REAC/TS shares unique radiation emergency medicine expertise with the world

The Radiation Emergency Assistance Center/Training Site (REAC/TS) in Oak Ridge, Tennessee, provides 24/7 emergency response to radiological/nuclear incidents around the globe. REAC/TS also educates health care personnel, first responders and others with the most advanced techniques for medical management of radiation incidents. In 2018, REAC/TS conducted courses in its own backyard and traveled internationally to present education tailored to meet diverse needs of a wide range of emergency and health professionals.

Hands on in East Tennessee

A collaborative effort between REAC/TS and the Knox-East Tennessee Healthcare Coalition has led to three, half-day educational offerings annually, open to anyone in the community who would potentially be part of the response effort in a radiological/nuclear emergency. The courses provided an overview of health physics and emergency medical care that emphasized, through lectures and a hands-on exercise, the practical aspects of initial pre-hospital and hospital management of contaminated patients. Ninety-three local emergency responders and health care providers have completed these courses.

“This course can be disseminated throughout the rest of the state via support from the other seven regional health care coalitions. It may serve as an educational best practice model that can be utilized throughout the country to enhance communities’ response to such events,” said REAC/TS Nurse/Paramedic Angie Bowen.

This collaborative effort also led to two poster presentations at the National Healthcare Coalition Preparedness Conference (San Diego, November 2017, and New Orleans, November 2018) as well a speaking invitation at the 2018 Emergency Management Summit and Training Session, which reached more than 900 participants. New partnerships with NATO and Estonia As part of its global mission, REAC/TS staff traveled to Tartu, Estonia, in August 2018, to conduct an International Medical Management of Radiation Injuries (I-MED) Course, hosted by the Estonia National Defence College. It was sponsored in cooperation with the North Atlantic Treaty Organization Center of Excellence (NATO COE) for Military Medicine and the National Nuclear Security Administration’s (NNSA) Office of Counterterrorism and Counterproliferation’s Office of Nuclear Incident Policy and Cooperation. This was the first I-MED course conducted under this new partnership with the NATO COE for Military Medicine.

Twenty-eight representatives from five countries, including Estonia, Finland, Lithuania, Romania and the United Kingdom, participated in the course. In addition to medics, nurses and physicians of the defense forces, participants included health care personnel from civilian hospitals and ambulance services, rescue personnel and representatives from the Estonian Environmental Board and the Estonian Defense Industry Association.

Participants learned how to diagnose radiation illnesses and injuries, treat patients with suspected contamination and determine the most appropriate levels of personal protective equipment to wear. They also participated in exercises and learned techniques for reducing the spread of radioactive contamination during medical care and treatment. One military physician participant commented, “After this course, I will look totally differently on radiation injuries.”

“Some of the participants indicated they had never had this type of course before,” said REAC/TS Director Carol Iddins, M.D. “We consider this the beginning of an unlimited new partnership with the NATO COE to educate more people about the medical management of radiation incidents.”

Learning with Japan REAC/TS continued global collaborative efforts by working with colleagues in Japan to provide radiation emergency medicine education. Iddins traveled to Hiroshima and Nagasaki in February 2018, where she presented the “Medical Treatment of Acute Radiation Syndrome” at the Research Institute for Radiation Biology and Medicine at Hiroshima University. The presentation was part of the 13th Phoenix Leader Education Program Seminar. During the same trip, she presented the “Medical Management of Radiological/Nuclear Casualties: An Overview and Focus on Cutaneous Radiation Injuries” in Nagasaki at the 2nd Annual International Symposium of the Program of the Network-type Joint Usage/Research Center for Radiation Disaster Medical Science. Faculty members from Hirosaki University Center for Radiation Support and Safety visited REAC/TS in March to learn about various aspects and processes of emergency medical systems. REAC/TS also facilitated a visit with local pre-hospital and in-hospital emergency providers during this meeting.

In August, REAC/TS hosted a course participant and special guest lecturer, Professor Nobuyuki Hirohashi, M.D., Ph.D., who presented “New Radiation Emergency Medical System in Japan: Lessons Learned from Fukushima and Hiroshima” as part of the REAC/TS Advanced Radiation Medicine Course. Professor Hirohashi is recognized globally for his role in the response to and recovery from the Great East Japan Earthquake and Tsunami in 2011.

At the end of September, REAC/TS Health Physicist Jason Davis, Ph.D., CHP, was an invited speaker at the 5th Educational Symposium on Radiation and Health by Young Scientists (ESRAH 2018) held in Sapporo, Japan. ESRAH is organized by Hirosaki University and co-hosted by Hokkaido University. The symposium served as an informational exchange and discussion forum on topics such as radiation effects on the environment and human body, radiation protection, radiation detection and emergency medicine. Davis presented “Dose Estimates to Medical Practitioners Following a Radiological Incident.”

“Radiation protection is often an afterthought in radiation biology, radiology and radiation oncology training programs,” said Davis. “ESRAH was a great opportunity to engage young investigators as they look for a better understanding of the radiation effects on the human body.”

NASA, Mars and beyond

During 2018, REAC/TS made multiple trips to the Kennedy Space Center (KSC) for meetings focusing on the Department of Energy/NNSA support for the Mars 2020 mission. In February, REAC/TS Business Operations Manager and Health Physicist Mark Jenkins, Ph.D., CSP, visited three hospitals near KSC to prepare for a presentation at the Mars 2020 Radiological Contingency Planning Meeting and to help structure an education outreach plan. The launch of the Mars rover involves a radioisotope thermal generator (RTG). This presents opportunities for education for the medical communities surrounding KSC in basic radiation physics, instrumentation, RTG characteristics related to patient care, decontamination procedures for patients and internal contamination and treatment with medical countermeasures.

In June, Davis and Iddins were invited to speak at the 2018 National Aeronoutics and Space Administration (NASA) Occupational Health Meeting at the Space Station Processing Facility at KSC. One hundred and twenty occupational health, environmental health, radiological health and industrial hygiene providers attended from the 10 NASA field centers from across the United States. Iddins presented “Biological Effects of Radiation,” and Davis presented “Industrial Radiography Accidents” in the Environmental Health Track.

While at the meeting, Iddins and Davis visited the Brevard County Emergency Operations Center to discuss preparations involved with the Mars 2020 launch. REAC/TS is continuing its mission in the coming year to respond and educate both within the United States and globally. Local, national and international courses are already scheduled to help improve public health and safety around the world.