Propuesta de tarjeta triaje en incidentes NBQ con múltiples heridos / Proposal of Triage Tag in NBQ Multi-Casualty Incidents

INTRODUCCIÓN: La amenaza por un incidente nuclear, químico o biológico (NBQ) es una preocupación que aumenta progresivamente en nuestra sociedad actual. El porcentaje de heridos en este tipo de sucesos puede ser potencialmente muy elevada. El triaje de éstos debe estar bien estructurado y adaptado a las distintas áreas de zonificación. OBJETIVO: El principal objetivo es presentar dos nuevas herramientas de diseño propio que sirvan para realizar el triaje de los heridos en escenarios NBQ con múltiples heridos. La primera de ellas es la «tarjeta triaje NBQZC» y está diseñada para su utilización en la zona contaminada. La segunda es la «tarjeta triaje NBQZNC», la cual se emplea en la zona no contaminada. Ambas están creadas para su utilización en zona de operaciones, siendo fáciles de interpretar y de cumplimentar. CONCLUSIONES: Se exponen dos tarjetas de triaje de heridos NBQ de aplicación en el ámbito militar

INTRODUCTION: Nuclear, Chemical or Biological incident's threat is a concerning issue progressively increasing in our society. In these events injures' percentage potentially might be very high. Casualties' Triage has to be well structured and adapted to the different zoning areas. OBJECTIVE: The main goal is to introduce two new own design tools assisting in the performance of CBRN triage in a Major Incident. The first one is «Triage Tag NBCZC» and it is accomplished in the contaminate zone. The second one is «Triage Tag NBCNZC» and it is filled in the not contaminate area. Both of them are created to be executed in an Area of Operations and their interpretation and completion can be made easily. CONCLUSION: Two news Triage Tag CBRN casualties are showing available to a military scene

DEVELOPMENT OF A NATIONAL EMERGENCY PLAN FOR MEDICAL DIAGNOSTICS AND THERAPY OF DETERMINISTIC EFFECTS AFTER RADIATION ACCIDENTS.

The focus of nuclear emergency planning in Austria has been so far on mitigating effects of widespread contamination (e.g. after NPP accidents); however, these plans did not contain provisions on the medical management of an acute radiation syndrome. To close this gap, a 'Medical Radiation Emergency Plan' was created in 2009 and 2011. This paper describes the development of this plan (including the selection of consulted guidance) as well as its structure and main propositions and closes with an outlook on probable enhancements for the second edition.

A review of post-nuclear-catastrophe management.

The purpose of this paper is to make radioactive risk more generally understandable. To that end, we compare it to smoking tobacco. Further, we show that the concept of loss of life expectancy permits a quantitative comparison between various aggressions. The demystification of radioactive risk should lead to basic changes in post-catastrophe management, allowing victims to choose whether or not to leave contaminated areas. A less emotional appreciation of radioactive risks should lead to the adaptation of legal practices when dealing with probabilistic situations.

250 mSv: temporary increase in the emergency exposure dose limit in response to the TEPCO Fukushima Daiichi NPP accident and its decision making process.

The Great East Japan Earthquake on March 11, 2011, led to an accident at the Fukushima Daiichi Nuclear Power Plant of the Tokyo Electric Power Company (TEPCO). In response to this accident, on March 14, 2011, the Ministry of Health, Labour, and Welfare (MHLW) of Japan enforced an ordinance that temporarily increased the radiation exposure dose limit allowed to 250 mSv during the emergency. This article explains the processes of a) temporarily increasing emergency dose limits, b) controlling for the combined emergency and normal exposure doses, and c) reducing the limit back to 100 mSv. Major issues addressed when deliberating the reduction of the emergency limits includes the following: a) political initiative, b) a phased reduction of dose limits, and c) transitional measures for workers who were exposed to more than 100 mSv. This article also identifies key challenges that need further deliberation to be resolved. These include: a) establishing a pre-defined protocol for applying pre-accident emergency dose limits and/or amending post-accident limits; b) designating the conditions in which to apply or amend emergency dose limits; c) selecting methods of radiation control for individuals who are exposed to more than the normal exposure dose limit during emergency work; and d) designating the conditions under which to terminate or reduce emergency dose limits after the accident.

Causation's nuclear future: applying proportional liability to the Price-Anderson Act.

For more than a quarter century, public discourse has pushed the nuclear-power industry in the direction of heavier regulation and greater scrutiny, effectively halting construction of new reactors. By focusing on contemporary fear of significant accidents, such discourse begs the question of what the nation's court system would actually do should a major nuclear incident cause radiation-induced cancers. Congress's attempt to answer that question is the Price-Anderson Act, a broad statute addressing claims by the victims of a major nuclear accident. Lower courts interpreting the Act have repeatedly encountered a major stumbling block: it declares that judges must apply the antediluvian preponderance-of-the-evidence logic of state tort law, even though radiation science insists that the causes of radiation-induced cancers are more complex. After a major nuclear accident, the Act's paradoxically outdated rules for adjudicating "causation" would make post-incident compensation unworkable. This Note urges that nuclear-power-plant liability should not turn on eighteenth-century tort law. Drawing on modern scientific conclusions regarding the invariably "statistical" nature of cancer, this Note suggests a unitary federal standard for the Price-Anderson Act--that a defendant be deemed to have "caused" a plaintiff's injury in direct proportion to the increased risk of harm the defendant has imposed. This "proportional liability" rule would not only fairly evaluate the costs borne by injured plaintiffs and protect a reawakening nuclear industry from the prospect of bank-breaking litigation, but would prove workable with only minor changes to the Price-Anderson Act's standards of "injury" and "fault."

Recent advances to address European Union Health Security from cross border chemical health threats.

The European Union (EU) Decision (1082/2013/EU) on serious cross border threats to health was adopted by the European Parliament in November 2013, in recognition of the need to strengthen the capacity of Member States to coordinate the public health response to cross border threats, whether from biological, chemical, environmental events or events which have an unknown origin. Although mechanisms have been in place for years for reporting cross border health threats from communicable diseases, this has not been the case for incidents involving chemicals and/or environmental events. A variety of collaborative EU projects have been funded over the past 10 years through the Health Programme to address gaps in knowledge on health security and to improve resilience and response to major incidents involving chemicals. This paper looks at the EU Health Programme that underpins recent research activities to address gaps in resilience, planning, responding to and recovering from a cross border chemical incident. It also looks at how the outputs from the research programme will contribute to improving public health management of transnational incidents that have the potential to overwhelm national capabilities, putting this into context with the new requirements as the Decision on serious cross border threats to health as well as highlighting areas for future development.

[Radiation measures and trend after the Fukushima Daiichi Nuclear Power Plant accident].

The radioactive materials spread by the Fukushima Daiichi Nuclear Power Plant (NPP) accident in March, 2011 caused NPP workers to be exposed to radiation above ordinance limits. The number of workers exposed to radiation within ordinance limits is increasing. Decontamination began at many places in Fukushima, although new laws were enforced in the decontamination work, in the current situation, medical examinations for radiation are limited due to a shortage of doctors. In this paper, I introduce the ordinances on the prevention of ionizing radiation hazards and the revised points about radiation exposure doses of the NPP workers, as well as the new ordinance for decontamination.

[Medical and hygienic aspects of instrumental supervision system over nuclear materials and radioactive substances transport on Russian Federation territory].

Hygienic evaluation of radiation situation in operation of mobile and stationery elements within a project of national system for instrumental supervision over nuclear materials and radioactive substances transport, created with a Global initiative against nuclear terrorism. Levels of exposure to ionizing radiation of the screening complexes appeared to match requirements on radiation safety for service personnel and general population.

Assuring operational readiness of the National Ignition Facility.

National Ignition Facility experiments involve the use of a variety of materials that generate a number of radiological issues. Along with the use of tritium and depleted uranium, shots generating neutrons create prompt radiation fields as well as fission and activation products. In order to assure readiness for these hazards, a series of readiness reviews was conducted as the hazards were introduced. Each step was built upon the previous steps, as well as the basic infrastructure and operating capability of the laser facility. A detailed preparation plan for the introduction of these hazards was developed. This included ensuring required equipment was in place and ready, all plans and procedures were developed, and personnel were trained and qualified to perform work in the environment. The approach for preparing the facility for operations under the new set of conditions, the preparations for the readiness reviews, the review process, as well as the approach to initial operations are discussed.

[Contemporary legislation and importance of psychophysiologic examination in system of medical support for workers engaged into production with radiation and nuclear danger].

In accordance with contemporary legislation, the article covers materials on specification and approbation of concept model for psychophysiologic examination in medical establishments during medical examination of workers engaged into production with raidation and nuclear danger. The authors defined methodology, examination methods and designed an order of psychophysiologic examination. The psychophysiologic examination and purpose-oriented rehabilitation appeared efficient.

Preparedness for radiological emergency situations in Austria.

This article presents the Austrian system of emergency preparedness for nuclear and radiological emergency situations. It demonstrates, in particular, the legal basis, the roles and competencies of the competent authorities, international and bilateral conventions on early notification of nuclear accidents, the Austrian emergency plans, the Austrian radiation monitoring system, the operated prognosis and decision support systems and the results of an estimation of possible impacts of nuclear power plant disasters on Austria.

The Fukushima Nuclear Power Station incident and marine pollution.

Based on the facts relating to the radioactive wastewater discharged by the Fukushima Nuclear Power Station in Japan, this paper intends to explore the international legal obligations for Japan from three perspectives, namely, the immediate notification, the prevention of transboundary harm and the prevention of dumping. Furthermore, this article defines and compares two types of international legal liabilities, the traditional state responsibility and the responsibility for transboundary harm. Through comparison, the international legal liability of Japan is discussed. After detailed analysis, the conclusion is that Japan should be responsible for the obligation of immediate notification and since Japan unilaterally discharge the wastes without prior specific permits of other contracting countries, it should also be responsible for the violation of prevention of dumping. Since so far, no material injury has emerged and there would appear to be no culpability as regards the prevention of transboundary harm. Finally, this paper stresses the necessity to develop a worldwide agreement concerning the liability for transboundary harm and to establish an institutional framework for the enforcement of a state's obligations, and also the great significance of international cooperation between nations and organisations in relation to marine environmental protection.

Communication of radiation benefits and risks in decision making: some lessons learned.

This paper is focused on summarizing the "lessons learned" from discussions at the 2010 NCRP Annual Meeting on effective communications on the subject of radiation benefits and risks in public exposures. Five main lessons learned are discussed in regard to effective methods of public communication: the use of new social media communication tools such as Facebook and Twitter, emergency situations that require rapid societal and personal messaging, medical radiological procedures where benefits must be described in comparison to long-term health risks of radiation exposures, and information that should be provided to stakeholders in situations such as environmental radionuclide contamination to which members of the public may be exposed. It is concluded that effective communications in which radiation benefits are contrasted with health risks of exposure are an important aspect of making and implementing decisions on employing radiation health protection procedures.

The U.S. government's medical countermeasure portfolio management for nuclear and radiological emergencies: synergy from interagency cooperation.

Following the attacks of 11 September 2001, emergency preparedness within the U.S. Department of Health and Human Services, as well as at the Department of Defense and other federal agencies, received higher visibility, new mandates and increased funding. Emergency deployment teams increased the frequency of drills to enable better response to the health consequences of mass-casualty incidents. Interagency coordination has also continued to increase to more efficiently and effectively leverage federal resources toward emergency medical preparedness for both civilian and military populations.

Revision of deposition and weathering parameters for the ingestion dose module (ECOSYS) of the ARGOS and RODOS decision support systems.

The ECOSYS model is the ingestion dose model integrated in the ARGOS and RODOS decision support systems for nuclear emergency management. The parameters used in this model have however not been updated in recent years, where the level of knowledge on various environmental processes has increased considerably. A Nordic work group has carried out a series of evaluations of the general validity of current ECOSYS default parameters. This paper specifically discusses the parameter revisions required with respect to the modelling of deposition and natural weathering of contaminants on agricultural crops, to enable the trustworthy prognostic modelling that is essential to ensure justification and optimisation of countermeasure strategies. New modelling approaches are outlined, since it was found that current ECOSYS approaches for deposition and natural weathering could lead to large prognostic errors.

Radiological accident and incident in Thailand: lesson to be learned.

Radioactive materials in Thailand have been used in medicine, research and industry for more than 50 y. Several radiological accident and incidents happened in the past 10 y. A serious one was the radiological accident that occurred in Samut Prakan, Thailand in 2000. The serious radiological accident occurred when the (60)Co head was partially dismantled, taken from that storage to sell as scrap metal. Three victims died and 10 people received high dose from the source. The lesson learned from the radiological accident in Samut Prakan was to improve in many subjects, such as efficiency in Ministerial Regulations and Atomic Energy Act, emergency response and etc. In addition to the serious accident, there are also some small incidents that occurred, such as detection of contaminated scrap metals from the re-cycling of scrap metals from steel factories. Therefore, the radiation protection infrastructure was established after the accident. Laws and regulations of radiation safety and the relevant regulatory procedures must be revised.