A comprehensive primer on the threat posed by radiological dispersion devices, or "dirty bombs," and the management challenges for first responders is presented. The discussion is scenario-driven, presenting guidance for medical responders as to triage and treatment priorities in the face of radiation risk. Key questions are posed that present the need for operational and tactical planning, equipping, and training around this scenario. Decontamination priorities and potential medical management are discussed for both victims and responders.