17.2 Preparing the Hospital to Receive Contaminated Patients
199
which the author was stationed; the plastic sheeting could be laid out and taped to
the walls in a matter of minutes.
Note, however, that arrangements such as this must be practiced periodically so
that staff know where the supplies are stored and how they are to be deployed [21–23].
In fact, the most common comment made to the author by workers at the hospitals
and shelters his group visited in Japan during his 2011 trip was “We knew what to
do because we practiced this every year but we never expected to have to do it for
real.”
Putting this together, there are several steps that a hospital can take to prepare to
receive contaminated patients:
1. Construct or modify at least one examination and treatment room to be suitable
for receiving contaminated patients.
2. Obtain contamination control materials for additional treatment rooms.
3. Develop institutional procedures for examining and treating contaminated
patients, including triage for radiological and non-radiological concerns.
4. Train staff, including periodic refresher training and exercises to develop and
maintain skills and familiarity with procedures and equipment.
5. If a radiological incident occurs, set up examination and treatment rooms to
receive contaminated patients.
6. Ensure staff are properly garbed in Personal Protective Equipment while waiting
for the first patients to arrive.
17.3 Medical Care in the Emergency Department
Practitioners of emergency medicine have ample experience in their specialty and it
is not the place of this book to go into the details of their work. However, most who
practice emergency medicine know very little about radiation, its health effects, its
treatment, or even how to recognize radiation injuries and, without such knowledge,
it is difficult to assess the entirety of a patient’s medical needs. Thus, here we will
take a look at the clinical impact of radiation exposure during the first few to several
hours after exposure.
17.3.1 Contaminated Wounds and Injuries and Embedded
Source Fragments
Contamination, whether on the skin or in wounds, can be identified and located
by performing a survey using radiation detectors. Embedded fragments can also be
identified using radiation surveys, in addition to leaving entry wounds at the point
where they entered the body. A high-activity source fragment within the body, though,
can generate a radiation field capable of swamping contamination instruments; thus,
199
which the author was stationed; the plastic sheeting could be laid out and taped to
the walls in a matter of minutes.
Note, however, that arrangements such as this must be practiced periodically so
that staff know where the supplies are stored and how they are to be deployed [21–23].
In fact, the most common comment made to the author by workers at the hospitals
and shelters his group visited in Japan during his 2011 trip was “We knew what to
do because we practiced this every year but we never expected to have to do it for
real.”
Putting this together, there are several steps that a hospital can take to prepare to
receive contaminated patients:
1. Construct or modify at least one examination and treatment room to be suitable
for receiving contaminated patients.
2. Obtain contamination control materials for additional treatment rooms.
3. Develop institutional procedures for examining and treating contaminated
patients, including triage for radiological and non-radiological concerns.
4. Train staff, including periodic refresher training and exercises to develop and
maintain skills and familiarity with procedures and equipment.
5. If a radiological incident occurs, set up examination and treatment rooms to
receive contaminated patients.
6. Ensure staff are properly garbed in Personal Protective Equipment while waiting
for the first patients to arrive.
17.3 Medical Care in the Emergency Department
Practitioners of emergency medicine have ample experience in their specialty and it
is not the place of this book to go into the details of their work. However, most who
practice emergency medicine know very little about radiation, its health effects, its
treatment, or even how to recognize radiation injuries and, without such knowledge,
it is difficult to assess the entirety of a patient’s medical needs. Thus, here we will
take a look at the clinical impact of radiation exposure during the first few to several
hours after exposure.
17.3.1 Contaminated Wounds and Injuries and Embedded
Source Fragments
Contamination, whether on the skin or in wounds, can be identified and located
by performing a survey using radiation detectors. Embedded fragments can also be
identified using radiation surveys, in addition to leaving entry wounds at the point
where they entered the body. A high-activity source fragment within the body, though,
can generate a radiation field capable of swamping contamination instruments; thus,