192
17 Medical Response
6. The hospital should minimize the spread of contamination by using double
sheets and stretchers to transport patients from the ambulance to treatment
areas
7. Staff should be able to recognize and treat patients who have been exposed to
high levels of radiation
8. Staff should be able to recognize radiation injury
9. The hospital should maintain a list of agencies and organizations to contact in
case of a radiological emergency
10. Hospital staff should develop a plan to evaluate and counsel uninjured patients
who were exposed to radiation.
Some of these are fairly straightforward radiation safety problems; the difficulty
is that emergency and medical responders are not radiation workers and what is
relatively simple and straightforward to radiation workers is not necessarily known
to emergency or medical responders. In addition, the relative lack of understanding as
to the health effects of radiation can cause medical responders to be more concerned
about the dangers of radiation than is warranted. This, in turn, can lead them to delay
needed treatment or to give radiological concerns a higher priority than they ought
to have.
Many of these issues will be discussed in this chapter.
17.1 Medical Care at the Scene
Medical care at the scene of an explosion should focus on largely the same things
whether the explosion includes radioactivity or not; as has been noted elsewhere
in this book, priority must be given to life-endangering medical issues (e.g. arterial
bleeding, amputated limbs, crush injuries, etc.) followed by lesser injuries. If it is
high, the radiation dose rate might complicate rescues at the scene, but will drop off
quickly with distance from any source(s) and will have little effect on medical care
provided outside of the Hot Zone. Contamination levels might also complicate the
work that needs to be performed due to requiring personnel to wear appropriate PPE
and possibly to perform decontamination, but it will rarely be a controlling factor
(Fig. 17.1).
When performing rescues at the scene of an attack the primary consideration
should be the safety of those being rescued and of the responders performing the
rescue. If conditions at the scene are more or less safe and stable then the safest
course of action might well be to stabilize the person being rescued before moving
them from the area; this avoids causing or exacerbating injuries that might occur when
moving the victims. If, however, conditions at the scene are potentially dangerous
due to fire, unstable structures, ruptured or broken utility lines, high radiation dose
rates, or other factor(s) then the victim(s) should be moved to a location that poses
little risk in and of itself so that the victim can be stabilized in safety. In addition,
17 Medical Response
6. The hospital should minimize the spread of contamination by using double
sheets and stretchers to transport patients from the ambulance to treatment
areas
7. Staff should be able to recognize and treat patients who have been exposed to
high levels of radiation
8. Staff should be able to recognize radiation injury
9. The hospital should maintain a list of agencies and organizations to contact in
case of a radiological emergency
10. Hospital staff should develop a plan to evaluate and counsel uninjured patients
who were exposed to radiation.
Some of these are fairly straightforward radiation safety problems; the difficulty
is that emergency and medical responders are not radiation workers and what is
relatively simple and straightforward to radiation workers is not necessarily known
to emergency or medical responders. In addition, the relative lack of understanding as
to the health effects of radiation can cause medical responders to be more concerned
about the dangers of radiation than is warranted. This, in turn, can lead them to delay
needed treatment or to give radiological concerns a higher priority than they ought
to have.
Many of these issues will be discussed in this chapter.
17.1 Medical Care at the Scene
Medical care at the scene of an explosion should focus on largely the same things
whether the explosion includes radioactivity or not; as has been noted elsewhere
in this book, priority must be given to life-endangering medical issues (e.g. arterial
bleeding, amputated limbs, crush injuries, etc.) followed by lesser injuries. If it is
high, the radiation dose rate might complicate rescues at the scene, but will drop off
quickly with distance from any source(s) and will have little effect on medical care
provided outside of the Hot Zone. Contamination levels might also complicate the
work that needs to be performed due to requiring personnel to wear appropriate PPE
and possibly to perform decontamination, but it will rarely be a controlling factor
(Fig. 17.1).
When performing rescues at the scene of an attack the primary consideration
should be the safety of those being rescued and of the responders performing the
rescue. If conditions at the scene are more or less safe and stable then the safest
course of action might well be to stabilize the person being rescued before moving
them from the area; this avoids causing or exacerbating injuries that might occur when
moving the victims. If, however, conditions at the scene are potentially dangerous
due to fire, unstable structures, ruptured or broken utility lines, high radiation dose
rates, or other factor(s) then the victim(s) should be moved to a location that poses
little risk in and of itself so that the victim can be stabilized in safety. In addition,