Nationwide Response Issues After an Improvised Nuclear Device Attack Medical and Public Health Considerations for Neighboring Jurisdictions: Workshop Summary (2014) / Chapter Skim
Currently Skimming:
7 Monitoring and Mass Care in Outlying Communities
7 Monitoring and Mass Care in Outlying Communities
Pages 57-70
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 57... ...
By setting up reception centers with screening and monitoring activities, communities can better triage incoming patients and victims to the appropriate care and more quickly integrate needy patients into national transport systems or the Radiation Injury Treatment Network (RITN) for specialized treatment.
|
From page 58... ...
THE NEED FOR RECEPTION CENTERS AND POPULATION MONITORING The goals of population monitoring, according to Ansari, are to build on the existing capabilities of mass care and public sheltering to assess evacuees' medical needs related to a radiological emergency. Components might include delivering first aid, determining radiation exposure, screening for radioactive contamination, performing decontamination, and establishing an exposure registry.
|
From page 59... ...
This care could also occur at a reception center or community hospitals and will be covered in more detail in Chapter 8. TABLE 7-1 Estimated Number of Irradiation Casualties Patients, n 1-kiloton 10-kiloton Patient Category Radiation Dose, Gy Detonation Detonation Combined injuries All doses 1,000–3,000 15,000–24,000 (minimal to intensive care)
|
From page 60... ...
SOURCE: Waselenko et al., 2004. BUILDING CAPACITY FOR COMMUNITY RECEPTION CENTERS Ansari described one tool recently developed by the CDC to guide local public health planners, a virtual community reception center (CRC)
|
From page 61... ...
Building on this existing "all-hazards" capacity and adding functions specific to a radiologic emergency can give local and state authorities confidence and progress in IND attack planning without the frustrations of starting from the beginning. Population Monitoring: Resources and Personnel To conduct population monitoring at a CRC requires a large cadre of trained staff.
|
From page 62... ...
The funding for that in-house calibration unit comes in part from fees collected from Florida's three major nuclear power stations and radioactive materials licensees. Promoting the Use of Volunteers for Population Monitoring The recruitment and training of volunteer radiation professionals to conduct population monitoring in the event of an IND or other radiological emergency is the focus of a cooperative agreement between the CDC and the Conference of Radiation Control Program Directors (CRCPD)
|
From page 63... ...
Langer said that the focus of the exercise was especially on the first 48 hours -- a crucial time before the expected arrival of substantial state and federal resources. The exercise proved highly successful for one specific goal: to demonstrate that the newly formed Kansas Radiation Response Volunteer Corps could effectively handle population monitoring.
|
From page 64... ...
could carry out many of these functions, she said. The concept of using an FAC after mass casualties traces back to the 1990s, when the military and the National Transportation Safety Board established FACs as a focal point for information and services geared for families of crash victims.
|
From page 65... ...
To enhance a response with needs going beyond local health care, national transport systems and health networks could be used, decreasing the burden on systems in close proximity to the detonation site and giving victims more access to needed beds and treatment. Daniel Weisdorf of the Radiation Injury Treatment Network (RITN)
|
From page 66... ...
Patients would need to be accompanied by their earliest blood count results before being transported to a receiving hospital within RITN. Once patients are admitted, RITN has established guidelines for how they should be treated for acute radiation syndrome (RITN, 2010)
|
From page 67... ...
One regional care system will have to be coordinated with other regional care systems, and sharing laboratory results and other types of medical information among these systems will be very difficult, as will coordinating transport between systems. Garrett concluded his presentation by observing that an IND attack imposes such a staggering threat that it is likely to overwhelm the community approach envisioned by the DHS's National Response Framework.
|
From page 68... ...
It will take time to mobilize them in a time of crisis. For critical care patients not only is there a limited number of highly trained personnel, but each three-member critical care air transport team can accommodate only three ventilator patients or six non-ventilator critical care patients per flight.
|
From page 69... ...
And between 1990 and 2009 the number of emergency rooms in non-rural hospitals declined by 27 percent. The lack of surge capacity and hospital beds means that local hospitals and health care centers will be unable to handle an influx of 100 patients needing advanced medical care.
|
From page 70... ...
To meet the high demand for formal medical treatment, outlying communities can draw on RITN, which can provide care to some 30,000 radiation casualties with bone marrow suppression, who will generally require a very specialized treatment. Another source of medical surge resources is NDMS, which has around 8,000 volunteers, 5,000 of whom are credentialed clinicians.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.