Capability Target 5.3: Transportation and Treatment of Contaminated, Injured Individuals

ASSESSMENT – DEMONSTRATION AND EVALUATION GUIDANCE

By observing the OROs’ capability to address the appropriate bullet points below and while considering the overall capability being assessed, the following key points of review and associated questions should be considered and will support an evaluation of this capability target.

OROs demonstrate the capability to:

TRANSPORTATION

  • Transport contaminated, injured individuals to medical facilities.
    • Who dispatched the medical transport provider and what information was provided?
    • Did the appropriate briefings occur? What was contained in the briefings?
    • Which agency or agencies demonstrated the transportation of contaminated, injured individuals to appropriate medical facilities?
    • What type of vehicle was used for the transportation of the contaminated, injured individuals?
    • Was the site of pick-up in a potentially contaminated area? If so, what precautions were taken?
    • How did the medical transport provider know to take radiological precautions with the contaminated, injured individual?
    • Was the contaminated, injured individual monitored for radiological contamination before arrival or during initial evaluation by the transport provider?
    • Who did the monitoring?
    • What survey instruments were used?
    • Were the instruments current in calibration?
    • Did medical care take priority over monitoring?
    • Were instruments and equipment operationally checked using an appropriate check source against a known range of reading to verify proper operation?
    • What contamination control measures were taken by the medical transport crew?
    • How was the patient transferred from the medical transport vehicle to the medical facility?
    • Were accident scene survey records transferred to the medical facility staff? Was the transfer made taking care not to spread contamination?
    • Was the medical transport crew knowledgeable about where the medical transport vehicle (or other transport vehicle) and crew would be monitored and decontaminated?
    • Where and by whom will the medical transport crew and medical transport vehicle (or other transport vehicle) be monitored and decontaminated, if required?
  • Maintain communications between the medical transportation provider and the receiving medical facility. 
    • What communications occurred between the medical transport crew and the receiving hospital? How?

MEDICAL FACILITY

  • Operationally check instruments and equipment.
    • How were background measurements obtained on a continuous basis?
    • What survey instruments were used?
    • Were the instruments current in calibration?
    • Were instruments and equipment operationally checked using an appropriate check source against a known range of reading to verify proper operation?
    • Was an appropriate radioactive check source used to verify proper operational response for each low-range radiation measurement instrument?
    • Did the receiving facility personnel don the appropriate PPE in accordance with procedures and in a manner to prevent the spread of contamination?
  • Set-up, activate, and operate an REA.
    • How was the hospital notified to establish a REA? With regard to the REA, what information was provided to the medical facility by the medical transport crew?
    • Were staff, equipment, and supplies readily available for monitoring and decontamination, and setting up the REA?
    • How was access into the REA controlled?
    • Did urgent medical care take precedence over monitoring, decontamination, and contamination control efforts by facility medical staff?
    • Who performed and/or supervised treatment of contaminated, injured individuals?
    • What equipment and supplies were available for treatment of contaminated, injured individuals?
    • How were items assured to be free of contamination before they were transferred out of the REA to the clean area?
    • After treatment and decontamination, how was the individual transferred out of the REA?
    • How did the staff exit the REA?
    • Was a doffing procedure correctly implemented?
    • Was the REA, and equipment within, monitored for contamination prior to returning it to normal operations?
  • Monitor and decontaminate the individual, equipment, and other items.
    • How were monitoring (i.e., survey measurements and samples) results documented and recorded?
    • Did the medical staff make decisions on the need for decontamination of the individual and follow appropriate decontamination procedures?
    • What contamination threshold triggers the need for decontamination of the individual?
    • What methods were used to decontaminate the potentially contaminated individual (once that person is medically stabilized)? Were decontamination methods progressive (e.g., mild decontamination used prior to scrubbing)?
    • What procedure was used if decontamination was not successful?
    • What methods were used to collect and analyze samples, including swabs and skin wipes?
    • Who did the monitoring? What equipment was used?
    • What records were maintained with regard to survey and decontamination?
    • What was the procedure for handling, decontaminating, and storage of contaminated items?
    • What was the action level to determine if equipment was contaminated or not?
    • Who decontaminated the equipment and other items?
    • How was waste water from decontamination operations handled?
    • What contamination control measures were taken?