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Accidental medical overexposures 92 Description Significant unplanned overexposures of patients resulting from controlled medical sources such as radiotherapy devices. Equipment, software, human factors, or confusing procedures could be contributing causes. Potential hazards Other users (national and international) using similar devices or procedures could have similar emergencies. Inadequate treatment resulting in unnecessary suffering of the overexposed patient. Emergency response Operator (registrant – licensee): — Reconstruct the scenario of the accidental medical overexposure; include an assessment of the dose and dose distribution within the patient needed for medical prognosis. — Perform a clinical assessment of the radiation effects due to the overexposure. — Initiate appropriate treatment; consult with physicians with relevant expertise in treating severe overexposures (possibly through the IAEA). — Conduct an investigation to determine the cause of the overexposure, take action to prevent further overexposures, and protect information that may be important in a further investigation of the case. — Submit to the regulatory body, as soon as possible after the investigation, a report that states the cause of the incident. — Inform the patient and his/her doctor about the incident. Incident commander (local officials): — Co-ordinate the response using the ICS (see Appendix 13) from an incident command post near the scene. — Ensure that all governmental agencies are informed. — Ask national officials for advice and an emergency team of radiation specialists (radiological assessor) (see Element A3.1). — If significant public contamination or exposure is possible, implement, as appropriate, the action guide for Public contamination/exposure. Incident investigation (regulatory body): — Operate under the ICS incident commander. — Promptly determine the cause of the overexposure. If it may have resulted from a problem that could occur in another facility or State (e.g. potentially a transnational emergency), promptly request the national competent authority to notify the IAEA (Element A2.15). Public information officer/team: — Operate under the ICS incident commander. — If there is public interest in the emergency, initiate media briefings from a single official source and activate the PIC if needed (see Element A9.1) 77 . — Initiate action, as appropriate, to prevent similar emergencies at this facility or others using similar practices. 93, 94 National competent authority for domestic accidents (if appropriate) — Operate under the ICS incident commander. — Contact the IAEA to arrange for consultation with physicians with expertise in treating severe overexposure. 92 See Ref. [3], para. II.30 for a related requirement. 93 The contact point that is authorized to issue a notification, warning messages or request for assistance to the IAEA ERC. 94 In accordance with the guidelines in Ref.[23] 164
— Notify potentially affected States and the IAEA if there are indications that other States or their citizens may be affected or may have involved a fault and/or problem (such as in equipment or software) that could have serious implications for safety internationally (transnational emergency - Element A2.15). IAEA resources (if provided): — Operate under the ICS incident commander. — Respond to international inquiries on transnational emergencies. — Arrange for activation of appropriate ERNET teams if assistance is requested (see Element A8.4). 165
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EPR- METHOD 2003 Method for Develop
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The originating Section of this pub
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EDITORIAL NOTE The use of particula
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4.2.8. Managing the medical respons
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1.2. OBJECTIVE This publication pro
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not appear for days, weeks or even
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TABLE I. FIVE CATEGORIES OF NUCLEAR
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2.1.3. AREAS AND ZONES For most eme
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National border Facility On-Site PA
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Typically, the operator declares a
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National (all hazards) emergency pl
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The co-ordinator should have in-dep
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(1) precautionary 9 urgent protecti
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2.2.6. TASK 3 — DEVELOP PLANNING
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TABLE IV. EMERGENCY THREAT CATEGORY
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2.2.12. TASK 9 — TEST CAPABILITY
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IDENTIFICATION AND ASSIGNMENT OF CR
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28 APPLICABLE CATEGORY THREAT CRITI
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4. EMERGENCY PREPAREDNESS CONSIDERA
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factors. Methods for compensation a
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Public exposure/contamination emerg
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exposure, protect the people nearby
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that could contribute to similar ov
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44 4.2.1. Establishing emergency ma
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46 A1 - ESTABLISHING EMERGENCY MANA
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48 A2 - IDENTIFYING, NOTIFYING AND
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56 A3 - TAKING MITIGATORY ACTION Th
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58 A3 - TAKING MITIGATORY ACTION Th
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60 A4 - TAKING URGENT PROTECTIVE AC
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62 A4 - TAKING URGENT PROTECTIVE AC
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64 4.2.5. Providing information, an
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66 A5 - PROVIDING INFORMATION AND I
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68 A6 - PROTECTING EMERGENCY WORKER
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70 A6 - PROTECTING EMERGENCY WORKER
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72 A7 - ASSESSING THE INITIAL PHASE
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74 A7 - ASSESSING THE INITIAL PHASE
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76 A8 - MANAGING THE MEDICAL RESPON
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78 A8 - MANAGING THE MEDICAL RESPON
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80 A9 - KEEPING THE PUBLIC INFORMED
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82 A10 - TAKING AGRICULTURAL COUNTE
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84 A10 - TAKING AGRICULTURAL COUNTE
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86 4.2.11. Mitigating the non-radio
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88 4.2.12. Conducting recovery oper
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90 4.2.13. Authority (B1 elements)
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92 4.2.14. Organization (B2 element
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94 4.2.15. Co-ordination of emergen
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96 B3- CO-ORDINATION OF EMERGENCY R
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98 B4 - PLANS AND PROCEDURES Threat
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100 B4 - PLANS AND PROCEDURES Threa
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102 4.2.17. Logistical support and
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104 B5 - LOGISTICAL SUPPORT AND FAC
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106 4.2.18. Training, drills and ex
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108 B6 - TRAINING, DRILLS AND EXERC
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110 B7 - QUALITY ASSURANCE Threat c
Page 119 and 120: Appendix 1 GENERIC INTERVENTION AND
Page 121 and 122: TABLE A1-III. GENERIC ACTION LEVELS
Page 123 and 124: Appendix 3 EMERGENCY WORKER GUIDANC
Page 125 and 126: Appendix 4 TYPICAL THREAT CATEGORIE
Page 127 and 128: Fuel cycle Practice Uranium milling
Page 129 and 130: Practice ≥ 2 100 MW(th) < 2 MW(th
Page 131 and 132: Practice Lost /stolen dangerous sou
Page 133 and 134: THREAT CATEGORY I AND II FACILITIES
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Page 137 and 138: General emergency Emergency class d
Page 139 and 140: Site area emergency Emergency class
Page 141 and 142: Facility emergency Emergency class
Page 143 and 144: Appendix 7 ACTION GUIDES FOR RADIOL
Page 145 and 146: terrorist threats. — If public co
Page 147 and 148: — If public contamination or expo
Page 149 and 150: — If a device is found, implement
Page 151 and 152: command, operational safety, public
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Page 155 and 156: Damaged dangerous source Descriptio
Page 157 and 158: contaminated/exposed individuals an
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Page 161 and 162: Radioactive satellite re-entry Radi
Page 163 and 164: Nuclear weapons accident Descriptio
Page 165 and 166: — Co-ordinate with the State resp
Page 167 and 168: — Evaluate all available informat
Page 169: Element A2.15). Incident investigat
Page 173 and 174: — Assess likely exposures of publ
Page 175 and 176: — Ensure operational guidance (OI
Page 177 and 178: Explosive radiological dispersal de
Page 179 and 180: needed (see Element A9.1) 77 . Radi
Page 181 and 182: — If a dangerous source is to be
Page 183 and 184: Intentional contamination of food/p
Page 185 and 186: • securing the scene against poss
Page 187 and 188: Appendix 8 DANGEROUS QUANTITIES OF
Page 189 and 190: Sources and material 105 Radionucli
Page 191 and 192: Appendix 9 INFORMATION NEEDS FOR TH
Page 193 and 194: Appendix 10 RESPONSE TIME OBJECTIVE
Page 195 and 196: Appendix 11 URGENT PROTECTIVE ACTIO
Page 197 and 198: A12.1 NATIONAL RADIATION EMERGENCY
Page 199 and 200: 2.6 Response communications (see El
Page 201 and 202: accomplished by use of a single spo
Page 203 and 204: List all major ministries and agenc
Page 205 and 206: A12.2 PARTICIPATING ORGANIZATIONS O
Page 207 and 208: implementing procedures that will b
Page 209 and 210: 3.12 Financing operations See the o
Page 211 and 212: A12.3 FACILITY (ON-SITE) EMERGENCY
Page 213 and 214: 3.1 Notification, activation and re
Page 215 and 216: 4.7 Exercises 4.8 Quality assurance
Page 217 and 218: 2. NORMAL STANDING INSTRUCTIONS 2.1
Page 219 and 220: 10. STEPS (ACTIONS) List steps and
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Unity of command, where each person
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Incident Commander (e.g. Fire Briga
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planning for the long term and reco
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The medical and radiation protectio
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(1) command functions as part of th
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TABLE A14-I. RECOMMENDED EMERGENCY
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Facility/ location Functions Charac
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Appendix 15 EMERGENCY RADIATION RES
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A15.1 OBJECTIVES OF EMERGENCY RADIA
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A15.2 SUGGESTED SPECIFICATIONS FOR
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DET: DECONTAMINATION TEAM Expertise
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PST: IN-PLANT SURVEY TEAM Expertise
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LAB: LABORATORY FACILITIES - TEAM A
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The actual facilities, equipment an
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Appendix 17 CATEGORIZATION OF TERRO
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TABLE A17-I PROPOSED TERRORIST/CRIM
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PLAIN LANGUAGE STATEMENTS A/D< 0.01
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cleaned up would depend on many fac
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[15] INTERNATIONAL ATOMIC ENERGY AG
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[55] INTERNATIONAL ATOMIC ENERGY AG
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ends when the situation is under co
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and directly (without further asses
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(4) A discovery of the loss or illi
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RAB RDD RF RMAC SPDS SRF T TLD TSC
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BENCHMARKS FOR INHALATION AI.5 Sele
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CONTRIBUTORS TO DRAFTING AND REVIEW
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da Silva, F. Sinkko, K.T.S. Smith,
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