Becker and Middleton reply:

We are grateful to Drs D’Orazio and Greenberg for their thoughtful comments and for sharing the results of their important new survey of hospital emergency departments (EDs) in the Philadelphia area. Their findings—that a majority of hospitals had no specific training in radiation emergencies, that just 1 in 10 hospitals had a Geiger counter in the ED, and that no hospital felt “very capable” of handling a radiation emergency—complement our own research and serve to further emphasize the urgent need for more attention to radiological/nuclear preparedness. In the event of a terrorist attack using radioactive materials (eg, a “dirty bomb” or even an improvised nuclear weapon), the dedicated, skilled professionals who work in the nation’s hospital EDs will be on the front line in terms of caring for the sick and injured and addressing the effects of the incident. Based on our research and the research by Drs D’Orazio and Greenberg, it is clear that the nation needs to do more to ensure that hospitals and ED professionals have the tools, information, and training they need to deal effectively with this emerging threat.