net/training. Additionally, it coordinates training opportunities for its network of transplant centers, donor centers, and cord blood banks. All other Program centers and banks are informed about the RITN and may be asked to help during an emergency that exceeds the response capabilities of the RITN.
Each facility incorporates the RITN Acute Radiation Syndrome treatment guidelines into their response plans, conducts annual radiological disaster training, communication drills and participates in an annual situational tabletop exercise (a scenario-based discussion of the response process) to assess and improve plans, procedures, and staff preparedness.
The RITN conducts a number of exercises each year to assess current planning and training efforts being made across the network. These exercises vary from discussion based tabletop exercises (TTX) to complex multi-day full scale exercises (FSE) simulating casualties arriving at the hospital via the National Disaster Medical System (NDMS). Each year the RITN develops an annual TTX that all network hospitals must participate in. This exercise is conducted utilizing web-based tools that allow hospitals to share best practices and discuss issues as a group.
Through the RITN Exercise Grant Program network hospitals are able to receive grants to support the development and conduct of additional functional and full scale exercises. These grants allow hospitals to validate their current plans and procedures related to an RITN activation and bring in local, state and federal stakeholders to participate.
In addition to RITN sponsored exercises the RITN provides technical support to local and state jurisdictions developing radiological exercises.
Since 2006 RITN has supported hundreds of radiation scenario exercises conducted by hospitals across the nation.
Centers are dispersed throughout the United States; some are pediatric treatment centers.
The RITN was developed through the cooperative efforts of the National Marrow Donor Program (NMDP) and the American Society for Blood and Marrow Transplantation (ASBMT). The NMDP and ASBMT collaborated with: