Phases | Factors | |||
---|---|---|---|---|
Host (victims) | Agent (terrorists/bombs) | Physical environment (materials/facilities) | Social environment (policies/procedures) | |
Pre-event (pre-bombing) | None | Gather intelligence and observe potential actors of malevolent acts Protect the access to sites storing HAZMAT or radioactive material | Ensure the availability of escape and evacuation routes from critical locations | Establish legal restrictions and control for the possession and commerce with radioactive material and components needed for an explosive device construction |
Event (bombing and pre-hospital management) | Ascertain rapid evacuation from the scene Choose the right medical management priorities for treatment and transportation (“treat first what kills first”) | Screen the scene rapidly for further explosive devices (“second hit”) and other technical dangers (e.g. electricity in a subway bombing) | Ascertain the rapid availability of radiation detection devices Ascertain a sufficient number of vehicles for transportation of critical victims to hospitals as well as vehicles that may become contaminated | Educate and train EMS personnel in basic NRBC protection and medical issues related to radiation |
Post-event (after evacuation to a medical care facility) | Ascertain specific triage to evaluate the expected health damages from irradiation and direct patients accordingly | Screen incoming people to the hospital for arms or explosive devices (to avoid “second hits” at hospital) | Ascertain a sufficient number of security personnel at emergency departments in case of panic or assaults to the personnel Ascertain the availability of sufficient antidotes and screening capacities for radioactivity as well as the logistics for distribution Ascertain the availability of a sufficient number of beds at specialized hematological wards at the regional/ national level to admit heavily irradiated victims Ascertain lines of communication from hospitals to medical NRBC experts to seek advice | Educate and train hospital staff on: 1. Self-protection 2. How to avoid secondary contamination 3. The health hazards resulting from radiation 4. Treatment priorities |