Local facilities that may potentially refer a radiation accident victim to the emergency department should be identified in advance and instructed to provide as much advance notification of potential incidents as possible to allow adequate time for mobilization of resources and the physical preparation of the emergency department. When receiving notification of a radiation accident, the emergency physician should request information that will facilitate the necessary preparation for receiving and treating the patient. Useful information to obtain includes:
1. Circumstances of the accident
2. Number of victims
3. Medical condition and physical injuries of the victims
4. Type and extent of radiological insult: irradiated, externally contaminated, or internally contaminated
5. Identification of the radioactive material
6. Exposure to other hazardous material that may be chemically toxic or corrosive.
This notification should serve to activate the Emergency Department Radiation Accident Protocol. The protocol should clearly identify the members and individual responsibilities of the radiation emergency response team as well as the location and contents of the radiation emergency supply kit. Additionally, the protocol should include specific details for the physical preparation of the emergency department and staff that is necessary to safely receive and treat a radiation accident victim. Such preparations, outlined in T,aMeJ,,99:,5,> are time-consuming and should be initiated prior to the patient's arrival.
TABLE 199-5 Key Contamination Control Principles
Initial activation of the protocol should include requesting assistance from predetermined local radiation specialists and, ideally, health physics professionals. Radiation specialists may assist by monitoring radiation dose of personnel, surveying personnel and areas for contamination, directing contamination control and decontamination efforts, and disposing of contaminated wastes. If faced with a severe or extensive radiological accident, additional sources of assistance are provided at the end of this chapter.
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