Radiation

Radiation injuries are closer to home than expected as radioactive sources are common in daily life. Our case study illustrates a case of radiation burns to the hand which presented about two weeks later to the emergency department after accidental exposure to an industrial radiation source. A 45-year old Chinese man presented 17 days later after being exposed accidentally to iridium-192 source at 43 curies. He subsequently suffered burns that required multiple operations to treat. The diagnosis of patients who present early after exposure with no clinical signs will likely pose a challenge for the emergency medicine clinician as radiation burns take time to manifest and may present days to weeks after radiation exposure.

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“…This is due to injury to the stem cells of the skin, which leads to dry or moist desquamation at sufficiently high doses 2,8 .…”

Section: Discussionmentioning

confidence: 99%

Radiation Injury Presenting to the Emergency Department: A Case Report

Tan

Lee

et al. 2014

Proceedings of Singapore Healthcare

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“…Alpha particles consist of two neutrons and two protons, and although they can travel up to 3 cm in air, they cannot penetrate skin but are extremely dangerous if ingested or inhaled. Beta particles are electrons that can penetrate approximately 5 mm in skin and 3 cm in air [ 73 ].…”

Section: Threats Directed At Emergency Respondersmentioning

confidence: 99%

Risks to emergency medical responders at terrorist incidents: a narrative review of the medical literature

et al. 2014

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As the threat of international terrorism rises, there is an increasing requirement to provide evidence-based information and training for the emergency personnel who will respond to terrorist incidents. Current major incident training advises that emergency responders prioritize their own personal safety above that of the ‘scene and survivors’. However, there is limited information available on the nature of these threats and how they may be accurately evaluated. This study reviews the published medical literature to identify the hazards experienced by emergency responders who have attended previous terrorist incidents. A PubMed literature search identified 10,894 articles on the subject of ‘terrorism’, and there was a dramatic increase in publications after the 9/11 attacks in 2001. There is heterogeneity in the focus and quality of this literature, and 307 articles addressing the subject of scene safety were assessed for information regarding the threats encountered at terrorist incidents. These articles demonstrate that emergency responders have been exposed to both direct terrorist threats and environmental scene hazards, including airborne particles, structural collapse, fire, and psychological stress. The emphasis of training and preparedness for terrorist incidents has been primarily on the direct threats, but the published literature suggests that the dominant causes of mortality and morbidity in responders after such incidents are the indirect environmental hazards. If the medical response to terrorist incidents is to be based on evidence rather than anecdote, analysis of the current literature should be incorporated into major incident training, and consistent collection of key data from future incidents is required.

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“…Compromised immune function was observed for Chernobyl firefighters and should be a treatment priority. 44 These lessons have assumed greater significance in the context of the current geopolitical realities. The ongoing oil crisis makes it likely that there will be more reliance on nuclear production of energy.…”

Section: Relevance To Today and Clinical Teaching Pointsmentioning

confidence: 99%

Preparedness Lessons from Modern Disasters and Wars

Dara¹,

Farmer

2009

Critical Care Clinics

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Disasters come in all shapes and forms, and in varying magnitudes and intensities. Nevertheless, they offer many of the same lessons for critical care practitioners and responders. Among these, the most important is that well thought out risk assessment and focused planning are vital. Such assessment and planning require proper training for providers to recognize and treat injury from disaster, while maintaining safety for themselves and others. This article discusses risk assessment and planning in the context of disasters. The article also elaborates on the progress toward the creation of portable, credible, sustainable, and sophisticated critical care outside the walls of an intensive care unit. Finally, the article summarizes yields from military-civilian collaboration in disaster planning and response.

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Radiation

Cited by 7 publications

References 13 publications

Radiation Injury Presenting to the Emergency Department: A Case Report

Radiation Injury Presenting to the Emergency Department: A Case Report

Risks to emergency medical responders at terrorist incidents: a narrative review of the medical literature

Preparedness Lessons from Modern Disasters and Wars

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