Medical management by a physician or nurse Medical management questionnaire (preparation of the medical record) Part 1: General medical management 11 • Pathology and treatment: Glasgow Coma Score – Dominant pathologies (Absolute Urgencies – AU / Relative Urgencies – RU): skull, thorax, abdomen, burned, poisoned, blast, fracture, polytraumatised, spine, other chemical, biological, radiological, nuclear (CBRN) risk? Diagnosis and treatment (peripheral venous catheter, intraosteal route, tourniquet, intubated). Development: improvement, stabilisation, aggravation (AU / RU / DECD)? 12 • Transport and destination: medicalised, non-medicalised, destination, service, means of transport, time, follower card (Victim Assembly Area – VAA / Advanced Medical Post – AMP / triage)? 13 • Medical surveillance and development: clinical, samples, therapeutic. Part 2: Radiological management (radiological evaluation sheet) Required information list: 14 • Acute radiation: yes/no, date and time, type of radiation (gamma/X-ray, neutrons), whole body and/or localised (part of body), estimated dose in gray (Gy) and diagram showing positioning with respect to the source. 15 • Headaches and/or impaired consciousness: yes/no, date and time. 16 • Early erythema: yes/no, location, date and time. 17 • Nausea and/or vomiting and/or diarrhoea: yes/no, date and time. 18 • Hyperthermia: yes/no, date and time. 19 • Guidance: total estimated dose (gamma/X-ray + neutrons) < 1 Gy (monitoring by) / total estimated dose (gamma/X-ray + neutrons) > 1 Gy Hospital 10 • Associated chemical risk: yes/no. Chemical agents concerned. 11 • External contamination: yes/no (if yes, indicate the contaminated zone). 12 • Emergency decontamination: yes/no, date and time. 13 • Full decontamination performed: yes/no, date and time. 14 • Residual external contamination: yes/no, detected or suspected radionuclides. Diagram of the residual contamination 15 • Internal contamination suspected: yes/no. 16 • Internal contamination: measured by in-vivo radiation measurement (yes/non), radionuclides and activities measured, suspected (yes/no), radionuclides. 17 • Contaminated wound: yes/no, location. 18 • Measurements – samples: in-vivo radiation measurement – urine radiotoxicology – nostril sampling – skin appendage sampling indicating location (or time-stamped) – time-stamped blood samples: Complete Blood Count (CBC), platelets, reticulocytes / haemostasis biochemistry enzymology / sodium-24 / phenotyping of the erythrocytes (red blood cells) / HLA class I and II typing / chromosomal aberrations. 19 • Internal contamination treatment: Potassium iodide (yes/no, time). This treatment is administered as quickly as possible in cases of internal contamination by radioactive iodine – Radiogardase® (yes/no, time, dosage) – Ca‑DTPA administered by slow IV injection or perfusion (yes/no, time, dosage) – Ca‑DTPA by inhalation (yes/no, time) – DTPA on contaminated wound: one or more vials (yes/no, time). 08 MEDICAL RESPONSE STRATEGY Questioning and description of the circumstances of an event SHEET 05 Download the medical management questionnaire Word file MEDICAL RESPONSE IN NUCLEAR OR RADIOLOGICAL EMERGENCY 23
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