REGULATORY FRAMEWORK Organisation of relief and medical care When faced with a radiological or nuclear (RN) emergency involving a large number of victims, the intervention of the medical teams to take care of the victims if a fourphase process. Organisation of the relief and emergency medical aid is governed by Interministerial Circular No. 800/SGDSN/PSE/PPS of 18 February 2011 9. Activation This phase concerns the alerting, the mobilisation of the medical teams and first-aid responders and informing about the presence of an RN risk. The Call Reception and Regulation Centre (CRRC) and the Alert Processing Centre (APC) receive and analyse the alert in order to identify the nature of the potential RN risk as quickly as possible. The Internal Security Forces (ISF) are always informed. It is vital for the operational centres to exchange information continuously and to define a First Destination Area (FDFA) and a Resources Assembly Area (RAA). If there are children among the victims, specialised teams – who have been identified beforehand – must be mobilised rapidly. The medical management of children follows the same procedure as for adults. The principles of child medical management are covered by professional recommendations (https://www.sfmu.org/upload/consensus/gbp_GT_NRBC_PEDIA-LG-161120.pdf). Prehospital medical care The prehospital medical response on site is supervised by the MOC, in collaboration with the regionally competent SAMU, which directs the patients to the appropriate healthcare facilities (medical regulation of transfers). The relief and emergency medical care are dispensed as required at the different stages of the victim management pathway. The SAMU and the Fire and Rescue Services (FRS) must implement operational and regulation procedures that are appropriate for this type of event. These procedures identify the medical teams of the Mobile Emergency and Resuscitation Services (SMUR) and the Rapid Response Health Unit (RRHU), that can intervene in controlled zones. • The medical teams provide the victims with medical care in the Victim Assembly Area (VAA) as soon as possible after their evacuation from the exclusion zone. • Full decontamination of the victims (injured and uninjured persons) is carried out on leaving the VAA. This is the responsibility of the specialised FRS units 9. The healthcare facilities must nevertheless be prepared for the arrival of unannounced, non-triaged and non-decontaminated victims who missed the prehospital screening. They are taken care of in the Hospital Victims Assembly Area (HVAA). • In a mass casualty emergency situation, the principles of disaster medicine are applied. In this context, the aim is to deliver damage control care: the SAMU categorises and prioritises the injured persons according to the nature of their lesions in order to organise medical regulation. • Dispatching victims to the 1st, 2nd or 3rd line healthcare facilities is the responsibility of the regionally competent SAMU. If necessary, dispatching is done with assistance of the zone SAMU and the Regional Reference Hospital for the RN risk (RRH RN). 9. Circular relative to the national doctrine concerning the use of emergency and medical care resources in the event of a terrorist attack involving radioactive materials. PHASE 1 PHASE 2 WHO DECIDES ON THE EVACUATION OF THE EXTREME URGENCIES (EU)? The decision is taken by the Emergency Operations Commander (EOC) and the Medical Operational Coordinator (MOC), along with the SAMU which is in charge of medical regulation and informing the receiving healthcare facility. i 09SHEET 34 MEDICAL RESPONSE IN NUCLEAR OR RADIOLOGICAL EMERGENCY
RkJQdWJsaXNoZXIy NjQ0NzU=