Medical response in a nuclear or radiological emergency

Preface	5
Contents	6
01 – WHAT YOU NEED TO KNOW BEFORE TAKING ACTION	9
Medical response strategy	9
Sheet 01 – The 7 essential principles	11
Sheet 02 – General conditions of intervention	14
Sheet 03 – Action priorities along the medical pathway	15
Sheet 04 – The 3 types of victim	18
Sheet 05 – Questionnaire and description of the circumstances of an event	20
Sheet 06 – Responders’ equipment and means of protection	24
Sheet 07 – Decontamination and internal contamination treatment procedures	28
Regulatory framework	9
Sheet 08 – Reference systems	30
Sheet 09 – Organisation of relief and medical care	34
Sheet 10 – Arrangements specific to healthcare institutions	37
Background	9
Sheet 11 – Irradiation: definitions	40
Sheet 12 – Dosimetry: individual measurements and methods of evaluating the received dose	43
02 – MANAGING THE VICTIMS	45
Action to take in the event of external irradiation	45
Sheet 13 – Confirming and characterising the irradiation	47
Sheet 14 – Guiding the diagnosis through questioning	49
Sheet 15 – Evaluating the dose received	50
Sheet 16 – Ensuring the radiation protection of the emergency response and medical teams	53
Action to take on the site of the event	45
Sheet 17 – Carrying out the initial first-aid measures	55
Sheet 18 – Organising the medical pathway of the victims in the 3 zones	58
Sheet 19 – Organising the relief work	62
Sheet 20 – Before evacuation: stabilising and preparing the victims	65
Sheet 21 – Evacuating the injured: leaving the controlled zone	68
Sheet 22 – Protecting the responders in the exclusion zone and the controlled zone	70
Sheet 23 – Triaging the victims in the VAA	75
Sheet 24 – In the VAA: treating the absolute urgencies	76
Sheet 25 – In the VAA: decontaminating the relative urgencies	78
Sheet 26 – In the VAA: detecting external contamination of able-bodied persons	80
Sheet 27 – In the VAA; treating internal contamination and contaminated wounds	82
Sheet 28 – At the AMP: managing the victims	84
Action to take in a 1st line healthcare facility	46
Sheet 29 – Preparing the premises, rehabilitating them and managing the waste	85
Sheet 30 – Protecting the healthcare facility personnel	90
Sheet 31 – Receiving and managing the victims	92
Sheet 32 – Detecting external contamination	96
Sheet 33 – Undressing the victims	98
Sheet 34 – Decontaminating the victims	102
Sheet 35 – Treating the injured persons in the operating theatre	104
Action to take in a 2nd or 3rd line healthcare facility	46
Sheet 36 – Receiving the victims	105
Internal contamination measurements and treatments	46
Sheet 37 – Internal contamination measurements	107
Sheet 38 – Internal contamination: initial treatment	110
Sheet 39 – Specific antidotes	112
Sheet 40 – Contamination of the digestive tract: non-specific treatments	114
Glossary	115
03 – RADIONUCLIDES HANDBOOK	117
Introduction	118
Aluminium	119
Americium	120
Antimony	121
Arsenic	122
Barium	123
Bismuth	124
Cadmium	125
Caesium	126
Calcium	127
Californium	128
Cerium	129
Chromium	130
Cobalt	131
Copper	132
Curium	133
Erbium	134
Europium	135
Fluorine	136
Gallium	137
Gold	138
Indium	139
Iodine	140
Iridium	141
Iron	142
Lanthanum	143
Lead	144
Lutetium	145
Manganese	146
Mixture of fission products	147
Mercury	148
Neptunium	149
Nickel	150
Phosphorous	151
Plutonium	152
Polonium	153
Potassium	154
Praseodymium	155
Promethium	156
Radium	157
Ruthenium	158
Samarium	159
Scandium	160
Silver	161
Sodium	162
Strontium	163
Sulphur	164
Technetium	165
Tellurium	166
Thallium	167
Thorium	168
Tritium	169
Uranium	170
Ytterbium	171
Yttrium	172
Zinc	173
Zirconium	174

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