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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

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Public health risks in radiological emergencies

Public Health RisksinRadiological Emergencies

Public Health and Healthcare Issues

Public health and healthcare

Public Health and Healthcare

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

Planning and communication

Planning and Communication

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