Area of Radiation damage management. Radiation injured patient management
Written by Anam Hussain
Radiological area of damage (RAOD) is defined as a territory that is under the impact of the radiological DF. The radiological damaging factor is: ionizing radiation
RAOD has 5 zones:
- Zone of biological threat
- Zone of moderate radiological contamination
- Zone of high radiological contamination
- Zone of dangerous radiological contamination
- Zone of extremely dangerous radiological contamination
FMS is located outside of RAOD at safe distance, opposite direction of wind because all zones possess threat to safety and health of medical staff and full protective equipment is required to operate in such contaminated zones. Vicinity, win and precipitation close to RAOD are main risk factors for enlargement of the contaminated area.
Disaster Medical support and Management in Radiological area of damage:
- Medical duty to remind search and rescue teams that no protective clothing can fully assure and maintain protection against all the types of ionizing radiation and operating time in AOD is limited
- Performance of medical intelligence
- After finding casualties, first step is to stop contact with DF: done by partial decontamination, brushing radioactive dust-off clothes, applying barrier between casualty and ionizing radiation by covering the body
- Perform primary triage.
- After primary triage performed, fast and organised evacuation is done followed by decontamination
- If not decontaminated, all casualties still considered dangerous and have to be isolated. Not allowed to enter the FMS
- During primary medical triage, important to obtain data regarding dose absorbed by the casualty
- Perform Biological dosimetry: a practical SOP for rapid field orientation regarding absorbed dose, which is a part of both physician and pre-physician aid
- After performing biological dosimetry, first pre-physician aid proceeds with activities to prevent complications:
- Administration if antiemetic drugs
- Irrigation of skin areas affected by radiological burns
- Covering and cleaning of wounds with sterile dressing
- Provision of psychological support
- Physician first aid in FMS is limited:
- Starts with aggressive fluid resuscitation, intravenously
- Initiation of prophylaxis of infectious complications by intravenous administration of a broad spectrum of antibiotics
- Casualties have to be evacuated with no delay due to risk of developing suppressed immunity. Due to radiological impact on haemopoietic tissue.