Radiation disaster response: preparation and simulation experience at an academic medical center.
نویسندگان
چکیده
OBJECTIVES A mass casualty disaster drill involving the simulated explosion of a radiation dispersal device (dirty bomb) was performed with the participation of multiple hospitals, emergency responders, and governmental agencies. The exercise was designed to stress trauma service capacities, communications, safety, and logistic functions. We report our experience and critique of the planning, training, and execution of the exercise, with special attention to the integrated response of the Departments of Nuclear Medicine, Health Physics, and Emergency Medicine. METHODS The Health Physics Department presented multiple training sessions to the Emergency Medicine Department, Operating Room, and ancillary staff; reviewing basics of radiation biology and risk, protection standards, and detection of radiocontamination. Competency-based simulations using Geiger-Müller detectors and sealed sources were performed. Two nuclear medicine technologists played an important role in radiation discrimination-that is, assessment of radioactive contamination with survey meters and radionuclide identification based on gamma-spectroscopy of wipe smears from patients' clothing, skin, and orifices. Three Health Physics personnel and one senior Nuclear Medicine staff member were designated the radiation control officers for assigned teams triaging or treating patients. Patients were triaged and, when indicated, decontaminated. RESULTS Within a 2-h period, 21 simulated victims arrived at our institution's Emergency Room. Of these, 11 were randomized as noncontaminated, with 10 as contaminated. Decontamination procedures were implemented in a hazardous materials (HAZMAT) decontamination trailer and, for the 5 patients with simulated serious injuries, in a designated trauma room. A full debriefing took place at the conclusion of the exercise. Staff largely complied with appropriate radiation protection protocols, although decontamination areas were not effectively controlled. The encountered limitations included significant lapses in communications and logistics, lack of coordination in the flow of patients through the HAZMAT trailer, insufficient staff to treat acute patients in a radiation control area, additional personnel needed for transport, and insufficient radiation safety personnel to control each decontamination room. CONCLUSION Nuclear Medicine personnel are particularly well qualified to assist Health Physics and Emergency Medicine personnel in the preparation for, and management of, mass casualty radiation emergencies. Simulation exercises, though resource intensive, are essential to an institution's determination of response capability, performance, and coordination with outside agencies.
منابع مشابه
Examining the effectiveness of initial response training program for nuclear emergency preparedness
Background: Although nuclear technology has various beneficial, it also has a variety of risks. In particular, initial response is very import to respond to risks. Therefore, the program to increase initial response proficiency can be regarded as very essential. The Republic of Korea annually conducts more than 10 nuclear emergency response training programs, and specialized training courses f...
متن کاملOrganization and Preparedness of Emergency and Disaster Medical Response Teams: Obstacles and Challenges
Background: Rising trend of emergencies and disasters in the world has caused a lot of damage to the health care facility infrastructures. This has led the health needs of the affected population to be the first and most requirement in emergencies and disasters. In most countries for the timely and appropriate response to the health needs of the affected areas, structured and organized teams ar...
متن کاملResponding to disasters: academic medical centers' responsibilities and opportunities.
Disaster preparedness and disaster response should be a capability of all academic health centers. The authors explore the potential role and impact of academic medical centers (AMC)s in disaster response. The National Disaster Medical System and the evolution of disaster medical assistance teams (DMAT) are described, and the experience at one AMC with DMAT is reviewed. The recent deployment of...
متن کاملProviding healthcare to evacuees in the wake of a natural disaster: opportunities to improve disaster planning.
BACKGROUND The impending landfall of Hurricane Katrina on the Mississippi Gulf Coast resulted in large numbers of evacuees into the Jackson, Mississippi area. Many evacuees with chronic medical problems had been directed to the Mississippi Coliseum in the downtown area near the University of Mississippi Medical Center. As the storm passed through Jackson, serious damage occurred to the municipa...
متن کاملCT-Based Brachytherapy Treatment Planning using Monte Carlo Simulation Aided by an Interface Software
Introduction: In brachytherapy, radioactive sources are placed close to the tumor, therefore, small changes in their positions can cause large changes in the dose distribution. This emphasizes the need for computerized treatment planning. The usual method for treatment planning of cervix brachytherapy uses conventional radiographs in the Manchester system. Nowadays, because of their advantages ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Journal of nuclear medicine technology
دوره 32 1 شماره
صفحات -
تاریخ انتشار 2004