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44 Cards in this Set
- Front
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Commands with potential for exposure or contamination of personnel are responsible for developing procedures or guidelines for/to: |
-plan and instal a good egress route for their personnel -Train personnel in their own Decon Procedures -Decon procedures for patients -Transport decontaminated persons -location of local decontamination facilities |
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Only procedure that takes priority over decon procedures |
treatment of LIFE THREATENING injuries |
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Requirements for decon facilities and transportation of contaminated personnel |
Know availability and location of local medical treatment and transportation facilities transp can be done in any type of conventional ambulance Place patient in blanket and cover floor and litter with herculite to prevent contaminating ambulance Most readily transferable contamination will be removed at scene ID personnel arriving Greet the patient Turnover others to the RHO |
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Discuss the hospital management and evaluation of contaminated personnel |
Prepare emergency plan in advance Pre-plan decon facility layout Be part of the planning meetings Train, Train, Train... Management must develop: *Hospital Pre-Emergency Plan, *Decontamination Facilities, *Decon of Patient, *MOA with appropriate organizations |
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List the required reporting and recording procedures for an accidental exposure or a personnel contamination event IAW BUMEDINST 6470.10B and NNPMs. |
SF-600 SF-531 Incident Report NAVSEA08 Message Report to NAVSEA08 & BUMED M342 SITREP or Annual 6470/1 NAVMED 6470/11 Radiation Physical (SE) |
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Identify the points of contact for special assistance in the event of a casualty. |
BUMED M3B42 DSN: 762-3444 Comm: 202-762-3444 Comm: 202-762-3211 (on-call after hours) |
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Discuss the NCRP Report #65 as a resource for management of internally contaminated personnel |
Provides additional guidance on: -specific internally deposited nuclides -basis for treatment decisions -resume of experience with important radionuclides -therapy procedures and drugs |
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Discuss the role of the UMO in an Emergency Command Center (ECC) during a personnel contamination event |
PROVIDE PATIENT OVERSIGHT! Medically clear the patient for decontamination, required to stay in the area to provide continuous medical oversight. Ensure decontamination is not causing further damage to patient. |
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Discuss the types of radiation exposures |
Penetrating Non-Penetrating |
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Penetrating Radiation |
External radiations with energy sufficient to contribute dose to deep tissues and organs other than the skin. gamma, x-ray, neutron |
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Non-Penetrating Radiation |
External radiationis of such low penetrating power that the absorbed dose principally in the skin and does not reach deeper organ. alpha, beta, very soft gamma or x-ray radiations |
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What four ways personnel can be exposed to radiation. |
External Irradiation External Contamination Wound Contamination Internal Contamination |
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External Irradiation |
Exposure to radiatioin that originates external to and usually not in direct contact with the body. e.g. fluoroscopy |
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External Contamination |
An area of the body is considered to be externally contaminated if it contained in excess of 450 uuCi of beta-gamma emitting contamination by direct frisk or 50uuCi of alpha contamination by direct frisk. |
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Wound Contamination |
Radioactive material present inside or at the border of a break in the skin, increasing potential for access to or retention in internal tissues. |
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Internal Contamination |
Radioactive material that has gained access into the body throught: -inhalation -ingestion -absorption -impingement |
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List the deontamination locker items ashore IAW BUMEDINST 6470.10 series. |
-Porous Tape -MagSulfate -Soap Bar -KI tabs -Waterless Hand Cleaner -CTA -Lava Soap -Magnetic Probe -Specimen Containers -Surgical Brushes -Aluminum Hydroxide -Laundry Soap |
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List the decontamination locker items afloat IAW BUMEDINST 6470.10 series. |
-Porous Tape -MagSulfate -Soap Bar -KI tabs -Waterless Hand Cleaner -CTA -Lava Soap -Magnetic Probe -Specimen Containers -Surgical Brushes -Aluminum Hydroxide -Laundry Soap -*STERILE WATER*
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State the exposure assessments of each type of radiation exposure |
??? |
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State the purpose of internal monitoring of contaminated personnel. |
To determine seriousness of the radiation exposure by estimating the whole body dose and using the table for external irradiation to penetrating radiation. IM is given to contaminated personnel when radioactive material has gained access into the body through inhalation, ingestion, absorption, impingement. |
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List the external and internal decon procedures IAW NCRP Report #65, BUMEDINST 6470.10 and NPIMs |
EVALUATE:-extent of skin contamination, -possibility of internal contamination INTERVIEW:-patient, -witnesses Before initiating treatment DETERMINE: -clinical seriousness, -biological response, -if problem worsened by loose or mobile contamination |
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What determines method of decontamination. |
Circumstances and materials available. Balance risk of skin damage with need for contamination control. Eyes, ears, nose and wounds must be deconned or supervised by medical personnel. |
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Rule of Thumb for injuries during decontamination |
Attend to acute medical problems first IF condition permits, decon may be performed at the scene. Do NOT delay transferring an individual needing life/limb-saving medical care for radiological controls. |
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Effective Decon Procedures |
-self adhering tape (for particulates) -Wash 1-3 minutes with mild soap and water -Wash 1-3 minutes with waterless hand cleaner -Wash 1-3 mintues with mild abrasive and water -Sloughing |
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Objectives of Decontamination |
Primary: Prevent internal contamination Secondary: Minimize skin dose |
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Proper set up for DECON station, supplies |
Medical and DECON supplies should be stored in close proximity to DECON station if possible. Each station should have a bill specifying required equipment/supplies. At a minimum: BUMEDINST 6470.10, Ref b; RM-3 or E140N frisker Radiac; Portable air sample; Tailor made yellow herculite; Spill kit; Step off pads; Survey maps; SF531; RADCON tape and radiological posting signs; DECON supplies |
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Proper set up for decon station, Organization |
All personnel, xpt HM, working in CSCA,DECON station, must be nuc trained. Req personnel: Man-in-Charge Corpsman Phone-talker RADCON assistant Control Point Watch |
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Man-in-Charge |
-Senior nuclear trained officer (big picture) -directs additional assistance/resources as needed -directs overall actions, ensures priorities are established, keeps control informed -options: NAV, WEAPS, Senior RADCON tech on shore stations. |
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RADCON assistant |
Nuc Trained qualified proficient at conducting whole body frisks and DECON options: ELT, senior-in-rate, qualified Nuc Trained |
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Corpsman |
perform triage treat life threatening injuries treat internal contamination supervise/perform wound DECON Det location and severity of wound track number/type/status of injured |
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Control Point Watch |
qualified per Art 108 supervises personnel exiting from DECON station obtain info from aarriving potentially contaminated personnel and provide initial direction |
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Pphone talker/recorder |
qualaified phone talker experienced in recording results of whole body frisks and contamination surveys of DECON station. located inside/outside the CSCA |
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In accordance with BUMED 6470.10B, when would you perform the "Quick Sort Method"? |
If no dosimetry was worn, a crude estimate of the exposure may be made using the quick-sort technique based on measurement of the sodium-24 activation in the body. |
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What is the rule of thumb for Quick Sort Method results? |
A reading of 0.2mR/H above background represents a neutron exposure above 25 rads. |
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What is the rule of thumb for calculating CDE for swallowed Co-60? |
Swallowing 1uCi of Co-60 will result in a CDE of approximately 80mRem to the GI tract. |
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Describe the "Rule of Eights" for Co-60 inhalation |
Ifinhaled,about80percentoftheisotopesareeliminatedwithabiologicalhalf-life of1dayorless. Approximately2/8oftheactivityisexhaled. Approximately5/8istrappedinthe mucous ofthe pulmonary system, swallowed, and passes through the intestinal tract. The remaining 1/8th is eliminated much more slowly |
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What is the rule of thumb for determining CDE by inhaled Co-60 |
1uCi of cobalt-60 still remaining in the lungs 24 hours after inhalation will result in a committed dose to the lungs of approximately |
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What is the measured gamma exposure rate of Co-60 in the lungs or digestive tract? |
One microcurie of cobalt-60 in the lungs or digestive system will produce a gamma exposure rate of approximately 0.04 mR!hr above background when measured with an AN/PDR-27 or MFR on contact with the chest or abdomen, or about 100 counts per minute above background with a DT-304 frisker. |
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What are the 3 primary organs of concern from plutonium exposure? |
Lung Liver Bone |
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Primary treatment therapy for tritium exposure |
heavy hydration with 2-4 liters of water per day. |
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What are 5 required follow-up actions and reports for internal contamination problem? |
NAVMED 6470/1 NAVMED 6470/10 NAVMED 6470/11 SF-531 Worker Statement Situational Examination (RME) Report to NAVSEA 08
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When performing initial assessment frisk, what five areas of the body must be frisked due to a high risk of internal contamination? |
FACT-B Face Abdomen Chest Thyroid Back |
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What four specific actions must be taken for an acute whole body exposure greater than 5 Rem? |
Attend to acute medical issues Establish control of external contamination IMMEDIATE message to BUMED with estimated dose RME, Situational Exam Follow up NAVMED 6470/1, Situational Report
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What is the appropriate method used for detecting the alpha and beta/gamma contamination in a wound? |
alpha: probe wound with swab, let dry, then probe
beta/gamma: direct monitoring with probe |
