Perparing for the Worst
October 5th, 2009 by PotatoWe’ve been doing some training lately, preparing for the worst. Specifically radiation disaster management. It’s a pretty interesting course, with some good take-home messages.
The first is that dealing with the (terrified) public can often be the hardest and least predictable part of disaster management, and in a radiation disaster situation that can be pretty bad. The public generally has exceptionally poor knowledge of what radiation is, how dangerous it actually is (yes, people have died, but it’s not nearly as dangerous as people are afraid it is), and what the difference between contamination and exposure are. We’re told that we have to explain physics concepts to the public at a grade 6 level, and that can be quite the challenge. Especially when you also have to deal with an attention span of maybe 1 minute. That speaks to me of a need for more general science outreach and education, something I’m all in favour of all the time (aside: notice the “science questions” topic tag — feel free to ask any, as this kinda sorta counts as a scientist working on educating the public ;)
For those of us worried about potential future terrorist attacks, there are a number of frightening scenarios thrown around. That of a dirty bomb or even a full-blown nuclear attack often top the fear lists. However, as our instructor today said, “I hope to hell that nothing happens, but if there is an attack, I hope it is radiological. We have detectors that go ‘beep’ at even very safe levels of background radiation. We can fairly quickly and very reliably screen those who have and have not been contaminated. We don’t have a meter for germs or nerve agents.”
Of course, we have to deal with the fear that the word radiation inspires. Sarin nerve gas is deadlier than the radiation in most dirty bomb scenarios, but thanks to poor delivery the attacks on the Tokyo subway resulted in only about 1000 casualties of some sort (those moderately ill with vision problems) as well as the 12 dead. For every sick person that showed up at a hospital tough, five more “worried well” came in to be checked out. So that’s going to be a huge issue with radiation, and hospitals are somehow going to have to deal with screening and even just corralling the thousands of frightened people.
An even bigger issue to deal with is the fear in the healthcare workers and first responders. Before training, many healthcare workers are afraid of radiation, and wouldn’t want to work on a person coming from a disaster or dirty bomb attack for fear of being contaminated themselves. Fortunately:
No caregiver in the history of radiological accidents has received a medically significant dose of radiation from treating a contaminated patient.
That includes the doctors and nurses who treated the firefighters at Chernobyl. It includes the rescuers at the SL-1 disaster. Now, that’s not to say that the environments can’t be dangerous — many firefighters did get excessive doses from going into the reactor at Chernobyl*. It’s not to say that it can’t happen that someone could get so contaminated that they’d put the rescue crews at risk, but it is exceptionally unlikely, and hasn’t happened yet.
* – a big part of that was poor training and misinformation: many of the figherfighters didn’t know it was a nuclear situation, they didn’t have the proper equipment or procedures in place to protect themselves — I can’t find a reference, but I’ve heard they weren’t even told to strip off their contaminated outer clothes after exiting the reactor. The USSR was too secretive for anyone’s good.
So for medical teams the issue becomes one they’re familiar with: stabilize the patient medically. Airway, bleeding, circulation. Only after those are taken care of do you worry about potential contamination and cleaning it up.
“There are no points for clean corpses.”