Radiation Detection Equipment for First Responders

• 2008 Aug 1

Editor's note:  This article is an online-exclusive supplement to "Death by Polonium-210: Lessons learned from the murder of former Soviet spy Alexander Litvinenko" by Robin B. McFee, DO, MPH, FACPM & Jerrold B. Leikin, MD, FACEP, FAACT, FACP, FACOEM, FACMT.

The death of Alexander Litvinenko on Nov. 23 2006, three weeks after he presented to a London Hospital has brought into focus the threat of radioactive materials that can be intentionally used against individuals or a society, such as Polonium-210 (Po). This case sets the stage for several important considerations for EMS and hospital personnel.

EMS providers and emergency departments (ED) must be able to recognize a potential radiation event, identify and treat patients suffering from conventional injuries that may be complicated by radiation exposure or contamination, utilize appropriate personal protective equipment (PPE) and alert the proper authorities to initiate a rapid response. Responding to a radiation incident requires advance planning and continuous training. Other issues to consider include having appropriate detectors and knowledge about their use. Note: Technology has limitations, including the risk of false positive alarms. Always learn the performance capabilities of your equipment and know what to do if the alarms go off. First responders should have different levels of equipment available depending on their level of training. (1)

Level 1: Initial Response (first on scene/awareness trained)
Each vehicle should be equipped with self-alarming dosimetry that can detect small amounts of radiation and produce an audible alarm. The recommended electronic personal dosimeter (EPD) is the MiniRadiac by Canberra or the RadEye G by Thermo Electron. Detection rata alarm set points are 0.1 mR/hr (investigate) and 2 mR/hr (isolate). The dose alarm set points are 900 mR (warning) and 1,000 mR (limit) accumulated dose.

Level 2: Post-Initial Response (operations trained)
This group should have equipment capable of detecting radiological contamination as well as EPD, which would be used to monitor total dose accumulation. Recommended instrumentation should provide the ability to detect radiation, measure levels of contamination and record accumulated radiation received. In addition to the above EPD, the Ludlum 14 C with 202-608 meter face and 44-9 detector is recommended. The EPD settings should be 0.1 mR/hr for early detection of radiation (investigate), two mR/hr (isolate) and resettable up to 1,000 mR/hr (turnback dose rate for all activities except lifesaving). Also have two accumulated dose limit alarms: 900 mR (dose warning), 1000 mR (dose limit), resettable up to 25,000 mR for lifesaving missions, which should only be done under the direction of the incident commander.

Detectors must be capable of identifying all forms of radiation, not just gamma. There are several approaches to contamination meter settings; however, responders might want to set them for 2 x background for all types (beta/gamma/alpha). Monitoring of personnel and equipment should be conducted in areas indicating <0.1 mR/hr.

Level 3: Hazmat (technical trained)
Recommended equipment includes the EPD and Ludlum 2241-3RK Response Kit, which contains survey meters, detectors, probes and cesium check source, and can assist with indications of and range concerning rates of exposure. The EPD settings are the same as for Level 2.

Personnel at this level should also be equipped with a dosimeter that has permanent record capability, such as a thermo-luminescent dosimeter (TLD) or optically stimulated luminescent (OSL) that records doses at the lowest level.

To review a complete case report on Alexander Litvinenko’s poisoning, diagnosis and its aftermath and learn the effects of polonium-210 on the body and how to identify radiation poisoning, read “Death by Polonium-210” in Response Guide For Chemical & Radiologic Threats: Are We Prepared? , a supplement to November 2008 JEMS, FireRescue and Law Officer magazines.

Reference

1. Ohio First Responder Radiological Equipment Committee, April 5, 2006:  www.ema.ohio.gov/Radiological_Detection.pdf      

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