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RE: OSHA & Radiation (was: Badges for surgery)
For what it's worth:
Back in the mid-90s, the Illinois Department of Nuclear Safety (now part of
Illinois Emergency Management) got a flurry of queries from hospitals
seeking ways to address JCAHO requirements that emergency rooms be able to
handle "contaminated" victims. Finding little comprehensive material written
for laypeople, we developed our own 40-page medical guide with a brief
overview of radiation, the kinds of situations that might produce
contamination/exposure, and practical advice on how to handle the victim,
decon, contamination control, monitoring techniques, etc. The goal was
reduce anxiety among responders and caregivers about the actual risks (or
lack thereof) involved.
After distributing about 1,200 copies of the original document to hospitals
and EMS providers statewide, the "guide" became the basis for a one-hour
in-service (PowerPoint) presentation that to date has been delivered to more
than 2,500 hospital ER and EMS personnel throughout the state. Overall, more
than 5,000 copies of the guide are now in distribution.
The program, including printing, travel, etc., has not been a large expense,
but the good will and public education return has been significant.
Among the things we learned early on were that misinformation among EMS and
ER staff about radiation hazards was rampant, and that those in emergency
medicine and their counterparts in radiology and nuclear medicine weren't
communicating. (At one large Chicago area hospital, I insisted that the ED
supervisor and the head of Nuclear Medicine be invited to the in-service.
They had never met.)
Things have improved, especially after 9/11 and the interest definitely is
there among the medical response community. If you make the information
usable, i.e., non-technical, and you put in in the context of what providers
already know and do, they will come.
Mike Sinclair
REP Coordinator
Illinois Emergency Management
-----Original Message-----
From: William V Lipton [mailto:liptonw@DTEENERGY.COM]
Sent: Thursday, January 15, 2004 6:20 AM
To: Bradt, Clayton
Cc: Radsafe-Digest (E-mail); 'crispy_bird@YAHOO.COM'
Subject: Re: OSHA & Radiation (was: Badges for surgery)
It's a good idea for a facility to provide training to local emergency
response
organizations, or, as a minimum, give them a tour of the facility.
The opinions expressed are strictly mine.
It's not about dose, it's about trust.
Curies forever.
Bill Lipton
liptonw@dteenergy.com
"Bradt, Clayton" wrote:
> All NYS Labor Dept. licensees are required to notify the local police and
> fire departments of the presence of rad material at their facility, and
> inform them of any special emergency procedures, contact information, etc.
> as necessary. There is even a special hazardous materials report form
that
> must be submitted to the fire department as well. It is up to the local
> responding agencies to make use of the information they are given to plan
> their response to these facilities. This is where the breakdown occurs.
> They take the information and file it (maybe) and never follow up on it.
If
> the EMTs who responded to the electrocution incident had just read the
> Emergency Response Guidebook, they would have known there was no reason to
> balk at entering this facility. But even that level of training was
> lacking.
>
> Clayton J. Bradt, CHP
> Principal Radiophysicist
> NYS Dept. of Labor
> Radiological Health Unit
> voice: (518) 457-1202
> fax: (518) 485-7406
> e-mail: Clayton.Bradt@labor.state.ny.us
>
> > -----Original Message-----
> > From: William V Lipton [mailto:liptonw@dteenergy.com]
> > Sent: Wednesday, January 14, 2004 11:02 AM
> > To: Bradt, Clayton
> > Cc: Radsafe-Digest (E-mail); 'crispy_bird@YAHOO.COM'
> > Subject: Re: OSHA & Radiation (was: Badges for surgery)
> >
> >
> > This incident shows the importance of emergency planning.
> > Facilities which may
> > require emergency response personnel to enter a posted area
> > should communicate
> > with those organizations who would respond to an emergency
> > regarding the meaning
> > of the posting, the expected hazards, and the appropriate
> > protective actions.
> > As you said, this can be a matter of life and death.
> >
> > It is important to train medical personnel regarding the rule
> > that potential
> > contamination should NEVER interfere with lifesaving medical
> > procedures. (I had
> > a wakeup call on this, back in 1983. We did not yet have
> > fuel on site, but were
> > refining our emergency plan. The site nurse told me that
> > should would not
> > attend to an accident victim until she was sure that he was
> > not contaminated!
> > We quickly corrected that misunderstanding.)
> >
> > The importance of training is illustrated by a medical drill,
> > at another nuclear
> > power plant, where I played a victim. The scenario had 2
> > victims: me - heavily
> > contaminated, only slightly hurt, other victim - slight
> > contamination, seriously
> > injured. I was also instructed to make a lot of noise. (A
> > scene was recorded
> > on the video of the Nuclear Shift Supervisor telling me to
> > "Shut the **** up.")
> > The responders did a good job, although, in retrospect, I
> > received too much
> > attention and the seriously injured victim not enough. The
> > ambulance drivers
> > took the whole thing a little too seriously. I was scared,
> > for real, when they
> > drove the ambulance at high speed through a blizzard.
> >
> > Nuclear power plant emergency plans generally require
> > training for offsite
> > medical responders. It's a good idea for other facilities.
> >
> > The opinions expressed are strictly mine.
> > It's not about dose, it's about trust.
> > Curies forever.
> >
> > Bill Lipton
> > liptonw@dteenergy.com
> >
> > "Bradt, Clayton" wrote:
> >
> > > John Jacobus wrote:
> > >
> > > "And when was the last (or first) time OSHA inspected a
> > > hospital? We had an overexposure at our cyclotron
> > > facility, and OSHA did not respond even when we
> > > contacted them. We are a federal agency, and do not
> > > come under state regulations. I assume a state agency
> > > would have been interested."
> > >
> > > We had a near electrocution at a cyclotron facility not too
> > long ago. OSHA
> > > investigated that incident, but radiation exposure wasn't
> > an issue. OSHA
> > > has very few people with any radiation background. This of
> > course does not
> > > prevent them from claiming that they regulate in the area
> > of radiation
> > > hazards from x-ray and non-AEA materials. They want the
> > turf but won't
> > > invest in the personnel to do the job.
> > >
> > > With regard to the electrocution incident: We have had a
> > running battle with
> > > local code enforcement people in some municipalities who
> > insist on requiring
> > > posting on the outside of all buildings where radioactive
> > materials are
> > > stored/used - regardless of the form or quantities. (For
> > the protection of
> > > first responders, they claim.) The cyclotron facility was
> > located in one
> > > such municipality, and had a radiation sign on the outside
> > of the building.
> > > When the EMTs arrived, they at first refused to enter
> > because of the sign.
> > > Meanwhile the victim was unconscious on the floor and the
> > pharmacist was
> > > yelling and cursing at the EMTs to get them to come in to
> > treat him. They
> > > finally overcame their radiophobia and the individual was
> > transported to
> > > hospital. The victim recovered but had some severe burns.
> > Here again we
> > > have an agency (code enforcement this time) guarding turf
> > in an area in
> > > which they have no expertise. This time with near fatal
> > consequences.
> > >
> > > I'm sure there is a lesson here for all of us......but I at
> > the moment I
> > > just can't think of what it is.
> > >
> > > Clayton J. Bradt, CHP
> > > Principal Radiophysicist
> > > NYS Dept. of Labor
> > > Radiological Health Unit
> > > voice: (518) 457-1202
> > > fax: (518) 485-7406
> > > e-mail: Clayton.Bradt@labor.state.ny.us
> > >
> > >
> > **************************************************************
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> >
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