Managing Radiation Emergencies
Guidance for Prehospital Emergency Services
Guidelines for Emergency Medical Management
1. Approach site with caution--look for evidence of hazardous materials.
2. If radiation hazard is suspected, position personnel, vehicles, and command post at a safe distance (approx. 150 feet) upwind and uphill of the site.
3. Notify proper authorities and hospital.
4. Put on protective gear and use dosimeters and survey meters if immediately available.
5. Determine whether injured victims are present.
6. Assess and treat life-threatening injuries immediately. Do not delay advanced life support if victims cannot be moved or to assess contamination status. Perform routine emergency care during extrication procedures.
7. Move victims away from the radiation hazard area, using proper patient transfer techniques to prevent further injury. Stay within the controlled zone if contamination is suspected.
8. Expose wounds and cover with sterile dressings.
9. Victims should be monitored at the control line for possible contamination only after they are medically stable. Radiation levels above background indicate the presence of contamination. Remove the contaminated accident victims' clothing, provided removal can be accomplished without causing further injury.
10. Move the ambulance cot to the clean side of the control line and unfold a clean sheet or blanket over it. Place the victim on the covered cot and package for transport. Do not remove the victim from the backboard if one was used.
11. Package the victim by folding the stretcher sheet or blanket over and securing them in the appropriate manner.
12. Before leaving the controlled area, rescuers should remove protective gear at the control line. If possible, the victim should be transported by personnel who have not entered the controlled area. Ambulance personnel attending victims should wear gloves.
13. Transport the victims to the hospital emergency department. The hospital should be given additional appropriate information, and the ambulance crew should ask for any special instructions the hospital may have.
14. Follow the hospital's radiological protocol upon arrival.
15. The ambulance and crew should not return to regular service until the crew, vehicle, and equipment have undergone monitoring and necessary decontamination by the radiation safety officer.
16. Personnel should not eat drink, smoke, etc., at the accident site, in the ambulance, or at the hospital until they have been released by the radiation safety officer.
Reference: Ricks, R.C., Prehospital/ Management of Radiation Accidents, ORAU 223, Oak Ridge Associated Universities, Oak Ridge, TN, 1984.
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