EMERGENCY MEDICAL MANAGEMENT OF RADIATION ACCIDENTS ON SITE AND PRE-HOSPITALIZATION Module XVI
Medic’s problem • What is a radiation accident? • Is it frequent? • What kind of health consequences may it lead to? • What are the main types of radiation injury? • What are the risks to myself and my colleaguesin treating a radiation accident victim? • What should I do first? • How can I reduce the harm in a radiation accident? Module Medical XVI.
Radiation accident statistics, 1944–June 2001 • Radiation accidents are rare: • In 1944-June 2001420 radiation accidents led to significant overexposure of at least one person Among 3000 overexposed persons 133 fatalities registered • However, loss of control over radiation sources has led to more severe accidents recently Module Medical XVI.
Types of accidental exposure and associated risk to medical staff • Medical response depends on typeand extent of exposure: • Exposure of public, workers, patients • External exposure only • External/internal contamination • Combined exposure and injuries • NO radiation threat yet to medical responders on site Module Medical XVI.
Triage Triage - first task for multiple casualties: • Sorting of victims depending on condition, urgent needs and number • Decision on • prompt FIRST medical intervention - life saving • immobilization of fractures • urgent investigations Module Medical XVI.
Radiation does not cause: • Immediate death • Immediate burns or wounds • Irradiation alone • not immediate threat to victim • not threat to responders or others Module Medical XVI.
Radiological emergency response team • Teamco-ordinator • Emergency physician • Triage officer • Nurse • Technical recorder Module Medical XVI.
Radiological emergency response team • Radiation safety officer • Public information officer • Administrator • Security personnel • Maintenance personnel • Laboratory technician Module Medical XVI.
Assessment ofaccident scene • What hazards present? • People injured? • How long accident in progress? • How material released to environment? • Where victim in relation to radioactive material? Module Medical XVI.
Assessment ofaccident scene Module Medical XVI.
Notification and accident verification Get call-back number and verify accident prior to assembling radiological emergency response team Assume victim is contaminated until proven otherwise Advise ambulance personnel of any special entrance to emergency department for the radiation accident victim Module Medical XVI.
Notificationto receive radiation accident victims • Number of victims • Each victim’s medical status • Radiological status of victims (exposed/contaminated) Module Medical XVI.
Contamination control during rescue operations • Use personal protective measures and means • Do not eat, drink, smoke, rub eyes, or apply make-up in contaminated area • Use good work practices • appropriate equipment • control lines. • assume contamination when in doubt Module Medical XVI.
Contamination control: patient care • Remove contaminated clothing • Cover patient and secure • Transfer patient • Clean team transfer Module Medical XVI.
Contamination control for ambulance personnel • Remove protective gear at control line and get surveyed • Clean team can transport patient to hospital OR • Remove protective gear, put on clean gloves and gown, and transport patient • At hospital, transfer patient to clean treatment table in contaminated patient area • Await survey for contamination Module Medical XVI.
SUMMARY - Actions of primary significance in pre-hospital medical management of radiation accidents 1. Rescue, resuscitation, emergency aid 2. Medical stabilization of general condition of victim and of serious injuries 3. Removal of patients from contaminated area 4. Assessment of external contamination 5. Decontamination and decorporation - preventing internal contamination of patient and contamination of staff Module Medical XVI.