UNCONTROLLED WHEN PRINTED
Quick Chart
Introduction
  • Radiation exposure is a measure of the ionization of air due to ionizing radiation from photons; that is, gamma rays and X-rays. It is defined as the electric charge freed by such radiation in a specified volume of air divided by the mass of that air.
Clinical Presentation
  • None peculiar to irradiation in the acute phase.
  • Being exposed to a lot of radiation over a short period of time, such as from a radiation emergency, can cause skin burns. It may also lead to acute radiation syndrome (ARS, or "radiation sickness"). The symptoms of ARS include headache and diarrhoea.
Exclusion Criteria
Exclusion Criteria
Risk Assessment

Handling of radiation accidents must be demystified. The officer should never hesitate to give medical attention to patients due to the "radioactive material" sign displayed on the vehicles.

  • Gather HAZCHEM information
    • Radioisotopes involved
    • Irradiation from solid sources
    • Industrial and laboratory waste
    • Duration of exposure
    • Type of contamination
    • If a vehicle displays the radioactive HAZCHEM sign, the Officer must assume that some form of radiation is present
  • Advise State Operations Centre that a radiation incident has occurred
  • Take direction from the Hazard Management Agency or Combat Agency
    • Officers should try not to spread the contamination unnecessarily i.e. into ambulances, hospitals or to other workers and to follow instructions from their Supervisors or the Hazard Management Agency or Combat Agency
    • Instruct patients, especially if not seriously injured, not to leave the scene until experienced specialists have tested them with monitors to ascertain whether or not they have been contaminated
  • Washing removes contamination
Management
Primary Care
  • If possible, remove the patient and all other people involved, injured or not from the source of contamination.
  • If required, follow decontamination instructions from the Hazard Management Agency or Combat Agency.
Note:
If the patient has not been adequately decontaminated or decontamination cannot be assured, then put on appropriate Personal Protective Equipment as soon as practical.
  • Primary Survey with C-Spine consideration
  • Perform vital sign survey
  • Secondary / CNS Survey (try to minimise contact where possible)
  • Put a sheet on the stretcher and wrap the patient. This will minimise the spread of contamination to officers, ambulance and hospital staff (patient can be unwrapped if continuing medical care is needed.)
Intermediate Care (EMT / Level 2)
  • Consider pain relief
  • Consider anti-emetic
  • Consider applying cardiac monitor if trained and authorised
  • Monitor patient persistently, recording full observations every 10 minutes (or 5 minutes if time critical)
  • Pre-notify receiving facility, regardless of priority of transport
  • Transport Priority 1 if patient time critical, 
Advanced Care (AP)
  • Establish IV access only if absolutely necessary
  • Consider pain relief
  • Consider anti-emetic
  • Apply cardiac monitor if trained and authorised
  • Monitor patient persistently, recording full observations every 10 minutes (or 5 minutes if time critical)
  • Pre-notify receiving facility, regardless of priority of transport
  • Transport Priority 1 if patient time critical, 
Critical & Extended Care (CCP, PSO)
  • As per Advanced Care (AP) guidelines
Additional Information

At Hospital

  • Place sheet on floor, place the stretcher on sheet, unwrap the patient and cut off patient's clothing
    • Avoid shaking the material and distributing contaminated material more than necessary.
  • Leave the patient’s clothing and the stretcher (this will remove at least 90% of the radioactive material in the case of surface contamination)
  • Emergency Department Staff will be gowned and gloved. They will lift patient onto a clean stretcher or decontamination tabletop where they will be further decontaminated by soap and water washing.
  • Officers may now need to remove their outer clothing if so instructed by a Radiation Officer and place either in a plastic bag or with stretcher and clothing.
  • Stretcher, patient’s clothes, and any other possibly contaminated clothes are carefully wrapped.
  • Officer and others to wash with soap and water, face first, then hands, and discard washcloths.
  • Await monitor check for any residual radiation.
  • Decontamination of the officer and equipment depends on the type of hazard encountered.
  • Decontamination remains the responsibility of the Hazard Management Agency or Combat Agency.
  • It may not be possible for Officers who have been contaminated to leave the scene.
    • (Note: Patients may have to be handed to non-affected officers and vehicles.)
  • The removal of the CBR PPE should be supervised and the contaminated suit bagged as per correct disposal methods.
  • Respirators, if used, should be bagged and kept separate, as these will be cleaned or destroyed.
  • Decontamination of the ambulance and equipment should be carried out at the direction of the Hazard Management Agency.
  • In the absence of clear instruction, the vehicle should be cleaned internally and externally with water and detergent.

General information about radiation

  • Radiation hazards to emergency personnel is extremely small, provided some basic precautions are taken, e.g.:
    • Avoid prolonged contact of material with skin as this could (over an extended period of time) produce a significant dose
  • The irradiated patient is no hazard to the attendants unless loose contaminants remain on the external surfaces
  • Contamination is never a medical emergency
  • The extent of radiation from an uncontrolled source cannot be guaranteed until measured by Radiation Health or the ChemCentre
  • The most common radiation incident arises from the daily transportation of numerous radioactive industrial and medical materials
  • The officer is protected from the radiation source by distance, a reduction of exposure time, and shielding.
  • Surface contaminations are not life threatening, and no patient has ever died from secondary exposure to surface contamination.
  • The officer is to make every possible attempt to prevent the spread of contamination to attendants, ambulance, hospital emergency facilities, etc.

References
References
Key Terms & Links
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