Perform Lifesaving Tasks Before Managing Radiation Problems
Guidance for responders in areas with widespread, high radiation levels in the environment1,
Widespread, high radiation levels in the environment (e.g., after IND detonation) may
Preclude any rescue actions in some areas
Limit work time in other areas, at least initially
Radiation safety personnel and incident managers will supervise response personnel entering and leaving high risk areas to minimize potential health risks from radiation exposure.
Minimally contaminated victims do not pose a health risk to rescuers or healthcare providers.
Perform life- and limb-saving tasks before managing external or internal radiation contamination.
Do not delay life-saving rescue or transport of a seriously injured or contaminated person.
This represents the most likely scenario for most radiological events.
Modified guidance for events where highly radioactive fragments or shrapnel (e.g., Cobalt-60 or Iridium-192) could be embedded in victims.
Detection of such fragments in an injured patient mandates an evaluation be performed by BOTH
A healthcare provider who will assess medical status AND
A radiation safety professional who will perform a detailed radiation survey of the patient
If a patient is found to have embedded, highly radioactive fragment/shrapnel, radiation dose to healthcare providers must be monitored closely and minimized for those who may be in prolonged, close contact with victims (e.g., CPR teams, surgeons, operating room staff) by
Rotating staff to decrease total exposure time and minimize risk of exceeding protective action guides.
Securing and shielding any debrided radioactive shrapnel
Smith, et al.2, provide excellent guidance for medical responses to explosive RDD events. They recommend that radiation safety professionals be engaged routinely to protect all staff along the entire medical response continuum.