1 / 29

Hospital Response to Radiological Events – Part II

Hospital Response to Radiological Events – Part II. Objective. Discuss roles of hospital radiation advisors during radiological events. Preparedness Training Command, control, communication PPE Detection Triage. Decontamination Contaminated remains Logistics Evidence preservation

kamea
Download Presentation

Hospital Response to Radiological Events – Part II

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Hospital Response to Radiological Events – Part II

  2. Objective • Discuss roles of hospital radiation advisors during radiological events

  3. Preparedness Training Command, control, communication PPE Detection Triage Decontamination Contaminated remains Logistics Evidence preservation Response actions Exercising “ the plan” Roles of the Radiation Safety Officer (RSO)

  4. CBRNE Preparedness Planning • Planning similar to other disasters • Unique characteristics of a radiological event • Must be familiar with local incident management system • “All hazards approach” to disaster planning

  5. Staff Preparedness • Rotate staff • Reduce fatigue from PPE • Reduce overall exposure • Limit exposure to ALARA • Regulatory limits: Annual 100 mrem vs. 5,000 mrem • Lifesaving limits never used for property • Manage exposure and training records

  6. Training • Prepare for HAZMAT contaminated patient • Supplement training to include radiation safety • Train facility-wide, tailored to the needs of hospital staff • Use realistic scenarios • Use equipment in training • Maintain proficiency

  7. Command, Control, & Communications • Accurate, timely notifications • Between event scene and hospital • Internal staff • Between hospitals involved • Internal alarm management • Notify response personnel • Record keeping • Media coordination

  8. Personal Protective Equipment (PPE) • PPE for decontamination personnel • PPE for healthcare providers • Limitations of PPE • Program management • OSHA training • Fit testing • Equipment maintenance

  9. Radiological Self-Protection (For Decontamination Personnel) • Respiratory - Particulate mask (Level C) • Enforce time, distance, and shielding • Dosimeter

  10. Radiation Detection • Recognize exposures • In patient: Information about event, ARS symptoms • In self: Detection instruments • Purposes of detection equipment • Alert to hazards • Hazard assessment • PPE decision • Need for decontamination • Decon efficacy

  11. Monitoring Personnel • Person from the site: responder or patient • Quick frisk technique with pancake probe • Area monitor alerts to radiation source • Staff monitoring • Bring hands to probe or area monitor • Frisk suspect areas by exception

  12. Monitoring Vehicles • Check for surface contamination • Pancake probe, slowly over each suspect area • Vehicle exterior: Doors, tires, wheel wells, hood, wipers (if dry) • Cab: Pedals, steering wheel, floor • Interior: Patient and crew areas • Residues from transport: Protective covers, discarded items, and where patients lay

  13. Monitoring Facilities • Check for elevated radiation first (gamma probe) • Check for surface contamination (pancake probe) • Surfaces: Anything touched or having residues • Equipment used: Handles, exposed surfaces • Check residues before overpack • Decon site and runoff • Patient’s clothing, personal effects, etc. • Staff laundry, used PPE

  14. Radiological Triage • Triage: • Stabilize the patient first • Ensure ABCs • Prevent internalizing • Consider exposures later • Segregate contaminated from not

  15. Radiological Triage (Cont.) Severe medical or life threatening injuries should take precedence over decontamination!

  16. Who Needs Decontamination? • Decon of casualties arriving at the hospital • Already decontaminated • Home showered and laundered • Not decontaminated • Decon of healthcare providers • Decon team members • Treating personnel • Transport and support staff

  17. Personnel Decontamination • Monitor/wash hot spots • Hands: Soap and water • Hair: Shampoo • Feet: Remove shoes • Clothes: Remove outer layer • How-to • Tepid water, not hot/cold • No scrubbing! • Gently rinse • Monitor and repeat as needed

  18. Radioactive Objects On/In Patients • Quick scan to determine radiation hazard • Remove clothing (modestly!) • Account for personal effects • Monitor and control items • Irrigate wounds (if possible) • High radiation objects • Place in tray away from others • Handle with hemostats

  19. Decontamination of Facilities/Objects • Protect area from contamination spread • Plastic sheeting on floor, in vehicles • Survey instrument to locate hot spots • Wash/rinse as needed • Control runoff • Send samples to supporting rad lab

  20. Contaminated Human Remains • All-hazards exposure risk • Decontamination • Containment • Refrigeration until definitive disposal • Follow legal, medical, cultural protocols • Establish cooperative agreements for fatality management • Secure personal effects • Not all can be decontaminated

  21. Logistics • Supply priority: “Get the right stuff to the right place at the right time” • PPE • Detection equipment distribution plan • Decontamination setup • Equipment maintenance program • Calibration • Scheduled checks and services

  22. Handling of Evidence • Maintaining evidence is critical to investigation • Clothing • Embedded objects • Decontamination runoff • Bioassay samples • Chain of custody EVIDENCE

  23. Radiation Response • Plan for who does what, when • Dosimeters: Who wears them? • Survey meters: Priority of effort • Patients? Equipment? Facility? Vehicles? • Area monitors: Which entrances? Remotes?

  24. Radiation Response (cont.) • Actions when alarms occur • Reduce personal exposure • Limit spread of contamination • Isolate danger areas • Decontaminate

  25. Example Area Alarm Response • Security acknowledges alarm • Stop offender, divert to safe area • Questions to investigate alarm • Receive any nuclear medical procedure? • Anyone close receive same? • Work with radioactive materials? • Involved in bombing or suspicious incident? • Where were they last?/Why come to hospital? • Follow up as needed

  26. Exercise the Plan • Start small, few casualties, simple problems • Be realistic—but only as needed • Safely handle radioactive sources • Coordinate with other agencies/hospitals • Exercise with all hazards approach

  27. Tabletop Exercise Guidelines • Define reasonable objectives • Basic scenario to address objectives • Who should/could participate • What level of involvement: Responder? Executive? • What point to start and stop play • Limit actions to discussion (not actually done) • How much is presented to players • Prepared handouts or presentation graphics • Facilitator keep on track and on schedule

  28. Example Tabletop Scenarios • Person enters and sets off alarm • Front door vs. ED • Nuisance vs. actual alarm • Ambulance inbound with reported “hot” patient • Vary type and extent of contamination • Radiation survey discovers contamination • During a radiation event vs. routine check • In the ED vs. foyer • In an ambulance

  29. Key Points • Plan and train for radiological events using all hazards approach • Use these materials to prepare instruction for hospital staff • Basic or advanced radiation safety • Operate and maintain each instrument • Round-table discussion of risk mitigation

More Related