Chapter 45. Nuclear and radiation incidents
In the emergency response to an incident involving radioactivity, the principles of casualty care remain the same:
• Rapid assessment
• Administration of life-saving procedures
• Stabilisation
• Evacuation.
All of these procedures should be carried out without risking the safety and health of the paramedic team who must be sure that they are not placing themselves or the casualty at unnecessary risk – or that the risk is acceptable.
The hazards to which paramedics may be exposed are:
• Penetrating radiation
• Contamination.
Ionising radiation cannot be detected by the human senses but at the levels likely to be encountered in plausible accidents, there is little risk, and simple precautions will promote safe management of the radiological aspects of the injury.
The hazards
Radioactive sources are widely used in the UK, in:
• Industry
• Hospitals
• Further education establishments
• Nuclear power stations
• Research establishments
• Military bases
• During transport (air, road, sea and rail).
Where radioactive materials are processed on a large nuclear site, there will be contingency plans in the event of an accident, which may require the support of ambulance, fire and local authority agencies as well as the employer’s own response team.
Substances are said to be radioactive when they give off radiation
Types of radiation
α-Radiation
Alpha particles travel a very short distance in air and are stopped by a sheet of paper, clothing, blood or dressings. Ingestion or inhalation must be avoided as the particles can damage more sensitive internal organs. Examples of substances that emit α particles are uranium, plutonium and radon.
β-Radiation
β-Radiation is stopped by a thin sheet of aluminium or heavier clothing. It can penetrate the skin surface and therefore damage the epidermis and dermis to produce radiation burns. The hazard is greatest when the β emitter is in direct contact with the skin. Examples are iodine and tritium.
γ-Radiation, X-rays and neutrons
γ-Rays, X-rays and neutrons all travel great distances in air and are only stopped by thick concrete or lead. These forms of radiation can pass through the body, depositing energy and causing damage as they proceed. They are therefore still a hazard at some distance from the casualty or incident. Examples are industrial radiography sources, caesium and cobalt.
Risks of exposure
Ionising radiation can affect a part of the body or the whole body, causing localised effects (radiation burns) or systemic effects (radiation syndrome).
Loose particles of radioactive material (dust, aerosol or liquid) are known as contamination.
The material will emit radioactivity but in addition, it can easily be inhaled or ingested and precautions are needed to prevent this.
There are three scenarios involving exposure to radioactive materials that the paramedic will have to consider in the immediate care situation:
• The exposure to γ-rays or X-rays from a source near to the patient
• The presence or spread of contamination onto skin, hair and clothes of the patient
• The inhalation or ingestion of contamination by the paramedic or patient during rescue, resuscitation and removal.
Related posts:
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
