A qualitative study on the suggestion of key nursing techniques and procedure optimization by medical staffs for patients with nuclear exposed in hospital / 中国实用护理杂志

Objective:To understand the views and suggestions of medical staff on the key nursing techniques and norms of in-hospital treatment of patients with nuclear exposure, so as to provide reference for the continuous optimization of follow-up processes.Methods:From September to October 2021,purpose sampling was adopted to select doctors and nurses who engaged in medical emergency rescue of nuclear exposure-related work in two divisions of the Nuclear Accident Medical Emergency Center of the National Health Commission as the research subjects, using a combination of online and offline methods to carry out semi-structured interviews with 6 research subjects,using content analysis methods in descriptive research for data analysis.Results:A total of four themes were refined including the need for the establishment of nursing technology and process specification for nuclear accident emergency rescue specialty; the need for specialized training of nursing technology in nuclear accident emergency rescue; the need for the construction of specialized nursing team for nuclear accident emergency rescue; the need to strengthen the closeness of multi-team cooperation.Conclusions:The current in-hospital care technology and processes for nuclear exposed patients need to be further refined and standardized, and in the future, we need to establish a perfect in-hospital care technology and processes for nuclear exposed patients, and according to the corresponding technology and processes, strengthen nursing staff professional training and simulation training in nuclear accident emergency rescue, and establish a nuclear emergency rescue professional nursing team to promote the development of nuclear accident emergency rescue nursing specialists.

Gestão de eventos QBRN e a utilização do modelo Hysplit: uma revisão integrativa de literatura / CBRN events management and the use of the Hysplit model: an integrative literature review

RESUMO O potencial risco de exposição das populações aos agentes Químicos, Biológicos, Radioativos e Nucleares (QBRN), seja por causas intencionais ou não, configura-se como questão de segurança nacional e demanda um constante aprimoramento do seu gerenciamento. Os modelos de dispersão atmosférica vêm ganhando destaque como ferramenta de apoio à gestão dos riscos aos agentes QBRN. O objetivo desta pesquisa foi identificar e avaliar estudos que utilizaram o modelo Hysplit no contexto de eventos QBRN. Para tanto, foi realizada uma revisão integrativa de literatura de artigos publicados entre 2014 e 2018, nas bases de dados PubMed, Scopus, Web of Science e Lilacs. A análise dos artigos selecionados permitiu verificar o potencial do uso do modelo Hysplit, enquanto modelo matemático, para compreender o transporte, a dispersão e a deposição de ameaças QBRN liberadas na atmosfera. Os dados produzidos pelas simulações geradas por esse código podem revelar quais áreas serão potencialmente impactadas em um determinado evento ou a região de origem de elementos dispersos no ar. Ademais, o Hysplit pode ser agregado como uma ferramenta de suporte às decisões perante as distintas fases da gestão de eventos QBRN.

ABSTRACT The potential risk of exposure of populations to Chemical, Biological, Radioactive and Nuclear agents (CBRN), either by intentional causes or not, is a matter of national security and demands a constant improvement in its management. The models of atmospheric dispersion have been gaining prominence as a tool to support the management of risks to CBRN agents. The objective of this research was to identify and evaluate studies that used the Hysplit model in the context of CBRN events. For this purpose, an integrative literature review of published articles was conducted between 2014 and 2018, from the PubMed, Scopus, Web of Science and Lilacs databases. The analysis of the selected articles revealed the potential of the Hysplit model, as a mathematical model, to understand the transport, dispersion and deposition of CBRN threats released into the atmosphere. The data produced by the simulations generated by this code can reveal which areas will be potentially impacted in a given event or the region of origin of elements dispersed in the air. In addition, Hysplit can be aggregated as a decisions support tool in the different phases of CBRN event management.

Fukushima: lecciones japonesas para la Salud Pública colombiana. Reporte de caso / Fukushima: japanese lessons to colombian Public Health

Resumen Introducción: Durante el 21o. Congreso Mundial de Epidemiología, organizado por la Asociación Internacional de Epidemiología (IEA) en Saitama-Japón en agosto de 2017, se aceptó invitación de los organizadores para visitar la Planta Nuclear # 1 de Fukushima. Objetivo: Explorar la situación operacional y de salud pública en el área de la prefectura de Fukushima y su planta nuclear #1, sitio afectado por el terremoto y tsunami de 2011. Métodos: Salida de inspección de campo (Inspection Tour) y encuentro con representantes de TEPCO (Tokyo Energy Power Company) en área de control; explicación didáctica de antecedentes y situación actual zonal, e instrucciones (briefing) para acceso. Visita con explicación de zonas de atención de salud y trabajos realizados. Recorrido en autobús especialmente adaptado al perímetro de cada reactor, portando dosímetro individual. Reunión final para resolución de dudas e inquietudes y lecciones del caso. Resultados: Visita y reuniones ejecutadas; exposición personal = 0,01 mSv/h. Radiación por zonas de reactor: central=230 mSv/h; paredes=40 mSv/h; planta=0,26 mSv/h, periferia=0,26 mSv/h. Zona de exclusión=20 km. Políticas de salubridad basadas en limpieza y remoción de fuentes de contaminación; aislamiento de aguas y bombeo de fuentes subterráneas; prevención y contención de escapes. Conclusión: La prevención lo es todo en asuntos industriales, sean nucleares o no; la colaboración interpersonal e interagencias es esencial en el manejo a muy largo plazo de desastres similares; debe evitarse incorporar técnicas o tecnologías industriales desconocidas o foráneas sin antes valorar su costo, alcance y posibles riesgos de salud individual, pública o medio-ambiental.

Abstract Introduction. During the 21st. International Epidemiology Association (IEA) World Congress of Epidemiology at Saitama (Japan), celebrated in August 2017, an invitation from its organizers to visit Fukushima Nuclear Plant # 1 was accepted. Objective: To explore operational and public health situation at the area of the Fukushima Prefecture and its nuclear plant #1, place affected by the 2011 earthquake and tsunami. Methods. Inspection tour and appointment with representatives of TEPCO (Tokyo Energy Power Company) at the control area; explanation on background and actual situation, and briefing before access. Guided visit to areas dedicated to healthcare and workers' attention, and work done. Tour by specially adapted autobus to the perimeter of each reactor, using individual dosimeter. Final meeting to solve questions and lessons of this case. Results. Visit and meetings were executed; individual exposure = 0,01 mSv. Radioactivity by reactor zones: central (inside) =230 mSv/h; walls =40 mSv/h; plant =0,26 mSv/h, perimeter =0,26 mSv/h. Exclusion zone =20 km. Public Health policies in place based upon cleansing and removal of sources of contamination; water isolation and subterranean sources pumping; prevention and containment of leaks. Conclusion. About industrial issues, prevention is everything, whether they be nuclear or not; interpersonal / interagencies' cooperation is paramount when dealing with similar disasters at a very long term; unknown or poorly understood industrial techniques or technologies should be avoided before a proper evaluation of their risk/benefit balance, scope and possible health risks to subjects, communities or environment.

Characteristics of Emergency Medical Service Provider Responded Chemical, Biological, Radiological, and Nuclear Incidents: Pilot Analysis of National Emergency Medical Service Rescue Records

PURPOSE: The aim of this study was to evaluate the characteristics of Emergency Medical Service (EMS) provider responded chemical, biological, radiological, and nuclear (CBRN) incidents in Korea. METHODS: Nationwide EMS rescue records from Jan 2012 to Dec 2014 were analyzed. All EMS rescue records were integrated according to the unique accident ID. Cases related to animal rescue, hive removal, and suicide-related were excluded. CBRN-associated keywords were extracted by literature review and pilot survey. In-depth review of cases containing CBRN-associated keywords in the activity summary were conducted by trained emergency medical technicians, and predefined information was abstracted. Descriptive analyses were performed to characterize the EMS provider responded CBRN incidents. RESULTS: A total of 1,571,293 cases were included, and 1,335,205 cases had a unique accident ID; 515,417 cases were excluded because of their association with animal rescue, hive removal, and suicide attempts; 19,663 cases contained CBRN-associated keywords in the activity summary, and in-depth review identified 1,862 cases as CBRN incidents. Among them 1,856 cases were chemical incidents, and 6 cases were radiological incidents; 144 cases were resulted to victims. In chemical incidents, ammonia, hydrogen chloride, sulfuric acid, hydrogen fluoride, and nitric acid were the top 5 toxic substances. In chemical incidents with victims, the proportion of explosion/implosion, and suffocation in sealed space was more prevalent than chemical incidents without victims. Median scene time of all CBRN incidents was 41 minutes (interquartile range 18.0-57.0). CONCLUSION: We evaluated the characteristics of CBRN incidents responded by EMS in Korea.