Re: Treatment of Contaminated Personnel

["J. J. Rozental" <josrozen@netmedia.net.il>]

Dear Jim, 

At 11:33 AM 2/24/99 -0600, you wrote:
>Radsafers,
>Can anyone please direct me to where guidance documents or such can be 
>reviewed regarding emergency medical treatment of personnel who are 
>also contaminated. We were challenged on this recently during a 
>training class where we indicated that emergency
>medical treatment of contaminated personnel should have priorty over 
>concern for potential contamination of emergency responders.

You mentioned the case of medical treatment of personnel who are
contaminated during an accident, however,  it  also can be the case that
only exposure of individuals is the situation of major concern as, for
instance,  during  transport accident involving sealed source. 

The complexity of coarse depends of the training scenario

Let's consider the following:

Approximately 10 P.M. Friday,  a light truck with adequate placard was
transporting two gamma radiography containers: One housing a 3.7 TBq (100
Curies) Ir-192 source and the other a 0.74 TBq (20 Ci) Co-60 source. Close
to a small city, 20 km away, in a rural area, the truck was involved in a
road accident. The  truck collided with a vehicle, traveling in opposite
direction and overturned. The truck's driver, was seriously injured  and
unconscious and the radiographer's right leg fractured. Also 2 passengers
and one children from the other vehicle were injured, and could not be moved
fom the car. Considering that the radiographer could not move,   he asked to
the first person who came to help them for the survey meter. Following, he
confirmed a dose rate of  25 R/h next the vehicles and he concluded that one
or both sources could be unshielded...

One part of the training (in an open area) was to observe the medical
response, first responder on-scene, after individual telephone  call,
together with police and fire brigade teams to help the victims.  No
Radiation Protection  Officer  help was possible in that region, or any
other radiation detector  was also available.

The main observations on  medical team, in this scenario were:
decisions, actions and ability of the medical team to move individual
injured, late at night;


The second part of this scenario, should consider that the survey   meter
was broken, and no measure could be made;

The third  part of this scenario, should consider the above  and also that
the radiographer was unconscious.

Now about guidance on this subject:

a) One of the first "bibles" was, and still is:

The medical Basis for Radiation Accident Prepardness - Karl F. Hubner and
Shirley A. Fry
Proceedings of the REAC/TS International Conference: The Medical Basis for
Radiation Preparedness - October 18-20, 1979, Oak Ridge, Tennessee -
Elsevier/North Holland, Inc

b) Manual on Early Treatment of Possible Radiation Injury, IAEA Safety
Series 47, 1978

c)Emergency Prepardness Exercises for Nuclear Facilities: Preparation,
Conduct and Evaluation - IAEA Safety Series 73, 1985

d) Medical Handling of Accidentally Exposed Individuals IAEA, Safety Series
No. 88, 1988 
 
e)  Health Surveillance of Persons Occupationally Exposed to Ionizing
Radiation: Guidance for Occupational Physicians Safety Reports Series No. 5,
1997

f) Dosimetric and medical aspects of the radiological accident in Goiania,
1987 - IAEA TEC DOC 1009, June 1998

(The above document contain the experience gained during 10 years dealing
with patients)
 
J.J. Rozental
josrozen@netmedia.net.il
Israel



 
>-Jim Casto
>----------------------
>Jim Casto
>Radiation Safety Officer
>Department of Environmental Health & Safety
>University of California
>Santa Barbara, CA. 93106
>(805) 893-3588
>(805) 893-8659 fax
>Jim.Casto@ehs.ucsb.edu
>
>
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jjrozental

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