HISTORY
The death and devastation evidenced by the first
and only use of nuclear power in wartime (in
Hiroshima and Nagasaki, Japan, at the end of World
War II) has, to date, kept it from being used again.
Although a nuclear nonproliferation treaty has been
signed by most of the major powers, nuclear weaponry
is still a part of the arsenal of many countries of the
world, some of which, if given the opportunity and
excuse, would not hesitate to employ it to achieve
victory at any cost.
History has shown that nuclear warfare is capable
of producing a large disparity between the available
medical care and the number of casualties requiring
care.
The capabilities of medical facilities and
personnel must be surveyed to determine how and
where they can best be utilized. Both professional and
nonprofessional personnel must be trained in
additional skills related as far as possible to their
primary duties.
Within medical organizations,
efficiency will depend upon controlled patient flow,
adequate supplies, and continuing essential
housekeeping and administrative functions. To meet
the requirements, it is essential that all medical service
personnel be trained to assume some additional
responsibilities.
EXPOSURE FACTORS
Teams entering contaminated areas to either
remove casualties or work in decontamination stations
have two major concerns. The first concern is the
prevention of their own contamination, and the second
is the prevention or reduction of radioactive exposure.
Contamination can be avoided by decontaminating
patients and equipment before handling, wearing
appropriate protective clothing and equipment,
avoiding highly contaminated areas, and strictly
observing personal decontamination procedures.
Exposure to radiation should also be avoided or
minimized. Alpha and beta particles and gamma rays
are emitted from radioactive contaminants and present
a direct risk to the health and safety of personnel in the
contaminated area. This risk can be avoided (or at least
minimized) by following some simple guidelines and
using common sense. Time, distance, and shielding
are the major elements that guide actions to avoid
exposure.
Time
Radioactive decay and the decomposition of
fallout products progress rapidly in the early hours
after a nuclear blast, and the hazards to rescue workers
can be reduced considerably if operations can be
delayed until natural decay has reduced the level of
radioactivity. Use teams trained in the use of survey
instruments since they will determine the intensity of
radiation and mark perimeters of danger zones.
Limiting the time of exposure is essential if total
avoidance is not possible. Rotating personnel entering
an exposure risk area, planning actions to minimize
time in the area, and prompt decontamination reduce
the total time the individual is exposed, thereby
reducing the dose of radiation absorbed by the body.
Distance
Both radioactive particles and electromagnetic
waves (gamma rays) lose energy and consequently
lose their ability to harm tissue as they travel away
from their source. Therefore, the farther one is from
the source, the more the danger of an exposure is
minimized.
Shielding
Shielding is an essential component in preventing
radiation exposure. Alpha and beta particles have very
little penetrating power, and the intact skin forms an
adequate barrier in most cases. Gamma radiation has
much greater penetrating power and presents the
greatest risk of exposure and damage to tissue.
Lead is the most effective shielding material.
Wood, concrete, other metals, and heavy clothing will
somewhat reduce the amount of gamma radiation that
reaches the body. Most particle exposure is the result
of inhalation or ingestion, although radiation particles
may enter the body through burned, abraded or
lacerated skin.
In avoiding particle exposure, full
personnel-protective clothing and a protective mask
with hood provides the best protection. The protective
mask and foul-weather gear will provide lesser but
adequate protection. In cases where no protective
breathing devices are available, some protection is
afforded by breathing through a folded towel,
handkerchief, or several surgical masks.
Avoid
hand-to-mouth contact, eating, or smoking in
contaminated areas.
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