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RADIATION BASICS

RADIATION BASICS. INTRODUCTION. What is Radiation? Types of Radiation Nonionizing Radiation I onizing Radiation. INTRODUCTION. Radiation Spreading Events Radiation Poisoning Radiation Exposure Device (RED) Radiation Dispersal Device (RDD) Improvised Nuclear Detonation (IND)

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RADIATION BASICS

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  1. RADIATION BASICS

  2. INTRODUCTION • What is Radiation? • Types of Radiation • Nonionizing Radiation • Ionizing Radiation

  3. INTRODUCTION • Radiation Spreading Events • Radiation Poisoning • Radiation Exposure Device (RED) • Radiation Dispersal Device (RDD) • Improvised Nuclear Detonation (IND) • Nuclear Weapon Detonation (NWD) • Time Distance Shielding • Inverse Square Law • Shelter in Place

  4. INTRODUCTION • Why are we afraid of Radiation? • Measuring Radiation • Patient Decontamination • Health Effects of radiation • Medical Management of Radiation Patients • Public Health Response

  5. RADIATION • RADIATION is energy that comes from a source and travels through some material or through space. Light, heat, X-ray and microwave energy are types of radiation. • IONIZING RADIATION is produced by unstable atoms. Unstable atoms differ from stable atoms because they have an excess of energy, mass and/or both.

  6. TYPES OF RADIATION IN ORDER OF PENETRATION • Alpha Particles • Beta Particles • Gamma Rays • Neutron Particles

  7. LIMITING EXPOSURE • AS LOW AS REASONABLY ACHIEVABLE (ALARA) • TIME • DISTANCE • SHIELDING

  8. INVERSE SQUARE LAW A = 4x = 32 rem B = x = 8 rem C = 1/4x = 2 rem

  9. RADIATION POISONING • Place in food or water • Gets more difficult with increase in number of people to poison • Creates panic • Doesn’t require explosives or high technology • Done effectively in the past. • Slow to affect people, but time is dose dependent

  10. RADIATION POISONING • Alexander Litvinenko • Polonium 210 (210 Po) – alpha emitter • Lost hair, Severe nausea, vomiting Bone marrow badly damaged • Unable to eat for 18 days, Died in 3 weeks • 210 Po was in green tea • Seven bar staff had levels of 210 Po • Several customers also had evidence of 210 Po exposure from same pot

  11. RADIATION DXPOSURE DEVICE (RED) • Radioactive source out of legal control • Potential to expose people to lethal doses of radiation • Irradiation, no incorporation if sealed source • Dose assessment, medical monitoring • Psychological & Economical impact

  12. RADIATION DXPOSURE DEVICE (RED)

  13. RADIOLOGICAL DISPERSAL DEVICE (RDD) • Conventional explosive incorporating radioactive materials • Explosion greatest hazard • Mostly creates panic with little injury

  14. NUCLEAR DETONATION • TWO DIFFERENT THREATS • Nuclear Weapon Detonation (HIGH YEILD) • Improvised Nuclear Detonation (IND) (LOW YEILD)

  15. IMPROVISED NUCLEAR DEVICE (IND) • Illicit nuclear weapon bought, stolen, or otherwise originating from a nuclear state, or built from the components of a stolen weapon or from scratch. (Pu or U) • Produces same physical and medical effects as nuclear weapon explosion

  16. IMPROVISED NUCLEAR DEVICE (IND) • Results in catastrophic loss of life, destruction of infrastructure, and contamination of a very large area • If nuclear yield is NOT achieved, the result would likely resemble a RDD • If nuclear yield is achieved, results would resemble a nuclear explosion • Like nuclear explosions, IND explosions can be evaluated with a fallout map

  17. FALLOUT MAP (PLUME)

  18. 76 % of all Fallout Always some CDC List of Interest out of 300+ I – Inhalation, ING – Ingestion, SC – Skin Contact, WHE – Whole Body Exposure, FF – Full Face Respirator

  19. RADIATION DECAY AFRRI - MEIR

  20. Fallout is distributed downwind from the blast site in a plume-like pattern.

  21. ELECTROMAGNETIC PULSE (EMP) • At the instant of the detonation (same time as thermal, gamma, and light) • Greatest nearest the epicenter and only lasts seconds • Disruption of the electrical grid, electronic and communications equipment • Equipment entering the area after EMP will function normally • Cell phones and handheld radios with small antennas may not be affected (Repeaters and towers will be)

  22. INITIAL BLAST INJURY • Thermal • Burns • Mortality Increases With Radiation • High Intensity Visible Light • Eye Damage

  23. BLAST INJURY • Over Pressure and Under Pressure • Blunt Trauma • Penetrations

  24. SHELTERING IN PLACE (SIP) • SIP will normally be the preferred protective action. • SIP should be directed if the projected effective dose greater than 10 mSv (1 rem). • SIP need not be implemented if the projected effective dose is less than 1 mSv (100 mrem).

  25. SHELTERING IN PLACE (SIP) • A brick building provides better protection than a brick veneer building, which is better than that of a frame building. • Less radiation exposure (increasing the Protection Factor) is seen at interior locations and below ground • Moving to a higher floor in the building increases the distance from the ground source but increases exposure from radiation on the rooftop.

  26. SHELTERING IN PLACE (SIP)

  27. FEAR RADIATION

  28. Radiation ??? Maybe I’m contaminated… OH what shall I do…

  29. GOIANIA, BRAZIL 1987 • 249 people contaminated • 20 people hospitalized • 4 people died • 2000 m2 contaminated. • 112,800 monitored in soccer stadium

  30. Which Do You Fear Most? OR H1N1 influenza pandemic (1918-1919) killed more people than WW I – 20 to 40 mil.

  31. Which Do You Fear Most? OR Yersinia pestis Deaths Plague of Justinian (541–542 AD) 25 mil. in Byzantine Empire Black Death (1348 - 1350) 40 – 60 % of Europe Great Plague (1665–1666) 20 % of London

  32. What would you rather live next to? Warning Time to Evacuate OR Little or No Warning Three Mile Island - 0 Death/Injuries Fukushima - 0 Deaths 3 injuries (latent period?) Chernobyl – Warning time not used SIP, KI, evacuation too late 47 known deaths from ARS >9,000 Cancer WHO estimated 2006 Union Carbide India Limited 12/84, methyl isocyanate gas release • 3,787 Dead • 558,125 injuries • 38,478 temporary partial disabling • 3,900 severely/permanently • disabling

  33. WOUNDS AND RADIATION • WOUNDS LEFT OPEN AND ALLOWED TO HEAL ARE POTENTIALLY FATAL DUE TO INFECTION • WOUND HEALING MARKEDLY COMPROMISED WITHIN HOURS OF RADIATION INJURY • WOUNDS SHOULD BE CLOSED AS SOON AS POSSIBLE. • EXTENSIVE DEBRIDEMENT OF WOUNDS MAY BE NECESSARY • CHECK WOUNDS PRIOR TO CLOSING WITH GEIGER COUNTER OR OTHER SOURSE…ALPHA CAN BE MASKED BY BLOOD

  34. “RADIOLOGICAL DECONTAMINATION SHOULD NEVER INTERFERE WITH ACUTE MEDICAL CARE. UNLIKE CHEMICAL AGENTS, RADIOACTIVE PARTICLES WILL NOT CAUSE ACUTE INJURY Medical Management Of Radiological Casualties Handbook, Second Edition, Military Medical Operations Armed Forces Radiobiology Research Institute, April 2003

  35. IONIZING RADIATION In most cases patients subjected to nuclear or radiological agents will be exposed, but not contaminated. Hiroshima thermal burn victim

  36. IONIZING RADIATION • A person is externally contaminated if radioactive material is on skin or clothing. • A person is internally contaminated if radioactive material is breathed in, swallowed, or absorbed through wounds. • The environment is contaminated if radioactive material is spread about or uncontained.

  37. CPM • A measure of radioactivity. • The number of atoms in a given quantity of radioactive material that are detected to have decayed in one minute. • Versus Disintegration Per Minute (DPM)

  38. ROENGTON (R) • Used to measure a quantity called exposure. • Gamma and X-rays, and only in air. • Measure of the ionizations of the molecules in a mass of air. • The main advantage of this unit is that it is easy to measure directly

  39. RAD • rad (radiation absorbed dose) • Used to measure a quantity called absorbed dose. • Amount of energy actually absorbed in material • any type of radiation • any material • Does not describe the biological effects of the different radiations.

  40. REM (roentgen equivalent man) • called equivalent dose. • absorbed dose in human tissue to the effective biological damage of the radiation. • Not all radiation has the same biological effect • Equivalent dose is often expressed in terms of thousandths of a rem, or rem.

  41. DOSAGE • For X rays and gamma rays in soft tissue • Exposure ≈ Absorbed Dose ≈ Dose Equivalent 1 R ≈ 1 rad ≈ 1 rem

  42. DOSAGE

  43. DOSAGE

  44. RADIATION PATIENT TRIAGE • Contaminated/exposed patients • Wounded but not contaminated/exposed • Wounded and contaminated/ exposed

  45. TREATMENT OF CONTAMINATED WOUNDS • In a contamination accident, any wound must beconsidered contaminated until proven otherwiseand should be decontaminated prior to decontaminating intact skin.

  46. RADIATION PATIENT MOVEMENT • Contaminated – Cocoon • Remember blood and water mask alpha particles • In Hospital movement

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