Triage and Treatment Philosophies

Managing hazardous material accidents of any type requires health care providers to perform the following initial key actions:

• secure the safety of the accident scene

• provide lifesaving emergency care

• limit exposure to the hazardous substance

• contain the spread of the hazardous substance

Additional precautions are required when managing radiation accidents because, unlike hazardous material of other types, radiation can be detected only by monitoring devices. After scene safety is secured and emergent resuscitation and stabilization is provided, medical management of these patients must employ the use of protective equipment and monitoring devices. Practices of dose reduction, contamination control, and decontamination are necessary in order to protect the safety of patients, health care providers, and the environment.

Radiation accidents can be most effectively managed if the patients are separated into one of the following three situations: (1) externally contaminated patients, (2) internally contaminated patients, or (3) externally irradiated patients. Each patient type requires specific treatment considerations, which are discussed below and illustrated in Iable.199:6. If there are multiple casualties, triage is based on the patient's acute medical condition. If all patients are medically stable, the order listed above is the suggested priority for providing treatment.

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