Question

You are on call and have been alerted by the media of a shopping mall bombing involving multiple injuries. The hospital has more than 40 injured in the emergency room. Viorel is a 10-year-old boy with multiple trauma due to a dirty bomb in the shopping mall. He is scheduled for an emergency exploratory laparotomy. His blood pressure is low, and his pulse rate is dropping.

1. You have arrived in the OR How do you prepare to receive casualties from a “dirty bomb”?

2. Viorel has multiple open wounds and is still wearing his clothes. What are the first priorities of treatment?

3. Viorel is being cared for in the surgical suite. In addition to the abdominal trauma, what other injuries may be seen with a “dirty bomb”? In what order do you think the potential injuries will be treated?

4. Describe how to decontaminate yourself if you are exposed to a nuclear device.

Answer 1

1.Some of the things to be done to receive a patient from dirty bomb are

• Ensure the area is less or not prone for further radiation
• Provide closed unit to prevent transmission to others from causality
• Self protect by using lead aprons ,mask, PPE

2.The first priority thing which has to be done is to remove the clothing of the patient because this can remove nearly 90% of any radioactive particles from the patient. This has to be seated in a bag and labels radiation hazard and discarded as per policy.

3.The other injuries which can be seen are with the gastrointestinal system, respiratory system, acute respiratory distress ,cancer in future. The potential injury should be treated in a way from high risk to low risk ,open wound to closed wound. Preventative care.

4.If exposed to nuclear device

• Remove the clothing to remove the radioactive materials
• Wash with soap and water adequately
• Ensure you are in a closed room from direct exposure
• A warm shower can also help to get rid of the substance from the body