Prevent and prepare

•  Be aware of sources of radiation such as:
  >   uncontrolled (abandoned, lost, stolen or found) dangerous sources or materials (particularly items found near or around nuclear               power stations or other nuclear facilities)
  >   misuse of dangerous industrial and medical sources (e.g., those used in radiography)
  >   public exposure and contamination from unknown origins
  >   malicious threats or acts
  >   transport emergencies.
• In places where radiation is known to exist, such as in nuclear or other industrial facilities, preparedness to deal with radiation injuries must form part of the emergency preparedness plan and employees should be trained specifically in how to behave and respond in an emergency (Turai & Veress, 2001).
• Ensure familiarity with safe operating procedures and that appropriate education on safe behaviour is made available.

Early recognition

It may be challenging to recognise a radiation emergency because people may not be able to see or smell hazardous levels. Therefore, the initial response is often carried out based on secondary indications such as the presence of radioactive material, people showing symptoms of exposure or readings from specialised instruments.

Signs that someone might have been exposed to radiation might include (Turai & Veress, 2001):

• burns, blister or ulcers
• nausea, vomiting, diarrhoea
• weakness, headaches, dizziness and or fatigue.

The first aid provider should protect their own safety and avoid touching or approaching suspected radioactive materials or accident scenes.

First aid steps

1. Direct the person to leave the scene as quickly as possible with due precaution and care. Avoid exposure to radiation without protective clothing.
2. Access emergency medical services (EMS).
3. Assess the person’s level of response, breathing, and circulation and treat them accordingly as a priority. Then treat any other conditions such as burns.

Access help

• Depending on the type of radiation emergency, it may be necessary to access EMS as well as other specialised emergency services.
• Explain the radiation injury clearly to EMS so they are able to send the appropriate response.
• Radioactive materials can lead to a person having external or internal contamination and can have serious effects on the body in both the immediate and longer term. Any person exposed to radiation must be immediately assessed and then monitored over time by a doctor.

Recovery

• Radiation does not produce life-threatening early symptoms, immediate death or immediate burns, and exposure to radiation alone is not a medical emergency. However, the person must be taken for further assessment and medical assistance (Turai & Veress, 2001).

Context considerations

• First aid programme designers must determine whether to include this topic in their first aid programmes depending on its relevance in specific contexts, local regulations and public health policies.
• Consider the emergency preparedness plans and availability of specifically trained workers or responders when designing learning for this topic.

Learner considerations

• Learners for this topic are likely to specifically face the risk of radiation because of their place of work. Programme designers should work closely with learners and their employees to understand risks, local practice, access to medical care and emergency procedures that are in place.

Facilitation tips and tools

• Encourage learners to become familiar with the radioactive symbol and be aware of emergencies that are dangerous due to potential radioactivity.
• Consider using photographs to illustrate the look of a radiation injury and video to explain the effects of radiation.
• Emphasise that the person exposed to radiation does not present a health risk to the first aid provider. Therefore, the focus should be on responding appropriately to the first aid priorities of ensuring the person is responsive, breathing normally with normal circulation (Turai & Veress, 2001).