Planning and Response Tools - PowerPoint Presentation

Planning and Response Tools
Planning and Response Tools

Planning and Response Tools - Description

for a Radiation Emergency Ed Waller PhD PEng CAIH CHP Professor NSERC Industrial Research Chair in Health Physics and Environmental Safety University of Ontario Institute of Technology Presented at the Centers for Disease Control and Prevention Atlanta Georgia 23 March 2011 ID: 510558 Download Presentation


www tools tool software tools www software tool http radiation emergency gov guidance cdc afrri local hardware management triage medical waller health

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Planning and Response Tools for a Radiation Emergency

Ed Waller, PhD, PEng, CAIH, CHPProfessorNSERC Industrial Research Chair in Health Physics and Environmental SafetyUniversity of Ontario Institute of TechnologyPresented at the Centers for Disease Control and Prevention, Atlanta, Georgia, 23 March 2011Slide2

“Security forces are taking "very seriously" the risk of a possible terrorist attack using radioactive agents.”

Jacqui Smith, British Home Secretary, 2007A dirty bomb attack against a major Western city is just a matter of time” UK Security Service: MI5, Dame Elizabeth Manningham-Buller“It’s not if a dirty bomb will go off; it’s when”

V.E. Anderson, California Dept of Public Health“We cannot train everyone to a health physicist level”

Rob Ingram, FDNY Chief WMD

Individual dose assessment in the early phase of a terrorist attack is currently not possible.US Department of Homeland Security


Anatomy of the RDD Event3

Adapted from “Human Error”, James Reason, Cambridge, 1990

Latent failures at the managerial level


in Depth

Realizable Damage to humans and/or infrastructure

System ‘holes’



Abnormal situations



Psychological precursors


: for a reactor accident, evil plans might be replaced by unsafe acts, inadequate training, etcSlide4

Need for ToolsIn the same way that all emergencies are local

emergencies, all medical management tools are by necessity local toolsTool must be tailored to local conditions, populations and resources availableAlthough tools are local, they need to be consistent with state/federal/territorial guidance and directives4Slide5

The Human FactorMost people have never been in a mass casualty emergency, let alone a radiological emergency.

Real experience is lacking.Who do you need?5


Problem SolverSlide6

What is a tool?

An implement used in the practice of a vocationEntity that interfaces between two or more domainsTools need to be simple and effective for emergency responseMarshall McLuhan: “We shape our tools. And then our tools shape us”6Slide7


TM noteTagPiece of paperMany sheets of paperSoftware (desktop, laptop, mobile app)WebWareIntegrated hardware/software7Slide8

ConundrumTool designers want to put as much functionality into their tools as possible

End-users want simplicity and efficiencyReality is in-between8Slide9


Where do I start?Slide10


First-on-the-SceneCBRNe RespondersIncident CommandersHealth Physics Reach-BackHospital Emergency ServicesRadiation BiodosimetryLaw Enforcement (forensic criminal investigation)10


Hardware & SoftwareHardware tools

Detect radiationQuantify radiation exposureQuantify radiation doseSoftware toolsExtent of conditionTriage decisionsTreatment assistanceDose assessmentRecordingForensicsSoftware Application CategoriesMedical TriageMedical Treatment

Hazard PredictionDosimetryTraining


Select Software Tools

“Overview of Hazard Assessment and Emergency Planning Software of Use to RN First Responders”, Waller, E.J., Millage, Blakely, Ross, Mercier, Sandgren, Levine, Dickerson, Nemhauser, Nasstrom, Sugiyama, Homann, Buddemeier, Curling and Disraelly, Health Phys, Vol. 97, No. 2, pp. 145-156, 2009.


Medical Management13Slide14

Of Importance to the Medical Management

Is the person injured?Treat this first (without compromising position)Is the person contaminated?External, internal or both?If external, decontaminated and re-assessDosimetry estimateIf internal, what is isotope & activity?Triage internal contaminationDosimetry assessmentLong term care & risk assessment14Slide15


AFRRI = Armed Forces Radiobiology Research Institute15Slide16


FRAT tool assists triage and treatment using



BAT software tool assists radiation dose prediction using lymphocytes, lymphocyte depletion and on-set of emesisSlide17

CDC Tools

CDC = Centers for Disease Control and Prevention17Slide18

HHS Tools

HHS = US Department of Health and Human Services18Slide19


REAC/TS = Radiation Emergency Assistance Center/Training SiteSlide20

TMT Handbook20Slide21


MEdical DECORporation)PDA app developed for DRDC-OttawaAssist in Triage and Treatment plans for internally contaminated personsFirst Revision tested at NATO exercise Peaceful Dragon in 2006Beta Version of MEDECOR2 tested in Czech Republic in Fall 2010Current testing within Canadian ForcesGuidance is consistent with NCRP161 (revision of NCRP65)


Combined Software and Hardware Solution

MEDECOR and RTM (Radiation Triage Mask)22

Or, alternatelySlide23

End-User Testing


Multi-Purpose Software24



Dosimetry and Shielding



ICRP 68/72



Guidance for Tool Selection

First, identify the type of guidance you needThen, try some of the tools that fit the needDesktop scenario simulationExerciseNext, integrate tool into response plansHave tool current and availableExerciseEnsure

appropriate people can use the tool

Ensure recommended

treatments are availableFDA, off-labelPeriodically re-evaluate the effectiveness of tool



REMM tool/general guidance (US HHS) BAT/FRAT/worksheets (AFRRI) Terrorism Toolkits (CDC) REAC/TS (ORAU) NCRP Report No. 161 (Management of Persons Contaminated with Radionuclides

MEDECOR2 and/or RTMContact Ed Waller (


TMT Handbook

Links (cont)

Rad Pro Calculator Decay IMBA ICRP68/72 CD Rom



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