In any situation, effective management requires the proper staff of trained professionals. These are as follows:
Nurses are the crucial element in the management of most emergency room patients. They clean the wounds and prepare the patient for care by the emergency room physicians and other specialists. The emergency room nurses are also responsible for sampling of area that may be contaminated and performing the subsequent decontamination. Depending on the criticality of the patient, one or two nurses should remain in the REA at all times.
Emergency room physicians are accustomed to taking immediate care of most trauma victims. Their training is to take care of the ABCs of emergency care. It is the responsibility of the ER physician to medically stabilize the patient so that decontamination be performed later. Medical management ALWAYS takes precedence over management of radiation contamination. The ER physician should remain in the REA with the patient until the patient is stable and out of immediate danger.
Sometimes, surgical procedures are required to stabilize a trauma victim. These procedures are often performed by a surgeon or trauma surgeon. Again, these lifesaving procedures take precedence over radiation decontamination. The trauma surgeon should remain with the patient until no longer needed. Alternatively, the trauma surgeon can take over complete care of the patient and the emergency room physician may leave.
When the patient has been stablized and is out of immediate danger, the areas of contamination should be identified. This task is performed by a nuclear medicine or radiation technologis. One of these individuals should remain in the room with the patient. If areas of contamination are known at the time of patient arrival, the technologist should remind the other personnel to change gloves after handling these regions so as not to spread contamination. In no circumstance should the technologist prevent or delay the initial medical care of the patient.
Curiosity is only natural. The general public and media will want to know what is happening and see it with their own eyes. This must be prevented for two reasons. First, there is the matter of patient confidentiality. Only the name, time of arrival, and condition can be released to the public. Any other information released is a violation of the patient's privacy. Second, if people are constantly entering and leaving a potentially contaminated area, the risk for spread of contamination increases dramatically. Hospital security plays an important role in preventing free access to the restricted areas preventing the spread of contamination and the release of unauthorized information.
Although most accidents elicit little attention, and are not mentioned by the media until after the fact, occasionally a highly visible accident will occur. In this situation it is important to involve the public relations department of the hospital. These individuals are experienced in dealing with the media. A potentially negative incident can be converted to a positive public relations experience if dealt with properly.