Radiation Disaster Medicine [recurso electrónico] Perspective from the Fukushima Nuclear Accident

While many books are available on disaster medicine, none is specifically devoted to the role of physicians in the management of patients exposed to radiation leakage from a damaged nuclear power plant. __Radiation Disaster Medicine__ aims to fill this void based on the response to the Fukushima nuclear accident. Each chapter addresses principles and practices of radiation medicine within the specific context of that accident. Topics covered include the role of physicians in radiation disasters, the concepts of external and internal exposure, prehospital and hospital response, disaster behavioral health, and radiation emergency response from the perspective of national and international institutions. Most of the contributors are active educators and researchers in radiation medicine with first-hand experience in dealing with prehospital triage and management of patients within secondary and tertiary care hospitals in Japan. Foreword 6 Preface 8 Contents 10 Contributors 12 Abbreviations 14 1: Physicians’ Early Response to the Fukushima Daiichi Nuclear Power Plant Accident: Challenges and Lessons Learned 16 1.1 Introduction 17 1.2 Physician as Expert 19 1.2.1 Experts in Radiation Disaster Medicine 19 1.2.2 Experts in Other Medical Fields 20 1.2.2.1 Radiologists, Nuclear Medicine Physicians, and Radio-Oncologists 20 1.2.2.2 Emergency Physicians 21 1.2.2.3 Family and Community Physicians 21 1.2.2.4 Geriatricians 22 1.2.2.5 Hematologists and Transfusion Medicine Physicians 22 1.2.2.6 Orthopedic Surgeons and Anesthetists 23 1.2.2.7 Pulmonary Specialists 23 1.2.2.8 Nephrologists 23 1.2.2.9 Pediatricians 23 1.2.2.10 Psychiatrists 24 1.2.2.11 Occupational Health Physicians (TEPCO Workers) 24 1.3 Physicians as Professionals 24 1.4 Physicians as Communicators 25 Conclusions 26 References 26 2: General Considerations in Radiation Disaster Medicine 29 2.1 Introduction 30 2.2 Preparedness and Objectives of Emergency Medicine in Radiation Disaster 30 2.3 Specific Considerations of Radiation Disaster 31 2.4 Basic Knowledge of Radiation 32 2.5 External Exposure and Contamination 34 2.6 Biological Effects of Radiation 35 2.7 Initial Evaluation and Prioritization in Radiation Disaster 37 2.8 Summary 40 References 40 3: Medical Perspective 42 3.1 Prehospital Emergency Medical Response 43 3.1.1 Introduction 43 3.1.2 Reestablishment of a Medical Response System in the Region 43 3.1.2.1 Planning for Medical Responses in an MCE and Evacuation of Inpatients 44 3.1.2.2 General Concepts in Prehospital Emergency Response 45 3.1.2.2.1 Basic Understanding Required for Medical Response 46 3.1.2.2.2 Goals of Prehospital Emergency Medical Response 48 Management of On-Site Response in Radiation Disaster 48 Triage and On-Site Decontamination 50 Treatment in Prehospital Emergency Settings 52 Example of On-the-Scene Evaluation and Treatment 53 3.1.3 Establishment of a Command Center 53 3.1.4 Information on Radiation 54 3.1.5 Development of a Sustainable Local Emergency Medical System 55 3.1.5.1 Emergency Medical Needs of the Workers 55 3.1.5.2 Irradiation Dose of the Workers 55 3.1.6 Major Public Health Consequences Following Evacuation 57 3.1.7 Summary 59 3.1.8 Experiences from the Initial Medical Response in Fukushima Accident 59 3.1.8.1 Disaster Response of Medical Professionals and Societies in the Great East Japan Earthquake 68 3.2 Hospital Emergency Medical Response 71 3.2.1 Introduction 71 3.2.2 Planning 71 3.2.3 General Considerations of Hospital Response 73 3.2.4 Hospital Emergency Response 73 3.2.4.1 Preparation 74 3.2.4.1.1 Before Patients’ Arrival 74 3.2.4.1.2 Preparation of a Radiation Emergency Area (REA) 74 3.2.4.1.3 Preparation of Medical Staff 76 3.2.4.1.4 Preparation of Survey Meters 77 3.2.4.2 Patient Reception 77 3.2.4.3 Triage and Life-Saving Treatment 77 3.2.4.4 Radiological Evaluation 77 3.2.4.5 Decontamination 79 3.2.4.6 Further Radiological Evaluation and Treatment 79 3.2.5 Dose Assessment 81 3.2.6 Local Radiation Injury (LRI) 81 3.2.7 Acute Radiation Syndrome (ARS) 81 3.2.7.1 Clinical Symptoms of ARS 83 3.2.7.2 Treatments of ARS 83 3.2.8 Summary 85 3.2.9 Experiences from Fukushima Accident 85 References 89 4: Disaster Behavioral Health: Psychological Effects of the Fukushima Nuclear Power Plant Accident 91 4.1 Introduction 92 4.2 Behavioral Effects Resulting from the Past Nuclear Accidents 92 4.3 Psychological Consequences of Fukushima Disaster 94 4.3.1 Posttraumatic Stress Responses 94 4.3.2 Chronic Anxiety and Guilt 96 4.3.3 Ambiguous Losses 96 4.3.4 Separated Families and Communities 97 4.3.5 Stigma and Self-Stigma 98 4.4 Summary and Implications 99 References 99 5: Management Perspective: Structure of Radiation Emergency Response in Japan 101 5.1 Introduction 102 5.2 History of Radiation Emergency Medicine in Japan 102 5.3 Laws and Regulations Related to Nuclear Disaster Measures 104 5.4 Response System for Radiation Emergency Medicine in Japan 105 5.5 Education, Training, and Exercise/Drills 107 5.6 Temporary House-Visit Program 108 5.7 Public Concerns 108 Conclusion 109 References 109 6: Management Perspective: Structure of Radiation Emergency Response in International Organizations 110 6.1 Introduction 111 6.2 Conventions 111 6.2.1 The Convention on Early Notification of a Nuclear Accident 111 6.2.2 The Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency 112 6.3 International Organizations 112 6.4 Incident and Emergency Centre 112 6.5 International Emergency Preparedness and Response Framework 116 6.5.1 Joint Radiation Emergency Management Plan of the International Organizations (Joint Plan or JPLAN) 116 6.5.2 Operations Manual for Incident and Emergency Communication (IEComm) 116 6.5.3 Response and Assistance Network (RANET) 117 6.6 Contact Personnel in the Case of Radiation Disasters 117 References 118 7: Radiation Disaster Medicine Curriculum Revisited in a Post- 120 7.1 Background 121 7.2 Introduction 122 7.3 Emerging Issues 122 7.4 Strategic Response from NAHU/IAEA 123 7.5 Theoretical Framework: Science and Technology Studies (STS) Approach 124 7.6 Existing Academic Responses to Knowledge Gaps Arising from the Fukushima Accident 125 7.7 Project NA9/16: “Enhancing Radiation Medicine Education by Building Capacity of Health Professionals and Medical Students” 126 7.8 Project NA9/17: “Strengthening Research Cooperation in Radiation Disaster Medicine Including Posttraumatic Stress Disorders” 127 Conclusion 128 References 129 Index 131 "The role of disaster medicine is becoming more important as the frequency and severity of natural and technological disasters increase. The triple disaster that occurred in Fukushima on March 11, 2011 calls for innovation in the training of health care professionals, pre-hospital emergency care providers, and emergency personnel in the management of the medical consequences of radiation disasters. While many books are available on disaster medicine, none is specifically devoted to the role of physicians in the management of patients exposed to radiation leakage from a damaged nuclear power plant. Radiation Disaster Medicine aims to fill this void based on the response to the Fukushima nuclear accident. Each chapter addresses principles and practices of radiation medicine within the specific context of that accident. Topics covered include the role of physicians in radiation disasters, the concepts of external and internal exposure, prehospital and hospital response, disaster behavioral health, and radiation emergency response from the perspective of national and international institutions. Most of the contributors are active educators and researchers in radiation medicine with first-hand experience in dealing with prehospital triage and management of patients within secondary and tertiary care hospitals in Japan. It is hoped that this book will assist in attaining the ultimate goal of radiation disaster medicine: to help the patients."--Publisher's website Front Matter....Pages i-xiv Physicians’ Early Response to the Fukushima Daiichi Nuclear Power Plant Accident: Challenges and Lessons Learned....Pages 1-13 General Considerations in Radiation Disaster Medicine....Pages 15-27 Medical Perspective....Pages 29-77 Disaster Behavioral Health: Psychological Effects of the Fukushima Nuclear Power Plant Accident....Pages 79-88 Management Perspective: Structure of Radiation Emergency Response in Japan....Pages 89-97 Management Perspective: Structure of Radiation Emergency Response in International Organizations....Pages 99-108 Radiation Disaster Medicine Curriculum Revisited in a Post-Fukushima Context....Pages 109-119 Back Matter....Pages 121-126