The treatment of severe injuries resulting from major nuclear accidents faces significant challenges due to the complex causes and severity of these injuries, the unique rescue environments, and a current lack of unified national standards. To make emergency medical rescue more scientific, standardized, and timely, this consensus focuses on the specific injury factors at nuclear accident sites and provides a standardized approach for managing life-threatening multiple and combined injuries. It introduces the guiding principles of "balancing radiation and injury" and "timely treatment", which guide clinical practice based on a damage-control concept. The former requires simultaneous decontamination and the dual achievement of treating trauma and controlling radiation hazards. The latter prioritizes rapidly stabilizing vital signs through emergency measures like hemostasis and respiratory/circulatory support, followed by staged damage control surgery for wounded personnel who require it. This expert consensus, developed through evidence-based medicine and extensive multidisciplinary expert discussion, systematically incorporates protective measures for special populations such as children and pregnant women, and for the first time identifies psychosocial trauma as a core pathological feature influencing physiological outcomes, mandating its assessment and intervention. The consensus aims to guide medical response during both the early and subsequent phases of a major nuclear accident and is applicable to hospitals, emergency teams, and institutions involved in formulating national standards.