SHEET ACTION TO TAKE ON THE SITE OF THE EVENT Organising the relief work 19 Mobilising reinforcements DISPATCH THE VICTIMS AMONG THE HEALTHCARE FACILITIES: 1st line and, if necessary, 2nd line facilities. Choice of facility based on the balancing of several criteria: • Condition of the victim. • Accommodation and treatment capacities for children (according to age) or adults. • Technical platform, particularly for specific treatments (severe injuries, poisoning, burns, irradiation, contamination by radionuclides, etc.). The capacity of the 1st line healthcare facilities is determined beforehand by the Regional Health Agency under the “Organisation of the Healthcare System Response in Exceptional Public Health Situations for the Chemical, Radiological and Nuclear Risk” (Orsan CRN). MOBILISE THE AVAILABLE REGIONAL RESOURCES to have reinforcements in the defence and safety zone (zonal plan for mobilising healthcare resources): • human and material resources, • healthcare products (medicines, including the radionuclide antidotes/chelating agents and oxygen). MOBILISE NATIONAL REINFORCEMENTS The national reinforcements can be mobilised alongside the regional resources by Operational Centre for Regulation and Response to Health and Social Emergencies – Health Crisis Centre (CORRUSS-CCS – national Orsan arrangement), possibly in collaboration with the Armed Forces Health Service 7 (SSA). • Health agencies, in particular the Institute for Radiation Protection and Nuclear Safety (IRSN). • Tele-expertise for assisting with the care of contaminated victims, especially children, by non-specialised teams confronted with this type of emergency. • Projection of national medical teams (SMUR, RRHU, radiotoxicology specialists, etc.) or healthcare products (strategic stocks of radionuclide antidotes/chelating agents) and other equipment. • Mobilisation of exceptional medical evacuation capabilities: ambulances, trains, buses, aircraft, boats, etc. • Regionally competent SAMU with the support of the zone SAMU and the RRH RN • Regional Health Agency of the defence zone • CORRUSS‑CCS • Armed forces health service (exceptional situations) Responders + Responders + The steps The steps CHILDREN: HOW ARE THEY TO BE MANAGED? As with any other accident involving many people, the presence of children necessitates the mobilisation of appropriate and previously identified medical resources. The strategy for the medical management of children is similar to that for adults. The particularities of child medical management are covered by professional recommendations published under the auspices of the French Society of Emergency Medicine. 7. The SSA is only called upon in exceptional situations, when civil resources are inexistent, insufficient, inappropriate or unavailable. Medical regulation (cont’d) 64 MEDICAL RESPONSE IN NUCLEAR OR RADIOLOGICAL EMERGENCY
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