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Public Health Risks in Radiological Emergencies. Public Health and Healthcare Issues. Public Health and Healthcare. Mass Casualty Events. Produce large number of patients quickly

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public health risks in radiological emergencies

Public Health RisksinRadiological Emergencies

Public Health and Healthcare Issues

mass casualty events
Mass Casualty Events
  • Produce large number of patients quickly
  • Surge of patients with severe and minor injuries can rapidly stress the healthcare system and first receivers
  • The majority of injured self report to healthcare facilities
  • Injured report to the closest hospitals to the event
radiation mass surge event
Radiation Mass Surge Event
  • Radiation further complicates response and adds additional stress to a stressful situation
  • Radiation raises the fear of contamination in staff who have little understanding of radiation
  • Radiation increases the number of worried well wanting medical evaluation and monitoring
perspective on mass surge
Perspective on Mass Surge
  • It is estimated that 10% of the total population will want to be screened for radioactivity exposure
  • Psychological trauma is the driving force
fukushima japan 2011
Fukushima, Japan 2011
  • 200,000 of a population of 2 million people were scanned and evaluated for contamination
  • Fear of contamination
  • Fear of health consequences
goiania brazil 1987
Goiania, Brazil 1987
  • 249 people found significantly contaminated
  • 112,000 were evaluated and screened
tokyo sarin attack
Tokyo Sarin Attack
  • Saint Luke’s International Hospital
  • 27% of staff contaminated
  • 526 victims
  • Over 5000 evaluated
  • Majority psychological
cdc guiding principles
CDC Guiding Principles
  • First priority is to save lives and treat the injured first
  • Contamination with radioactive materials is not immediately-life treating
  • Initial population monitoring activities should focus on preventing acute radiation health effects
  • Scalability and flexibility are an important part of the planning process
cdc guiding principles continued
CDC Guiding Principles Continued
  • Fear of radiation is high, higher than with other agents of terrorism
  • Radiological decontamination differs from those for chemical agents
  • Law enforcement agencies will be involved in response to a radiological terrorism event
roles and responsibilities of public health
Roles and Responsibilities of Public Health
  • CDC lists 15 responsibilities for federal, state and local Public Health
  • “As a general rule, during the initial stages of the incident local and state officials should be prepared to handle the crisis without federal


(CDC PopulationmonitoringinRadiationEmergencies)

roles and responsibilities
Roles and Responsibilities
  • Protecting the public’s health
  • Monitoring workers health and safety
  • Ensuring safe shelters for the population Ensuring the safety of food and water
  • Coordinating sampling and laboratory analysis of bio and environmental samples
  • Conducting field investigations
  • Monitoring people who may have been contaminated with radioactive materials or exposed to radiation
  • Conducting or assisting in decontamination
  • Recommending management protocols for affected populations or individuals
hospital mass surge issues
Hospital Mass Surge Issues
  • Patients arrive before the event is recognized as radiological by first responders
  • Contamination of the ER occurs before the event is recognized as radiological
  • Staff ill prepared to deal with radiological effected patients
  • Correct staff not present
  • Surge of worried well stresses facility’s ability to care for the seriously injured
hospital mass surge issues1
Hospital Mass Surge Issues
  • Hospital staff lack the ability to communicate with the massive crowds of people
  • Staff fearful of radiation and the large crowds seeking care
  • Limited decon capabilities and limited ability to scan patients for radiation
  • Traffic management issues, abandoned cars, contaminated cars
the role of community reception centers
The Role of Community Reception Centers
  • To divert people with minor or no injuries away from the hospital for scanning and counseling
  • To decrease the impact of surge on patient care and hospital staff
  • To identify people who may need immediate assistance----decontamination, medical attention, psychosocial needs
objectives of monitoring
Objectives of Monitoring
  • Identify individuals whose health is in immediate danger
  • Identify people who may need medical treatment for contamination or exposure
  • To try to minimize future health for long term health monitoring
  • Register potentially affected populations for long term health monitoring
security needs
Security Needs
  • Traffic management at hospitals and Reception Centers
  • Security of facilities inside and on grounds
  • Risk of facility contamination
  • Threatening environment to staff responding to the incident
  • Risk as a secondary target
why security for hospitals
Why Security for Hospitals
  • Represent critical infrastructure in their community
  • Symbols of safety and security for a community being affected by a mass casualty event
  • To ensure safety of staff while providing care to the surge of patients
  • To facilitate traffic flow, campus lock down, facility lock down
why reception center security
Why Reception Center Security
  • Traffic management
  • Crowd containment and management
  • Safety of staff and patients
  • Secondary target
  • Limit access to the facility and grounds
  • Security of personal belongings