The limitations of diethylenetriamine pentaacetic acid (DTPA) use in radiological mass casualty events: Challenges and future directions

Authors

DOI:

https://doi.org/10.5055/ajdm.0505

Keywords:

diethylenetriamine pentaacetic acid, mass casualty management, chemical, biological, radiological, nuclear, radiation emergency, chelation therapy, internal contamination, radiation countermeasures

Abstract

This paper examines the critical challenges associated with the use of diethylenetriamine pentaacetic acid (DTPA) as a chelating agent in radiological mass casualty incidents (MCIs). While DTPA is effective in binding and removing certain radioactive isotopes from the body, its use in MCI is significantly restricted by logistical barriers that prevent timely administration to large numbers of individuals. The requirement for delivery either intravenously or by nebulizer, which is recommended only for inhalational exposure and not approved for pediatric use, necessitates specialized medical personnel and equipment, making DTPA infeasible for MCI. This paper emphasizes the urgent need for the development of alternative countermeasures that are easy to administer to large numbers of people, suitable for both adults and children, and capable of being rapidly deployed in the event of a radiological emergency.

Author Biographies

Eman Alshaikh, MD, FIBODM

Department of Emergency Medicine, Beth Israel Deaconess Medical Center; Harvard Medical School, Boston, Massachusetts; Emergency Department, Rashid Hospital Trauma Center, Dubai Health, Dubai, UAE

Attila J. Hertelendy, PhD

Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts

Fadi Issa, MD

Department of Emergency Medicine, Beth Israel Deaconess Medical Center; Harvard Medical School, Boston, Massachusetts

David DiGregorio, PA, MSEM

Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts

Amalia Voskanyan, RN

Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts

Gregory Ciottone, MD

Department of Emergency Medicine, Beth Israel Deaconess Medical Center; Harvard Medical School, Boston, Massachusetts

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The limitations of diethylenetriamine pentaacetic acid (DTPA) use in radiological mass casualty events: Challenges and future directions

Published

03/01/2025

How to Cite

Alshaikh, Eman, et al. “ The Limitations of Diethylenetriamine Pentaacetic Acid (DTPA) Use in Radiological Mass Casualty Events: Challenges and Future Directions”. American Journal of Disaster Medicine, vol. 20, no. 1, Mar. 2025, pp. 59-64, doi:10.5055/ajdm.0505.

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