- Acute radiation syndrome - Wikipedia
- 2nd Edition
- Hospital Response to Radiological Events
- What we do
- Acute radiation syndrome caused by accidental radiation exposure - therapeutic principles
Acute radiation syndrome - Wikipedia
External decontamination of intact skin Wash under a stream of water, gently scrubbing at the same time with a soft disposable brush or surgical sponge. Special attention should be given to nails, skin folds and hair Use gentle, neutral pH soap if required Scrub for 3 — 4 minutes, rinse for 2 — 3 minutes and then dry Monitor Repeat if necessary Decontamination stops when no further significant reduction in radiation level can be achieved top of page Avoid excessive scrubbing. Even minimal abrasions may result in a greater than ten-fold increase in incorporation of radioactive material.
After decontamination Replace the sheet beneath the patient. Waste management Waste Water Ideally waste water from decontamination procedures would be collected. However, this is unlikely to be practical. The installation of a holding tank is almost certainly not justified because of the infrequency of this event. Any radiation hazard to the public or the environment from the comparatively small volume of waste water will be massively diluted in the sewer system.
Bagged Waste At the conclusion of the decontamination of the patient soiled linen, dressing materials, etc.
Bagged contaminated waste should then be stored in a secure, isolated area, free from human interference, until decay has occurred naturally, rendering the waste no longer radioactive. The time for this to occur is dependent on the specific radioisotope. In the case of waste with a long half-life, contact the radiation regulator or the health department radiation adviser in your state or territory for advice on arrangements for the proper disposal of the waste. Disposable floor coverings and other coverings should be rolled up and placed in plastic bags.
The entire area should then be thoroughly surveyed for residual contamination. In most cases, normal cleaning methods will remove the material.
Vacuum cleaners that can handle wet material and have high efficiency filters are useful. Some surfaces may require repeated scrubbing and vacuuming before they are free of contamination. Disposal of Waste All waste materials should be disposed in accordance with prescribed procedures. Hospital radiation safety officers can obtain further advice from the health department radiation adviser. Obtaining specialist advice Contact the hospital on-call health physicist or radiation safety officer RSO to attend at the ED.
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Contact the health department radiation adviser in your state or territory for advice and to ensure notification of the incident has occurred. Whilst the regulation of radiation may not rest with State or Territory health departments in every jurisdiction, health departments will provide initial public health advice, links to appropriate radiation expertise and overall coordination of health resources in emergencies.
Clinical advice on the care of victims with acute radiation injury or illness can be obtained from radiation oncologists in each State and Territory. Contact Peter MacCallum switchboard on 03 Request the on call radiation oncologist. Occasionally this role is fulfilled by the occupational health and safety unit.
The radiation safety officer supports safe operations in a radiological emergency, assisting responding staff to ensure their doses are as low as reasonably achievable, and providing technical support and documentation. Responsibilities pre-event top of page Advise management on matters relating to radiation safety including: Radiation monitoring programs. Condition of and need for radiation monitoring and protective equipment.
Action to be taken to reduce the radiation exposure of employees or members of the public to as low as reasonably achievable. Action to be taken in the event of an emergency or accidental exposure. Prescribed standards for discharge of radioactive waste.
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Prepare safe working procedures with respect to radiation protection for use in routine operations or in an emergency or accidental exposure. Be responsible for instruction of employees in radiation hazards, safe working procedures to ensure radiation protection, the proper use of radiation monitoring and protective equipment, and measures to limit radiation exposure.
Hospital Response to Radiological Events
Maintain sufficient radiation monitoring and radiation protection equipment and ensure that equipment is calibrated and in a ready and working condition. Ensure that prescribed radiation signs are maintained in good condition and located in places where they will be easily seen. Investigate sources of radiation exposure, the radiation protection equipment and working procedures and recommend any change that would reduce exposure to employees and members of the public.
Maintain detailed records on all the above matters. Responsibilities during event Ensure that appropriate radiation protection monitoring surveys are carried out as required. Implement personal monitoring systems for the determination of effective doses for any employee or class of employees as required. Assess accumulated effective dose and committed effective dose of any employee or class of employees.
What we do
Ensure compliance with prescribed standards for radioactive waste handling. Ensure that radiation signs are located in places where they will be easily seen. Monitor transport containers and ensure they comply with the Code of Practice for the Safe Transport of Radioactive Material or later as amended. Role Statement: Medical Health Physicist Medical health physicists work in the areas of radiography, nuclear medicine, or radiation oncology. They can provide advice to clinicians managing radiological casualties. Responsibilities pre-event Contribute to the development of radiological emergency response plans for their hospital, based on health physics principles.
Ensure these are consistent with local state and territory arrangements. Contribute to staff development, training and exercising for radiological emergencies. Coordinate activities with the radiation safety officer. Nuclear medicine physicians and technologists should familiarise themselves with Anigstein R, et al. Use of radiation detection, measuring, and imaging instruments to assess internal contamination from inhaled radionuclides; part 1: feasibility studies.
Available from CDC web site. Responsibilities during event top of page Orient medical staff with the principles of dealing with radiological contaminants. Evaluate the level of external or internal contamination of casualties. Assist clinical staff to evaluate and understand the significance to patient and staff of the levels of radiological contamination with which they are dealing, Particularly with respect to the stabilisation of life-threatening injuries in a timely way consistent with safety of personnel.
Assist with advice regarding special precautions required to provide patient care where there are shrapnel fragments with significant radiological activity.
- Medical Management of Radiation Accidents | Taylor & Francis Group.
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Provide guidance on the decontamination of casualties, facilities and the vehicles involved in transporting casualties to hospital. Oversee the recalibration of hospital gamma cameras, thyroid cameras, etc for use in evaluating internal contamination. Make preliminary dose estimates and communicate these to treating clinicians. Include an explanation of the uncertainty in the dose estimate. Inform communications with patients, staff and management on radiological issues.
Assist public health authorities in monitoring people who are not injured but are concerned they have been exposed to radiation or radiological material. Responsibilities pre-event top of page Contribute to the development of radiological emergency response plans for their hospital.
Acute radiation syndrome caused by accidental radiation exposure - therapeutic principles
Responsibilities during event Make a preliminary dose estimate utilising available clinical information for each individual. See Radiation Dose Assessment on page Establish the symptom and location history. Assess the degree of myelosuppression based on lymphocyte depletion kinetics. Seek the advice of a health physicist in interpretation of bioassays and dicentric analysis, when these results are available. Stratify casualties into risk groups: 1. Will not require medical intervention 2. Needs further evaluation for haematopoietic stem cell transplant.
Not able to be salvaged. Provide ongoing clinical management of patients with myelosuppression in conjunction with the multidisciplinary management team. Implement colony stimulating therapy in eligible patients as early as feasible, ideally in the first 24 hours. References top of page 1. Available from CDC website. Armed Forces Radiobiology Research Institute. Medical management of radiological casualties handbook, military medical operations.
The roles of medical health physicists in a medical radiation emergency.