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1
Training Course on Medical Preparedness and Response
for a Nuclear or Radiological Emergency
Tabletop Exercise Scenario –
Basic
Assessment of Patient’s Exposure
2
Case 1: An accident involving workers in a nuclear power plant
At a nuclear power plant, a pipe of the primary water cooling system cracked and hot water leaked
from the primary system into the containment of the reactor. Three days after the reactor was cooled
down, some workers entered the containment with a full face mask. The temperature was still high in
the containment. Wearing an anorak and a full face mask made these workers feel sick. During
decontamination, a worker fell from the work platform at a height of 3 meters and hit his waist on a
corner of equipment made of metal. His water proof anorak was torn, and he suffered a 5 cm diameter
(20 cm2) shallow scratch. However, no information on the iliac bone fracture and other severe injuries
was provided to the hospital.
The main contaminant was an oxide form of Cobalt-60 (Co-60). The level of contamination was
2 000 0000 counts per minute (cpm) (2×106 cpm) on the floor when measured by a GM survey meter
with a large diameter window (20 cm2). The contamination level of surfaces with -emitting
radioactive material in the working area1 is usually less than 5000 disintegrations per minute per
100 cm2.
Question 1
A nurse from the medical service at the facility was informed of the accident and decided to send the
patient to your hospital. You are an attending physician responsible for radiation emergencies at your
hospital.
1) How do you receive the patient?
2) How do you prepare for this?
3) What is your plan for the patient’s care?
4) What plan is there in your hospital for a radiological emergency?
Question 2
A contamination of 1 000 000 cpm (1.0×106 cpm) was detected at the wound by a large diameter
window (20 cm2) GM survey meter.
1) How much is the surface activity concentration?
2) How do you manage this contamination?
Question 3
A contamination of 1 000 000 cpm (1.0×106 cpm) was detected around the wound by a large
diameter window (20 cm2) GM survey meter.
1) What is the skin RBE weighted dose at the wound area if no decontamination was performed?
Question 4
Decontamination procedures did not work for this patient. If it is supposed that all the radioisotopes in
the wound were absorbed, how much is the dose for internal contamination? Despite searching for
reference books, you could only find the effective dose and RBE weighted organ dose coefficients of
inhalation or ingestion in Refs [1, 2 and 3], and could not find data for absorption through the wound.
For an initial estimate it could be assumed that intake through a wound is similar to direct injection of
radioactive material into a systemic circulation. In this particular case:
1) How do you evaluate the dose for internal contamination in this situation?
1 Radiological control, DOE Standard DOE-STD-1098-99, U.S. Department of Energy, Washington, D.C. (1999).
3
2) How do you evaluate dose coefficients for the case when 1 Bq of Co-60 goes into a systemic
circulation through wound?2
3) How much is the committed effective dose and 30 day committed RBE weighted dose in red
marrow?
Question 5
You tried decontamination of the wound, but it was difficult to decontaminate. How do you deal with
a contaminated wound that was difficult to decontaminate?
2 Use GSR Part 3 Table III-2A [2], EPR MEDICAL Table XII-D1-1 and Table XII-D2-2 [3], EPR-D-VALUES Table 19
[1].
4
Reference data 1:
Surface activity concentration
605.0100
100
Wf
d
CCA B
S
AS - Surface activity concentration (Bq/cm2)
C - Contamination (cpm)
CB - Background contamination (cpm)
Iβ - Emission rate of β-particles (%)
d - Efficiency of detection of β-particles (%)
W - Window area(cm2)
Eff
icie
ncy
of
regis
trat
ion, %
/2π
maximum energy of β-ray (MeV)
Eff
icie
ncy
(%/2π
)
Eβ, MeV
Figure 1. GM efficiency of registration as a function of maximal energy of β-spectrum, Eβ
Condition of measurements: source-detector distance = 5 mm; source size = 10×10 cm
Co-60 emits -particles with maximal energy of 0.318 MeV with 99.9% emission rate. Efficiency of
the GMsurvey meter to -ray emitted from Co-60 is about 32% according to the manufacture
document (see Figure 1.). Supposing, there is no counting loss and the area of window of the survey
meter was 20 cm2.
5
Deposited activity
SAA S
A - Deposited activity (Bq);
AS - Surface activity concentration (Bq/cm2);
S: - Contaminated area (cm2).
According to GSR Part 3 Table III-2B [2] the gut transfer factor for cobalt oxides in the case of
ingestion intake by workers is 0.05. This means that 0.05 Bq of Co-60 is absorbed into the systemic
circulation from GI tract after ingestion of 1 Bq of Co-60 oxide. Approximately, the effective dose
and 30 day committed RBE weighted dose in red marrow coefficient for ingestion is caused by 0.05
Bq Cobalt-60 entering the systemic circulation, because a fraction of the Co-60 excreted directly in
early faeces may not contribute to the mentioned dose coefficients.
Because the absorption rate of the cobalt oxide into the wound is not known, we can assume all Co-60
in the patient’s wound would be absorbed promptly (i.e. providing that absorption rate is 100%) and
goes into the systemic circulation. Therefore, the activity deposited on the wound will be injected into
the systemic circulation.
Dose of internal exposure
Pathwaymarrowdmarrowd
Pathway
AdAAD
eAE
,ReRe )()(
)()(
E(τ) – committed effective dose (Sv);
AD(Δ)Red marrow – 30 day committed RBE weighted dose in red marrow (Gy);
A - Intake of radioactive material (Bq);
Ad(Δ)Red marrow, Pathway –coefficient of 30 day committed RBE weighted dose in red marrow for unit
intake of radionuclide through given pathway (Gy/Bq);
e(τ)Red marrow, Pathway – a radionuclide specific coefficient committed effective dose for unit intake of
radionuclide through given pathway (Gy/Bq).
Dose coefficients are provided in three publications of the IAEA, in Refs [1, 2 and 3]:
According to GSR Part 3 Table III-2A [2] and EPR MEDICAL Table XII-D1-1 [3] or EPR-D-
VALUES Table 19 [1], the effective dose coefficient for ingestion of Co-60 (cobalt oxide) is 2.5
×10-9
Sv/Bq (namely, committed effective dose per 1 Bq in a case of ingestion).
According to EPR MEDICAL Table XII-D2-2 [3], the dose coefficient of 30 day committed RBE
weighted dose in red marrow for a case of ingestion of Co-60 is 5.8×10-10
Gy/Bq.
Dose from contamination
dermaSkinSdermaSkin AdtAAD
ADSkin derma – RBE weighted dose in skin derma (Gy);
AdSkin derma – coefficient of RBE weighted dose rate in skin derma ((Gy/s)/(Bq/cm2));
AS - Surface activity concentration (Bq/cm2).
Dose coefficient are collected in three publications of the IAEA in Refs [1,2 and 3]:
6
According to GSR Part 3 Table III-2A [2] and EPR MEDICAL Table XII-D1-1 [3] or EPR-D-
VALUES Table 19 [1], the effective dose coefficient for ingestion of Co-60 (cobalt oxide) is
2.5×10-9
Sv/Bq;
According to EPR MEDICAL Table XII-D2-2 [3], the dose coefficient of 30 day committed RBE
weighted dose in red marrow for a case of ingestion of Co-60 is 5.8×10-10
Gy/Bq.
Evaluation of exposure
The IAEA safety standard [4] provides generic criteria for the evaluation of exposure cases in
emergency exposure situation.
7
Case 2: an accidental exposure to radiation in an industry
A radiation accident occurred in a facility in your town. At this facility, agricultural and medical
products are sterilized by a radioactive Co-60 (30×109 MBq) source in a moveable rack. Products are
irradiated using an internal transport system in a controlled manner. Following a jam in the product
transport system, the operator tried to check the system. Ignoring a number of the safety systems,
including the alarm, he entered the radiation facility. When he entered the facility, he thought that the
source was in the safe position (the source was shielded). However, on entering the facility, the source
was in the working position (the source was not shielded). Thus, the operator was exposed to radiation
for about 1 to 2 minutes and then noticed that the source was in the irradiation position. The accident
was reported to the manager of the facility and the operator was transported to your hospital with a
radiation safety officer. He started vomiting 5 minutes after irradiation.
Question 1
1) How do you take care of this patient when you receive him?
2) What plan is there in your hospital for a radiological emergency?
Question 2
1) How much is your dose assessment from his clinical appearances?
2) What is your plan for medical response?
Question 3
After 30 minutes of his arrival, a journalist calls your hospital and asks about the patient’s name, age,
chronology of the accident, your name, your phone number, and contact person in your hospital.
1) How do you respond to this?
Question 4
When the operator was exposed to radiation, he was at a distance of 4 to 4.7 m from the source rack.
1) How much was the RBE weighted dose to the red marrow of operator at that time?3
Question 5
1) Supposing the operator survived the acute phase, what will be the long-term problem?
2) How will you undertake a medical follow-up?
3 Use EPR-D-VALUES Table 15 [1]
8
Reference data 2:
RBE weighted dose in red marrow
Pathwaymarrowdmarrowd Adr
tAAD ,Re2Re
ADRed marrow - RBE weighted dose in red marrow (Gy)
AdRed marrow - coefficient of RBE weighted dose rate in red marrow at 1 m (Gy/(Bq×s))
A - Source activity (Bq)
t - Exposed time (s)
r - Distance between source and reference point (m)
According to EPR-D-VALUES Table 15 [1] the coefficient of RBE weighted dose rate in red marrow
at 1 m for Co-60 is 4.1×10-17
(Gy/(Bq×s)).
9
Case 3: lost source
A 13 year old boy visited your outpatient clinic with complaints of burn-like symptoms on both hands.
He had mild nausea and mild diarrhoea. He did not remember touching hot or warm materials by hand
recently. However, he told you that he found an unfamiliar shaped metal object in a pocket of his
father’s jacket almost one week ago. He kept it in a drawer of the kitchen. The metal object had been
brought to his home by his father one month ago. His father suffered a small burn-like injury in his
right leg at that time, and he had become severely ill suddenly and died two weeks ago, although the
wound had not been large. The doctor who saw his father diagnosed him with sepsis. Additionally,
the family pet dog that slept in the kitchen suffered from vomiting for a while and died yesterday. The
boy lived with his mother and grandmother, and his family had many visitors.
Question 1
1) How do you proceed with the diagnostic process?
2) What is your plan for treatment of the boy?
3) What should you do in addition to the diagnosis and treatment of the boy?
Question 2
The police notified you the next day that the metal object was Cs-137 radioactive source sealed in a
metal package, which has about 2×1012
Bq (2 TBq = 2×106 MBq) activity.
1) Supposing that the duration of contact was 1 minute, how much was the RBE weighted dose
to soft tissue of the hand? 4
Question 3
1) Supposing that the boy remained at an average distance of 4 m from the source, for 12 hours
every day, how much was the red marrow exposure dose for this one month?
Question 4
Following media coverage of this accident, local residents visit or call your hospital with anxiety.
They ask, for example, “Am I dying because I also do not feel well for these weeks?”, or “Will my
descendants have genetic diseases?” Unfortunately your name was included in newspaper articles.
1) How do you react to these inquiries?
Question 5
1) Supposing that the boy survived the acute phase, what will be the long term problem for him?
4 Use EPR-D-VALUES Table 15 [1]
10
Reference data 3:
RBE weighted dose in soft tissue
tissueSofttissueSoft AdtAAD
ADSoft tissue - RBE weighted dose in soft tissue (Gy)
AdSoft tissue – coefficient of RBE weighted dose in soft tissue from adjusent source (Gy/Bq/s)
A - Source activity (Bq)
t - Exposed time (s)
According to EPR-D-VALUES Table 15 [1] the coefficient of RBE weighted dose rate in in soft
tissue from adjusent source for Co-60 is 5.9×10-15
(Gy/(Bq×s)).
RBE weighted dose in red marrow
marrowdmarrowd Adr
tAAD Re2Re
ADRed marrow - RBE weighted dose in red marrow (Gy)
AdRed marrow - coefficient of RBE weighted dose rate in red marrow at 1 m (Gy/(Bq×s))
A - Source activity (Bq)
t - Exposed time (s)
r - Distance between source and reference point (m)
According to EPR-D-VALUES Table 15 [1] the coefficient of RBE weighted dose rate in red marrow
at 1 m for Co-60 is 4.1×10-17
(Gy/(Bq×s)).
11
References
[1] INTERNATIONAL ATOMIC ENERGY AGENCY, Dangerous Quantities of Radioactive
Material, Emergency Preparedness and Response Series EPR-D-VALUES, IAEA, Vienna (2006).
[2] INTERNATIONAL ATOMIC ENERGY AGENCY, Radiation Protection and Safety of
Radiation Sources: International Basic Safety Standards. Interim edition, General Safety
Requirements Part 3, Safety Standard Series No. GSR Part 3 (Interim), IAEA, Vienna (2011).
[3] INTERNATIONAL ATOMIC ENERGY AGENCY, WORLD HEALTH ORGANIZATION,
Generic procedures for medical response during a nuclear or radiological emergency, Emergency
Preparedness and Response Series EPR-MEDICAL, IAEA, Vienna (2005).
[4] FOOD AND AGRICULTURE ORGANIZATION OF THE UNITED NATIONS,
INTERNATIONAL ATOMIC ENERGY AGENCY, INTERNATIONAL LABOUR
ORGANIZATION, PAN AMERICAN HEALTH ORGANIZATION, WORLD HEALTH
ORGANIZATION, Criteria for Use in Preparedness and Response for a Nuclear or Radiological
Emergency, IAEA Safety Standards Series No. GSG-2, IAEA, Vienna (2011).
1
Dose calculation
Case 1 Question 2 Surface activity concentration
605.0I
100
100
Wd
CCA B
S
AS - Surface activity concentration (Bq/cm2)
C - Contamination (cpm)
CB - Background contamination (cpm)
Iβ - Emission rate of β-particles (%)
d - Efficiency of detection of β-particles (%)
W - Window area(cm2)
60 – umber of seconds in one minute
0.5 – effectiveness of registration in 2π geometry
C = 1.0×106 cpm (GM counts)
One doesn’t need to consider CB , because C is much higher than
background.
d = 32 % (From Figure 1)
Iβ = 99.9% (From Co-60 decay scheme) [4]
W = 20 cm2
AS =1.0×106 (cpm)/((32/100)×(100/99.9)×0.5×20 (cm
2)×60 (s/min))
= 5.2×103 Bq/cm
2
Question 3 Skin (derma) RBE weighted dose rate
dermaSkinSdermaSkin AdtAAD
ADSkin derma – RBE weighted dose in skin derma (Gy);
AdSkin derma – coefficient of RBE weighted dose rate in skin derma ((Gy/s)/(Bq/cm2));
AS - Surface activity concentration (Bq/cm2).
AdSkin derma = 3.4×10-11
((Gy/s)/(Bq/cm2)) (Table 19 from [1])
t = 1 h = 3600 s
ADSkin derma = 3.4×10-11
((Gy/s) /(Bq/cm2))×2.24×10
2 (Bq/cm
2)×3.6×10
3 (s/h)
= 2.5×10-5
Gy/h ≈ 0.03 mGy/h
2
Question 4 1) Dose of internal exposure from intake of radionuclide
Pathwaymarrowdmarrowd
Pathway
AdAAD
eAE
,ReRe )()(
)()(
E(τ) – committed effective dose (Sv);
AD(Δ)Red marrow – 30 day committed RBE weighted dose in red marrow (Gy);
A - Intake of radioactive material (Bq);
Ad(Δ)Red marrow, Pathway –coefficient of 30 day committed RBE weighted dose in red
marrow for unit intake of radionuclide through given pathway (Gy/Bq);
e(τ)Red marrow, Pathway – a radionuclide specific coefficient committed effective dose for
unit intake of radionuclide through given pathway (Sv/Bq).
2) Dose coefficients for intake of Co-60 oxide through wound Absorption rate of cobalt oxide from GI tract is 5 % Therefore, if patient ingests 1 Bq
of Co-60, 0.05 Bq of Co-60 is absorbed into circulation system. If 1 Bq of Co-60 is
totally absorbed into circulation system from wound, the ratio of dose coefficients for
ingestion intake and wound intake will be about 0.05:1.0.
Coefficient of committed effective dose for ingestion of Co-60 (e(τ)Red marrow, ingestion) is
2.5×10-9
Sv/Bq (Use GSR Part 3 Table III-2A [2] and EPR MEDICAL Table XII-D1-
1 [3]). Therefore
e(τ)Red marrow, wound = 2.5 x 10-9
(Sv/Bq)×(1/0.05)
= 50×10-9
Sv/Bq
Coefficient of 30 day committed RBE weighted dose in red marrow for ingestion of
Co-60 (Ad(Δ)Red marrow, ingestion) is 5.8×10-10
Gy/Bq (Use EPR-D-VALUES Table 19
[1])
Therefore
Ad(Δ)Red marrow, wound = 5.8×10-10
(Gy/Bq)×(1/0.05)
= 1.18×10-8
Gy/Bq
3) Dose from intake of Co-60 oxide through wound Intake:
S = 20 cm2.
AS = 5.2×103 Bq/cm
2.
A =20 (cm2)×5.2×10
3 (Bq/cm
2)
= 1.04×104 Bq
Committed effective dose:
E(τ) = 50×10-9
(Sv/Bq)×1.04×104 (Bq)
= 5.2×10-3
Sv ≈ 5 mSv
3
30 day committed RBE weighted dose in red marrow:
AD(Δ)Red marrow = 1.14×10-8
(Gy/Bq)×1.04×104 (Bq)
= 1.1×10-4
Gy ≈ 0.1 mGy
4
Case 2 Question 4 RBE weighted dose in red marrow
Pathwaymarrowdmarrowd Adr
tAAD ,Re2Re
ADRed marrow - RBE weighted dose in red marrow (Gy)
AdRed marrow - coefficient of RBE weighted dose rate in red marrow at 1 m
(Gy/(Bq×s))
A - Source activity (Bq)
t - Exposed time (s)
r - Distance between source and reference point (m)
The operator had been irradiated maximum at 4m form the source rack for 2 minutes,
and minimum at 4.7 m from the source rack for 1 minute.
AdRed marrow : 4.1×10-17
(Gy/(Bq×s)) (Use EPR-D-VALUES Table 15 [1])
A = 30×109 MBq= 3×10
16 (Bq)
h =1/60 hour or 2/60 hour = 60 (s) or 120 (s)
r = 4.7 m or 4 m
AdRed marrow = 4.1×10-17
(Gy/(Bq×s))×3×1016
(Bq)×120 (s) /42
= 9.2 Gy Maximum
AdRed marrow = 4.1×10-17
(Gy/(Bq×s))×3×1016
(Bq)×60 (s) /(4.7)2
= 3.3 Gy Minimum
5
Case 3 Question 2 RBE weighted dose in hand
tissueSofttissueSoft AdtAAD
ADSoft tissue - RBE weighted dose in soft tissue (Gy)
AdSoft tissue – coefficient of RBE weighted dose in soft tissue from adjusent
source (Gy/Bq/s)
A - Source activity (Bq)
t - Exposed time (s)
The radiation dose to the hand
AFSoft tissue =5.9×10-15
(Gy/(Bq×s)) (Use EPR-D-VALUES Table 15 [1])
S = 2×1012
(Bq)
h = 1/60 hour = 60 (s)
AFSoft tissue = 5.9×10-15
(Gy/(Bq×s))×2×1012
(Bq)× 60 (s)
= 0.708 Gy
Question 3 RBE weighted dose in red marrow
marrowdmarrowd Adr
tAAD Re2Re
ADRed marrow - RBE weighted dose in red marrow (Gy)
AdRed marrow - coefficient of RBE weighted dose rate in red marrow at 1 m
(Gy/(Bq×s))
A - Source activity (Bq)
t - Exposed time (s)
r - Distance between source and reference point (m)
AFRed marrow = 9.6×10-18
(Gy/(Bq×s)) (Use EPR-D-VALUES Table 15 [1])
S =2×1012
(Bq)
h = 12 hour×30 days = 12×30× 3600 = 1.3× 106 (s)
r = 4 m
ADRed marrow = 9.6×10-18
(Gy/(Bq×s))×2×1012
(Bq)×1.3× 106 (s) / 4
2
= 1.56 Gy
6
References
[1] INTERNATIONAL ATOMIC ENERGY AGENCY, Dangerous Quantities of
Radioactive Material, Emergency Preparedness and Response Series EPR-D-
VALUES, IAEA, Vienna (2006).
[2] INTERNATIONAL ATOMIC ENERGY AGENCY, Radiation Protection and
Safety of Radiation Sources: International Basic Safety Standards. Interim edition,
General Safety Requirements Part 3, Safety Standard Series No. GSR Part 3
(Interim), IAEA, Vienna (2011).
[3] INTERNATIONAL ATOMIC ENERGY AGENCY, WORLD HEALTH
ORGANIZATION, Generic procedures for medical response during a nuclear or
radiological emergency, Emergency Preparedness and Response Series EPR-
MEDICAL, IAEA, Vienna (2005).
[4] INTERNATIONAL COMMISSION ON RADIOLOGICAL PROTECTION,
Nuclear Decay Data for Dosimetric Calculations, ICRP Publication 107, Ann.
ICRP, Ann ICRP Vol. 38 (3), Pergamon Press, Oxford (2008).
IAEA International Atomic Energy Agency
Medical Preparedness and Response for
a Nuclear or Radiological Emergency
Assessment of Patient’s Exposure
Tabletop Exercise - Basic
IAEA 2
Contamination of the Individual
Contamination of the individual
· Surface activity concentration: AS [Bq/cm2]
· Total deposited activity: A [Bq]
Contamination of the individual
· Surface activity concentration: AS [Bq/cm2]
· Total deposited activity: A [Bq]
Contamination monitor
· Contamination (Monitor reading): C [cpm]
· Window area: S [cm2]
Contamination monitor
· Contamination (Monitor reading): C [cpm]
· Window area: S [cm2]
Radioactive leakage
· Radionuclide: R· Maximal energy of β-spectrum: Eβ [MeV]
Radioactive leakage
· Radionuclide: R· Maximal energy of β-spectrum: Eβ [MeV]R
CC
AS
AAS
A
IAEA 3
Contamination of the Individual (2)
AS: Surface activity concentration (Bq/cm2)
C: Contamination (cpm)
CB: Background contamination (cpm)
Iβ: Emission rate of β-particles (%)
d: Efficiency of detection of β-particles (%)
W: Window area(cm2)
A: Deposited activity (Bq)
S: Contaminated area (cm2)
SAAS
60W5.0
I
100
100
d
CC
AB
S
β
IAEA 4
Efficiency of Registration of β-decay
Maximal energy of
β-spectrum, MeV
Maximal energy of
β-spectrum, MeVEff
icie
nc
y o
f re
gis
tra
tio
n, %
/2π
Eff
icie
nc
y o
f re
gis
tra
tio
n, %
/2π
5 mm
2π
2π
60Co 0.318 MeV
137Cs 0.514 MeV
192Ir 0.675 MeV
IAEA
Emission Rate in Radioactive Decay
Emission rate of β-particles in Cu-64 decay is 55.1%
For Co-60 decay it is 99.9% 5
IAEA 6
Dose from Intake of Radionuclide
Committed RBE
weighted organ
dose
Committed
effective dose
Intake
of R Exposure scenario
Pathway,marrowdRemarrowdRe
Pathway
)(AdA)(AD
)(eA)(E
ΔΔ
ττ
IAEA
Skin Dose from Surface Contamination
dermaSkinS
dermaSkin
AdtA
AD
7
IAEA
Soft Tissue Dose from Adjacent Source
tissueSoft
tissueSoft
AdtA
AD
h = 0 mm
d = 5 mm
8
IAEA
Red Marrow Dose from Distant Source
Pathway,marrowdRe2marrowdReAd
r
t
AAD
No shielding, χ = 0
9
IAEA
Use of Default Dosimetric Model (DDM)
Default dosimetric model expands Elementary
model to irradiation of a reference man
10
Training Course on Medical Preparedness and Response
for a Nuclear or Radiological Emergency
Tabletop Exercise Manual –
Advanced
2
CONTENT
1.0 GENERAL INFORMATION FOR PLAYERS ......................................................................... 3 1.1 Introduction ............................................................................................................................ 3 1.2 Exercise objectives ................................................................................................................. 3 1.3 Exercise scope ........................................................................................................................ 4 1.4 Exercise organization ............................................................................................................. 5 1.5 Exercise management ............................................................................................................. 8 1.6 Exercise rules ......................................................................................................................... 8 1.7 Preparation for the exercise .................................................................................................... 8 1.8 Equipment .............................................................................................................................. 8 1.9 Radiological data .................................................................................................................... 9 1.10 Start state .............................................................................................................................. 10
2.0 EXERCISE TEAM INSTRUCTIONS ..................................................................................... 11 2.1 Exercise organization ........................................................................................................... 11 2.2 Roles and responsibilities ..................................................................................................... 11 2.3 Exercise schedule ................................................................................................................. 11 2.4 Instructions for Lead Controller ........................................................................................... 11 2.5 Instructions for controllers during the exercise .................................................................... 12 2.6 Logistics ............................................................................................................................... 12
3.0 SCENARIO .............................................................................................................................. 13 3.1 Narrative ............................................................................................................................... 13 3.2 Start state .............................................................................................................................. 13 3.3 Master events list (MEL) ..................................................................................................... 14 3.4 Radiological data .................................................................................................................. 16 3.5 Medical data ......................................................................................................................... 16
4.0 EXERCISE INJECTS .............................................................................................................. 17 5.0 EXERCISE DATA ................................................................................................................... 34
5.1 Radiation data ....................................................................................................................... 34 5.2 Medical data ......................................................................................................................... 35
6.0 CONSEQUENCES OF VICTIMS AND WITNESS ............................................................... 36 6.1 Victims ................................................................................................................................. 36 6.2 Witnesses .............................................................................................................................. 43
3
DISTRIBUTE THIS SECTION TO THE PLAYERS
1.0 GENERAL INFORMATION FOR PLAYERS
1.1 Introduction
TEX-01 is a tabletop exercise that is part of the basic course on emergency preparedness and
response for terrorist acts involving radioactivity.
1.2 Exercise objectives
On-site management objectives
On-site command and control is promptly established.
The medical response at the scene is well coordinated with other response organizations,
particularly radiological response, in terms of cooperation, command and control and
communication links.
The medical responders at the accident scene (critical first aid) promptly address the
immediate medical consequences of an acute event involving trauma, internal and external
contamination and acute radiation syndrome.
Life-saving medical first aid is given priority over decontamination.
The radiological response at the scene is well coordinated with other response organizations,
particularly medical response, in terms of cooperation, command and control and
communication links.
Triage of those involved at the scene of an accident (workers, responders, and public) is
performed appropriately based on medical needs, contamination and potential overexposure.
The transfer of responsibility at the site, if it occurs, is carried out seamlessly and effectively
while minimizing the spread of contamination.
Immediate conventional hazards are promptly mitigated.
Notification of public health is demonstrated.
An effective media management strategy for dealing with the threat is identified.
Media management measures at the scene are implemented.
Hospital management objectives
Hospital management is promptly established.
Effective initial and subsequent medical management of symptomatic, asymptomatic,
externally contaminated, and internally contaminated patients is provided.
Medical treatment for serious conditions is given priority over decontamination.
The medical response at the hospital is well coordinated with on-scene command and control
and communication links.
The radiological response at the hospital is well coordinated with command and control and
communication links.
Medical authorities correctly assess the current and potential public health issues related to
the accident and notify authorities.
Measures are promptly taken to confine contamination.
Triage victims on hospital scene.
Media management measures at the hospital are implemented.
4
1.3 Exercise scope
The exercise will be a tabletop exercise. Area maps will be used to simulate the movement and
deployment of response teams. Colour-coded chips will be used to simulate the position of different
teams.
The exercise will last two hours. It will involve the participation of all workshop attendees. No
outside organization will participate.
5
1.4 Exercise organization
The players will be divided into the following:
On-Site team
Position Role Resources
Emergency medical
service team
Tactical coordination of medical first
responders and ambulance services.
You normally work from the city’s
emergency response centre.
You are responsible for providing first aid
for injured persons using standard methods
for medical first, and also you might be the
first responders until arrival of the first
responders.
4 major hospitals, 2 of which have a
system to respond to radiological
emergencies.
Medical transport team You are responsible for transporting the
casualties from the scene of the emergency
to the Emergency Departments of the
hospital.
10 ambulances distributed
throughout the city, with two
attendants per ambulance, all
trained in advanced life support
(ALS).
Radiation technicians Radiation safety officer for one of the
hospitals.
Secondary duty as special advisor to the
local chief of civil defence on preparedness
issues for radiological accidents.
Trainer for city emergency response
personnel on radiation detection and
protection.
Access to a network of 3 radiation
safety officers, all trained in the use
of detection instruments and
radiation protection.
Triage physicians You normally work for the Emergency
Department of the hospital. In case of mass
casualty you dispatch to the scene.
2 physicians and they have first aid
kit.
Triage nurses You normally work for the Emergency
Department of the hospital. In case of mass
casualty you dispatch to the scene with
physicians.
2 nurses.
Medical officer You normally work for the Department of
health at the local level.
You are responsible for the public health
and respond to the public and media.
Social assistant You notify the public about possible threats
and initiate the response.
Administrator/Coordinator You coordinate the EMS and hospital.
Security staff You are responsible for the security on the
scene.
They all have personal protect equipments.
6
Hospital A team
Hospital A is located in 2km away from Stephansplatz.
Position Role Resources
The head of hospital In normal situations, you are
responsible for policies of the hospital.
In times of emergency, you remain the
executive in charge of any policy issue
affecting the safety and well-being of
the patients in your hospital.
Official hospital spokesperson.
The emergency medical
manager
In normal situations, you manage the
emergency department. In times of a
disaster, you are requested to manage
the medical response team in your
hospital.
You report to the head of the hospital.
Emergency physicians You decide on maintaining the patient
in the appropriate services of the
hospital and provide resuscitation for
patients that are in life threatening
conditions.
2 emergency physicians.
Medical specialists You are responsible for providing the
necessary treatment for the patient.
1 surgeon, 2 internists and 1
orthopedist.
Nurses You take care of the patients and assist
emergency physicians and medical
specialists.
4 nurses.
Radiation safety/protection
personnel
Radiation safety officer the hospital. 5 radiation safety officers all
trained in the use of detection
instruments and radiation
protection.
Laboratory technicians You are responsible for examining
blood and urine in the hospital
laboratory and you report the results to
doctors.
You are unable to radiation
measurements.
Administrator/Coordinator You coordinate the hospital and EMS.
7
Hospital B team
Hospital B is located 5km from Stephansplatz.
Position Role Resources
The head of hospital In normal situations, you are
responsible for policies of the hospital.
In times of emergency, you remain the
executive in change of any policy issue
affecting the safety and well-being of
the patients in your hospital.
Official hospital spokesperson.
The emergency medical
manager
In normal situations, you manage the
emergency department. In times of a
disaster, you are requested to manage
the medical response team in your
hospital.
You report to the head of the hospital.
Emergency physicians They make a decision about
maintaining the patient in the
appropriate services of the hospital and
provide resuscitation for patients that
are in life threatening conditions.
3 emergency physicians.
Medical specialists They are responsible for providing the
necessary treatment for the patient.
1 brain surgeon, 1 internist and 1
general surgeon.
Nurses You take care of the patients and assist
emergency physicians and medical
specialists.
5 nurses.
Radiation safety/protection
personnel
Radiation safety officer for the hospital. 4 radiation safety officers all
trained in the use of detection
instruments and radiation
protection.
Laboratory technicians You are responsible for examining
blood and urine in the hospital
laboratory and you report the results to
the doctors.
You are unable to use radiation
measurements.
Administrators You coordinate the hospital and EMS.
8
1.5 Exercise management
The exercise will be conducted by controllers. Controllers will provide simulated information and
data (injects). They are NOT there to help with procedures or to guide you in your response. If you
have questions about aspects of the exercise that are not clear, or if you need to access
organizations/agencies that are not simulated in the exercise, talk to a controller.
1.6 Exercise rules
Play your role seriously.
Do not fight the scenario.
Simulated data will be provided by the controllers if the appropriate actions are taken.
No outside calls.
The On-site group and hospital groups can (and should) communicate with each other, but
only through telephone.
Resources will be simulated using colour-coded chips/magnets.
The position and movement of resources will be simulated by placing the chips on city maps
provided. Each group will have its own map.
Additional information can be entered on the maps using grease pencils provided.
The situations and symptoms that you can see and hear of each victim and witness are all
written on the “card”.
If you need the data, ask the controller to provide the data.
1.7 Preparation for the exercise
Before the exercise can start, the following actions must take place:
Roles must be assigned and explained;
Groups must be organized.
1.8 Equipment
You should have the following equipment:
a. Maps and layouts for each group;
b. Pencils;
c. Resource chips (see colour code below, which may change depending on availability of
chips);
d. Paper and pens;
e. Triage tags.
Chip colour Simulated persons
White Triage physician, Triage nurse, Nurse, Medical specialist
Red Medical officer, Head of hospital
Yellow Security service, emergency medical manager
Orange Emergency medical service, Emergency physician
Blue Medical transport, Laboratory technician
Green Radiation technician
Red + cross Social assistant, Administrator/Coordinator
Black Journalists
9
1.9 Radiological data
Ambient dose rates and air sampler readings will be simulated using an exercise software based on
the location of the reading. If you want radiation readings, you need to:
1. Indicate to the controller what resources you have at the scene that can detect radiation;
2. Tell the controller where you are taking readings.
10
1.10 Start state
We are in Bredonia. The International Newcomers (INO) is hosting a meeting of the General
Council. One of the discussion items is the enhancement of non-proliferation inspections in West-
Asian countries. The issue has been met with skepticism by some countries who feel that this
represents added pressure and control on their programs for the peaceful use of nuclear energy by
Western countries.
In the morning, a local radio station receives a call from an unknown individual with a foreign accent
(accent unknown but the person communicated in English) , they said that there would be a dirty
bomb attack on a busy Bredonia district to protest against the interference of the INO in West Asia
domestic affairs. They intend to go with a report on the news.
It is tourist season in Bredonia. There is a classical music festival throughout the streets of the first
district. Most hotels are fully booked. Today, two major concerts are planned at noon at West
District and the East District. Each is expected to attract thousands of people.
There are two hospitals both of them has an emergency department and ICU. Many patients are
always waiting their turn in both emergency departments. Today you are working as usual ……
11
DO NOT/NOT DISTRIBUTE THIS SECTION TO PLAYERS
2.0 EXERCISE TEAM INSTRUCTIONS
2.1 Exercise organization
There will be three controllers for this exercise: one for lead and two for support. Roles will be
assigned before the exercise.
2.2 Roles and responsibilities
The lead controller is responsible for the overall conduct of the exercise.
Controllers are responsible for ensuring that the scenario inputs are provided in accordance with the
master events list, for ensuring that the scenario stays on track and for monitoring the safety of the
actions taken. In case of safety concerns, the controllers will stop the exercise, notify the lead
controller and wait for safe conditions to be re-established before resuming.
2.3 Exercise schedule
30 minutes before start time Briefing of players
Exercise 2 hours duration
30 minutes after exercise Evaluation and debriefing
2.4 Instructions for Lead Controller
Day before the exercise
Assign players roles.
Review the scenario with the controllers and assign roles.
Make required adjustments to the times on the input messages.
Ensure the room for the exercise is ready. Depending on the size of the room and the groups,
three rooms may be required. If so, ensure that there is a telephone link between the rooms. The
three groups must be physically separated (although they can be in the same room if big enough).
Ensure that all equipment is available for the next day (maps, figures, grease pencils, note pads,
pens and victim cards).
Select 2 victim cards from delayed category, 4 victim cards from minor category, and 4
witnesses. And put remaining cards on the map (Stephansplatz).
Briefing and preparation
Go through the players guide part of this document.
Give the team sufficient time to get organized.
During the exercise
Start the exercise only when you feel that the participants are ready. Do not delay too much.
Make sure that all controllers know the exact start time and, if required, make last minute
adjustment to the exercise timing.
12
2.5 Instructions for controllers during the exercise
Identify yourself as controller to the organization being evaluated at the start of the exercise;
Confirm you have reached an exercise participant before delivering scripted messages;
Begin each message with “THIS IS AN EXERCISE” and the name of the organization/individual
being simulated;
Begin and end hard copy messages with “EXERCISE, EXERCISE, EXERCISE”;
Closely follow the instructions in the Master Event List;
If the scenario gets off track, immediately report the problem to the Lead Controller;
Do not provide additional information unless requested by the organization being evaluated, and
then, only within the limits of the scenario;
Do not accelerate the exercise by providing information ahead of schedule, unless directed by the
Lead Controller;
Immediately halt an activity that is unsafe and report the action to the Lead Controller;
Report to and seek permission from the Lead Controller to terminate the exercise when a real
emergency occurs;
Monitor exercise play and make minor adjustments only when necessary to keep the exercise on
track or to maintain a safe environment.
2.6 Logistics
The following equipment will be required:
Map of first district (A3-size);
Map of Bredonia (A3-size);
Layout of the hospital A and hospital B (A3-size);
Layout of the emergency departments of hospital A and hospital B;
Victim and witness consequence cards;
Pencils;
Note pads;
Pens;
Telephones (if the groups are in three separate rooms);
EPR-MEDICAL 2005 (one for each group)
13
3.0 SCENARIO
3.1 Narrative
At 10:00 h, the Bredonia emergency dispatcher (emergency call service) receives a call from the INO
security section informing them that an unknown individual with a foreign accent (accent unknown
but the person communicated in English) called to say that there would be an dirty bomb attack on a
busy Bredonia district to protest against the interference of the INO in West Asia domestic affairs.
At 10:30 h, a local radio station receives a similar call and contacts the city media relations manager
to warn him. They intend to go with a live report on the 12:00 h news.
At 14:00, an explosion occurs in the Stephansplatz U-bahn station, near the Rottendrumstrasse exit.
The bomb contained 1000 Ci of Cs-137. The bomb was carried by a suicide bomber, who is now
dead and unrecognizable.
Fifty people are seriously injured and smoke quickly fills the U-bahn station. Smoke is seen coming
out of the U-bahn exit. There are approximately 500 people around Stephansplatz. Street performers
are present. The explosion causes panic. Most people leave the scene running. Approximately 50
people stay around to help people coming out of the U-bahn station with various degrees of injuries.
Some are filming the event.
At 15:00, five victims and witnesses go to the Hospital A and Hospital B by themselves, and they are
not surveyed by radiation detector or decontaminated at the scene.
At 15:20, there are approximately 20 journalists at the scene, from different nations. Many were
present at a press conference at the INO and went to the scene when they heard about the explosion.
At 15:30, National coordinator for radiological resources tells the On-site team that the radionuclide
used for the bomb is Cs-137.
By 16:00, medical officers are urged to respond to public health. And 2 victims start vomiting.
By 16:20, there are 10 journalists at Hospital B, and are interfering with the medical response.
By 18:20, all victims are decontaminated and referred for further hospital care or discharged.
3.2 Start state
See players guide.
14
3.3 Master events list (MEL) # Simulated
time
Inject real
time (min)
Prevent to Inject/controller instructions Points for discussion
-0:30 All Start state
1 1400 0 On-site team On-site team receives call about an explosion on
Stephansplatz.
□ What is your assessment of the situation?
□ What actions should you take and what are the priorities?
2 1410 5 On-site team On-site team goes to the scene and receives a situation
report from the scene.
When the on-site team starts triage, controller gives
them “victim and witness information card”.
□ What is your assessment of the situation?
□ What actions should you take and what are the priorities?
□ Contamination control
□ Safety of responders and victims
□ Communication with other organization
□ What are the implications for the hospital?
3 1430 15 Hospital A and B Commander of first responders requests to receive
victims.
(When there is no request from the site within 15
minutes)
□ What is your assessment of the situation?
□ What actions should you take and what are the priorities?
□ How do you establish the hospital management?
4 1430 15 Hospital A Hospital A receives a situation at their hospital. □ How do you prepared the hospital to receive the victims?
□ What should you do to regular admissions and
outpatients?
□ How many victims can you receive?
5 1430 15 Hospital B Hospital B receives a situation at their hospital. □ How do you prepare the hospital to receive the victims?
□ What should you do to regular admissions and
outpatients?
□ How many victims can you receive?
6 1500 30 Hospital A 5 victims and witnesses come to the Hospital A and B
by themselves, and they are not surveyed for
contamination.
(Controller selects a victim from yellow category and 2
victims from green category, and 2 witnesses)
□ How do you manage this situation?
7 1500 30 Hospital B 5 victims and witnesses come to the Hospital A and B
by themselves, and they are not surveyed for
contamination.
(Controller selects a victim from yellow category and 2
victims from green category, and 2 witnesses)
□ How do you manage this situation?
8 1520 40 On-site team 20 journalists come to the scene and they are asking a
lot of questions and interfering with the EMS action.
□ How do you make the communication with media on
scene?
15
# Simulated
time
Inject real
time (min)
Prevent to Inject/controller instructions Points for discussion
9 1530 45 On-site team The national coordinator for radiological resources
informs that the radionuclide is Cs-137.
□ What should you do for contamination?
□ How do you let hospital staff know this?
10 1600 60 Medical officer Health Department receives many calls from witnesses
who already left the site, then, health department asks
the medical officer.
□ What should you need to answer the questions?
□ How do you get the information to answer the questions?
□ What and how do you answer to them?
11 1610 65 Hospital ? Victim #1 and #3 start vomiting.
(Give inject to Hospital which received victim #1
and/or #3.)
□ What is needed for dosimetry and which organization do
you ask for radiological dosimetry?
12 1620 70 Hospital A The head of the hospital receives media inquiries. □ What do you answer to the media?
13 1620 70 Hospital B 10 journalists come to hospital B and they are asking a
lot of questions and interfering with medical response.
□ How do you communicate with the media?
14 1800 90 On-site team All victims are transported to another area and all
witnesses are decontaminated.
(When victims or witnesses are still on scene,
controller tells them all victims are transported to
hospital or other place.)
□ How do you leave the area?
□ What are necessary for cleanup of the area and which
organization will do it?
15 1820 100 Hospital A and B All victims are decontaminated and referred for further
hospital care or discharged.
□ How do you recover the emergency department?
120 ENDEX
This exercise is terminated when the final patient has
received emergency care, been decontaminated and
been referred for further hospital care or discharged
and all witnesses have been decontaminated.
16
3.4 Radiological data
When responders are at the scene and when they indicate that they have radiation detection
instruments, provide ambient gamma readings and air samples as requested for the location
requested.
When responders indicate radiological survey for contamination, give them readings of more than 2
times of background levels. All victims and witnesses are externally contaminated; their clothes,
shoes, face, hands and arms.
3.5 Medical data
All victims are normal for lymphocyte count in initial 6 hours.
For Victim #7 and #15, AST and ALT are increased because of abdominal injury.
17
4.0 EXERCISE INJECTS
18
EXERCISE EXERCISE EXERCISE
Inject number 1
Simulated time 14:00 h
To: EMS and On site team
The emergency medical service just received a call that there has been an explosion at Stephansplatz.
It appears that the explosion happened in the U-bahn station. Many people are injured.
EXERCISE EXERCISE EXERCISE
19
EXERCISE EXERCISE EXERCISE
Inject number 2
Simulated time 14:10 h
Situation report from the accident scene
Explosion originated in Stephansplatz U-bahn station, rottendrumstrasse exit.
The station is filled with smoke.
Smoke is spilling out in the street, on Stephansplatz side.
50 casualties in the station.
5 people outside the station suffering from smoke inhalation
About 50 people on the street helping people and taking videos
One person in the U-bahn station is blown to pieces; looks like he/she may have been a suicide
bomber; body is unrecognizable.
Electronic dosimeters in alarm.
Dose rate around 2 mSv/ at 50 m from the U-bahn exit.
There are no first responders.
EXERCISE EXERCISE EXERCISE
20
EXERCISE EXERCISE EXERCISE
Inject number 3
Simulated time 14:30
To: Hospital A and B
Hospital A and B just received a call from the medical service that there has been an explosion at
Stephansplatz. It appears that the explosion happened in the U-bahn station. Many people are
injured. And you are required to receive the victims.
EXERCISE EXERCISE EXERCISE
21
EXERCISE EXERCISE EXERCISE
Inject number 4
Simulated time 14:30
Situation of Hospital A
10 people are waiting in the emergency department.
2 emergency physicians and 4 nurses are working in the emergency department.
Hospital A has 10 intensive care units (ICU), 2 units are vacant today.
There are 4 rooms for hospitalizing in the emergency department.
Hospital A has 200 beds; there are 10 vacant rooms and 14 beds for hospitalizing today.
Hospital A has 3 operating rooms and all of them are booked.
Hospital A has the following medical countermeasures:
Potassium iodide
Dimercaprol
Penicillamine
Deferoxamine
Prussium blue
Ca-DTPA
Zn-DTPA
ED has enough medical equipment for receiving victims.
EXERCISE EXERCISE EXERCISE
22
EXERCISE EXERCISE EXERCISE
Inject number 5
Simulated time 14:30
Situation of Hospital B
10 people are waiting in the emergency department.
3 emergency physicians and 4 nurses are working in the emergency department.
Hospital B has 8 intensive care units (ICU), 1 unit is vacant today.
There are 3 rooms for hospitalizing in the emergency department.
Hospital B has 150 beds, there are 8 vacant rooms and 12 beds for hospitalizing today.
Hospital B has 3 operating rooms and all of them are booked.
Hospital B has these medical countermeasures:
Potassium iodide
Dimercaprol
Penicillamine
Deferoxamine
Prussium blue
Ca-DTPA
Zn-DTPA
ED has enough medical equipment for receiving victims.
EXERCISE EXERCISE EXERCISE
23
EXERCISE EXERCISE EXERCISE
Inject number 6
Simulated time 15:00 h
Hospital A
Two witnesses come to Hospital A in their own vehicle with a victim.
And two victims come to the Hospital A by themselves.
They have not been surveyed at the scene.
EXERCISE EXERCISE EXERCISE
24
EXERCISE EXERCISE EXERCISE
Inject number 7
Simulated time 15:00 h
Hospital B
Two witnesses come to Hospital A in their own vehicle with a victim.
And two victims come to the Hospital A by themselves.
They have not been surveyed at the scene.
EXERCISE EXERCISE EXERCISE
25
EXERCISE EXERCISE EXERCISE
Inject number 8
Simulated time 15:20 h
Situation report
20 journalists are at the scene. They are asking a lot of questions and interfering with rescue efforts.
EXERCISE EXERCISE EXERCISE
26
EXERCISE EXERCISE EXERCISE
Inject number 9
Simulated time 15:30 h
From: National coordinator for radiological resources (Nuclear regulatory agency)
To: On-site team
The radionuclide that was used for the bomb is Cs-137.
No other radionuclides are identified from samples of contamination.
EXERCISE EXERCISE EXERCISE
27
EXERCISE EXERCISE EXERCISE
Inject number 10
Simulated time 16:00 h
To: Medical officer
Health Department receives many calls from witnesses who have already left the site, such as the
following:
1) I was near the station when the incident happened, was I exposed?
2) Am I contaminated?
3) What should I do now? Should I go to hospital?
4) Will I get cancer later?
The health department requests the medical officer to respond to these questions.
EXERCISE EXERCISE EXERCISE
28
EXERCISE EXERCISE EXERCISE
Inject number 11
Simulated time 16:10 h
Controller tells the doctor:
Victim #1 and #3 have started vomiting.
EXERCISE EXERCISE EXERCISE
29
EXERCISE EXERCISE EXERCISE
Inject number 12
Simulated time 16:20 h
To: Head of the Hospital A
The head of the Hospital A receives the following inquiries from the media:
1) What is happening?
2) Is the threat serious?
3) What are you doing about it?
4) How many victims did you receive in your hospital?
5) How many people died?
EXERCISE EXERCISE EXERCISE
30
EXERCISE EXERCISE EXERCISE
Inject number 13
Simulated time 16:20 h
At Hospital B
10 journalists are at Hospital B. They are asking a lot of questions and interfering with the medical
response.
EXERCISE EXERCISE EXERCISE
31
EXERCISE EXERCISE EXERCISE
Inject number 14
Simulated time 17:00 h
On-site team
All victims are transported to another area and all witnesses are decontaminated.
EXERCISE EXERCISE EXERCISE
32
EXERCISE EXERCISE EXERCISE
Inject number 15
Simulated time 17:20 h
Hospital A and B
All victims are decontaminated and referred for further hospital care or discharged.
EXERCISE EXERCISE EXERCISE
33
EXERCISE EXERCISE EXERCISE
Inject number 16
Simulated time --
ENDEX
EXERCISE EXERCISE EXERCISE
34
5.0 EXERCISE DATA
5.1 Radiation data Raw downwind data (approximate)
Distance
(m) Ambient dose rate (microSv/h) after plume
Air sample reading (during plume) in CPS
50 710 1.5 M
100 200 0.45 M
200 50 0.1 M
500 10 0.03 M
35
5.2 Medical data
Complete blood cell counts Complete blood cell counts
Victim #
3,6,9, 11,13
WBC 6000 /mm3
Victim # 7
WBC 5500 /mm3
Lym 2300 /mm3 Lym 2200 /mm
3
RBC 2.7 x106/mm
3 RBC 3 x10
6/mm
3
Hb 11 g/dl Hb 10 g/dl
Ht 30 % Ht 25 %
Plt 18 x104/mm
3 Plt 13 x10
4/mm
3
Blood Chemical Analysis Blood Chemical Analysis
AST 20 IU/l AST 200 IU/l
ALT 18 IU/l ALT 150 IU/l
BUN 13 mg/dl BUN 12 mg/dl
Crea 0.7 mg/dl Crea 0.6 mg/dl
Glu 96 mg/dl Glu 98 mg/dl
Complete blood cell counts Complete blood cell counts
Victim # 15
WBC 5000 /mm3
Victim #
others
WBC 5000 /mm3
Lym 2000 /mm3 Lym 2000 /mm
3
RBC 4.5 x106/mm
3 RBC 4.5 x10
6/mm
3
Hb 13 g/dl Hb 15 g/dl
Ht 40 % Ht 40 %
Plt 20 x104/mm
3 Plt 25 x10
4/mm
3
Blood Chemical Analysis Blood Chemical Analysis
AST 350 IU/l AST 16 IU/l
ALT 300 IU/l ALT 12 IU/l
BUN 15 mg/dl BUN 15 mg/dl
Crea 0.8 mg/dl Crea 0.8 mg/dl
Glu 100 mg/dl Glu 100 mg/dl
36
6.0 CONSEQUENCES OF VICTIMS AND WITNESS
6.1 Victims # Consequence On-site card Hospital card Category
1
Right tension pneumothrax External contamination Internal contamination Dose received = 2 - 3 Sv
Age 54, Male Right chest pain, Can’t walk Vitals; RR 40/min CRT 1sec Can follow simple command
Age 54, Male Right chest pain, varicose jugular vein, loud breathing, decreased in right, trachea deviated to left, Vitals; RR 40/min PR 120/min BP 76/40mmHg SpO2 84% GCS E3V5M6
IMMEDIATE
2
Brain injury External contamination Internal contamination Dose received < 1 Sv
Age 32, Male Unconscious, can’t walk Vitals; RR 16/min CRT 1sec Can't follow simple commands
Age 32, Male Unconscious, anisocoria Vitals; RR 12/min PR 50/min BP 180/100mmHg SpO2 96% GCS E1V2M3
IMMEDIATE
3
Bilateral femur fracture, shock External contamination Internal contamination Dose received = 2 - 3 Sv
Age 45, Female Bilateral leg pain, can’t walk Vitals; RR 20/min CRT 3 sec Can follow simple command
Age 45, Female Deformation of bilateral thigh, X-p; bilateral femur fracture Vitals; RR 26/min PR 126/min BP 70/40mmHg SpO2 98% GCS E3V5M6
IMMEDIATE
4
40% burn External contamination Internal contamination Dose received < 1 Sv
Age 36, Male Severe burn on face, body, arms, can’t walk Vitals; RR 38/min CRT 1Sec Can follow simple commands
Age 36, Male DDB+DB burn (BSA 40%), dyspnea Vitals; RR 40/min PR 118/min BP 136/70mmHg SpO2 86% GCS E3V5M6
IMMEDIATE
5
40% burn and right antebrachal bone fracture External contamination Dose received < 1 Sv
Age 12, Female Severe burn on face, body, arms, can’t walk Vitals; RR 38/min CRT 1sec Can follow simple commands
Age 12, Female DDB+DB burn (BSA 40%) , dyspnea Vitals; RR 38/min PR 112/min BP 126/68mmHg SpO2 88% GCS E3V4M5
IMMEDIATE
6
Pelvic fracture, shock External contamination Internal contamination Dose received < 1 Sv
Age 60, Male Abdominal pain, face is pale, can’t walk Vitals; RR 20/min CRT 3 sec Can follow simple command
Age 60, Male Abdominal pain, FAST; positive, X-p; pelvic fracture, anemic palpebral conjunctiva Vitals; RR 24/min PR 136/min BP 74/40mmHg SpO2 96% GCS E3V5M6
IMMEDIATE
7
Abdominal injury, face burn External contamination Internal contamination Dose received < 1 Sv
Age 46, Male Intestine prolapse, abdominal pain, burnt face, can’t walk Vitals; RR 20/min CRT 3 sec Can follow simple commands
Age 46, Male Intestine prolapse, abdominal pain, difficulty in breathing Vitals; RR 24/min PR 122/min BP 60/40mmHg SpO2 94% GCS E3V5M6
IMMEDIATE
37
# Consequence On-site card Hospital card Category
8
Cervical vertebra fracture External contamination Internal contamination Dose received < 1 Sv
Age 26, Female Neck pain, total paralysis, abdominal breathing, can’t walk Vitals; RR 12/min CRT 3 sec Can follow simple commands
Age 26, Female Neck pain, total paralysis, abdominal breathing, X-p; C3-4 fractures Vitals; RR 12/min PR 40/min BP 80/40mmHg SpO2 99% GCS E4V5M6
IMMEDIATE
9
30% burn and left femur fracture External contamination Internal contamination Dose received < 1 Sv
Age 38, Male Severe burnt face, body, arms, legs, can’t walk Vitals; RR 36/min CRT 3sec Can follow simple commands
Age 38, Male Severe burns (DDB+DB, BSA 30%) Vitals; RR 40/min PR 130/min BP 74/40mmHg SpO2 96% GCS E3V5M6
IMMEDIATE
10
Brain injury External contamination Internal contamination Dose received < 1 Sv
Age 40, Female Unconscious, can’t walk Vitals; RR 20/min CRT 1sec Can't follow simple commands
Age 40, Female Unconscious, anisocoria Vitals; RR 20/min PR 88/min BP 150/70mmHg SpO2 96% GCS E1V2M4
IMMEDIATE
11
Left femur open fracture External contamination Internal contamination Dose received < 1 Sv
Age 24, Male Left leg deformation, bleeding and pain, can’t walk Vitals; RR 20/min CRT 3sec Can follow simple commands
Age 24, Male Left femur open fracture Vitals; RR 20/min PR 138/min BP 70/54mmHg SpO2 96% GCS E3V5M6
IMMEDIATE
12
Pelvic fracture, right upper arm open fracture External contamination Internal contamination Dose received < 1 Sv
Age 62, Male Abdominal pain, right upper arm deformation, bleeding, can’t walk Vitals; RR 20/min CRT 4sec Can follow simple commands
Age 62, Male Right upper arm bleeding, abdominal pain, FAST; positive, X-p; Pelvic fracture, right upper arm open fracture Vitals; RR 20/min PR 138/min BP 64/44mmHg SpO2 96% GCS E3V5M6
IMMEDIATE
13
Right upper arm traumatic amputation External contamination Internal contamination Dose received < 1 Sv
Age 27, Male Right upper arm traumatic amputation, bleeding and pain, can’t walk Vitals; RR 20/min CRT 3sec Can follow simple commands
Age 27, Male Right upper arm traumatic amputation, bleeding Vitals; RR 20/min PR 144/min BP 74/56mmHg SpO2 96% GCS E4V5M6
IMMEDIATE
14
Left tension pneumothrax External contamination Internal contamination Dose received < 1 Sv
Age 31, Female Left chest pain, can’t walk Vitals; RR 36/min CRT 1sec Can follow simple commands
Age 31, Female Left chest pain, varicose jugular vein, loud breathing decreased in left, trachea deviated to right Vitals; RR 40/min PR 138/min BP 84/40mmHg SpO2 84% GCS E4V5M6
IMMEDIATE
38
# Consequence On-site card Hospital card Category
15
Abdominal injury External contamination Internal contamination Dose received < 1 Sv
Age 42, Male Abdominal pain, can’t walk Vitals; RR 32/min CRT 1sec Can follow simple commands
Age 42, Male Abdominal involuntary guarding, tenderness, FAST; positive, intestinal perforation Vitals; RR 32/min PR 138/min BP 110/60mmHg SpO2 96% GCS E4V5M6
IMMEDIATE
16
Cardiac tamponade External contamination Internal contamination Dose received < 1 Sv
Age 78, Male Chest pain, can’t walk Vitals; RR20/min CRT 4 sec Can follow simple commands
Age 78, Male Chest pain, FAST; positive, Cardiac tamponade Vitals; RR 20/min PR 138/min BP 60/40mmHg SpO2 96% GCS E3V5M6
IMMEDIATE
17
Right tibia fracture External contamination Internal contamination Dose received < 1 Sv
Age 18, Female Right leg pain, can't walk Vitals; RR20/min CRT 1 sec Can follow simple commands
Age 18, Female Right tibia disformation, swelling, X-p; right tibia fracture Vitals; RR 20/min PR 100/min BP 120/74mmHg SpO2 96% GCS E3V5M6
DELAYED
18
Bilateral tibia fracture External contamination Internal contamination Dose received < 1 Sv
Age 80, Female Bilateral leg pain, can't walk Vitals; RR18/min, CRT 1 sec Can follow simple commands
Age 80, Female Bilateral tibia disformation, swelling, X-p; bilateral tibia fracture Vitals; RR 18/min PR 88/min BP 118/56mmHg SpO2 92% GCS E4V5M6
DELAYED
19
Severe soft tissue injury External contamination Internal contamination Dose received < 1 Sv
Age 44, Male Left femur bleeding, can't walk Vitals; RR16/min, CRT 1 sec Can follow simple commands
Age 44, Male Left femur bleeding, soft tissue injury Vitals; RR 18/min PR 88/min BP 138/68mmHg SpO2 92% GCS E4V5M6
DELAYED
20
Right arm and leg wound External contamination Internal contamination Dose received < 1 Sv
Age 16, Male Right arm bleeding, right leg injury and pain, can't walk Vitals; RR16/min, CRT 1 sec Can follow simple commands
Age 16, Male Right arm bleeding, right leg wound and bleeding Vitals; RR 18/min PR 78/min BP 120/70mmHg SpO2 100% GCS E4V5M6
DELAYED
21
Left humerus and tibia fracture External contamination Internal contamination Dose received < 1 Sv
Age 35, Female Left upper arm and leg pain, can’t walk Vitals; RR14/min, CRT 1 sec Can follow simple commands
Age 35, Female Left upper arm and leg disformation, swelling, pain X-p; left humerus and tibia fracture Vitals; RR 14/min PR 68/min BP 108/52mmHg SpO2 99% GCS E4V5M6
DELAYED
22
Left upper arm wound External contamination Internal contamination Dose received < 1 Sv
Age 33, Male Left upper arm injury and bleeding, can't walk Vitals; RR12/min, CRT 1 sec Can follow simple commands
Age 33, Male Left upper arm bleeding and pain Vitals; RR 14/min PR 66/min BP 132/88mmHg SpO2 99% GCS E4V5M6
DELAYED
39
# Consequence On-site card Hospital card Category
23
Right femur fracture External contamination Internal contamination Dose received < 1 Sv
Age 29, Male Right leg pain, can't walk Vitals; RR14/min, CRT 1 sec Can follow simple commands
Age 29, Male Right femur disformation, swelling, pain, X-p; right femur fracture Vitals; RR 14/min PR 70/min BP 108/52mmHg SpO2 99% GCS E4V5M6
DELAYED
24
Left ribs bone fracture External contamination Internal contamination Dose received < 1 Sv
Age 15, Female Left chest pain, feel hard to breath, can’t walk Vitals; RR 22/min, CRT 1 sec Can follow simple command
Age 15, Female Left chest pain, difficulty in breathing, X-p; left ribs fracture Vitals; RR 24/min PR 68/min BP 126/54mmHg SpO2 99% GCS E4V5M6
DELAYED
25
Left tibia fracture and upper arm wound External contamination Internal contamination Dose received < 1 Sv
Age 17, Female Left upper arm bleeding, left leg pain, can’t walk Vitals; RR16/min, CRT 1 sec Can follow simple commands
Age 17, Female Left upper arm bleeding, left tibia disformation, X-p; left tibia fracture Vitals; RR 16/min PR 88/min BP 112/64mmHg SpO2 99% GCS E4V5M6
DELAYED
26
Right ribs fracture External contamination Internal contamination Dose received < 1 Sv
Age 54, Female Right chest pain, feel hard to breath, can't walk Vitals; RR14/min, CRT 1 sec Can follow simple commands
Age 54, Female Right chest pain, feel hard to breath, X-p; right ribs fracture Vitals; RR 24/min PR 92/min BP 118/52mmHg SpO2 99% GCS E4V5M6
DELAYED
27
Right femur fracture and lower leg wound External contamination Internal contamination Dose received < 1 Sv
Age 29, Male Right femur pain, lower leg bleeding, can't walk Vitals; RR12/min, CRT 1 sec Can follow simple commands
Age 29, Male Right femur disformation, swelling, pain, X-p; right femur fracture, right lower leg bleeding Vitals; RR 14/min PR 70/min BP 128/54mmHg SpO2 99% GCS E4V5M6
DELAYED
28
Right tympanic membrane rupture and right femur wound External contamination Internal contamination Dose received < 1 Sv
Age 15, Male Right ear pain, fight femur bleeding, can't walk Vitals; RR 18/min, CRT 1 sec Can follow simple commands
Age 15, Male Hearing disorder of right ear, right tympanic membrane rupture, right femur wound Vitals; RR 18/min PR 92/min BP 110/54mmHg SpO2 99% GCS E4V5M6
DELAYED
29
Left tympanic membrane rupture, head bruise External contamination Internal contamination Dose received < 1 Sv
Age 21, Female Left ear pain, vertigo, can't walk Vitals; RR14/min, CRT 1 sec Can follow simple commands
Age 21, Female Hearing disorder of left ear, left tympanic membrane rupture, vertigo Vitals; RR 14/min PR 76/min BP 106/48mmHg SpO2 99% GCS E3V5M6
DELAYED
40
# Consequence On-site card Hospital card Category
30
Head bruise External contamination Internal contamination Dose received < 1 Sv
Age 57, Female Headache and dizziness, can’t walk Vitals; RR20/min, CRT 1 sec Can follow simple commands
Age 57, Female Dizziness and headache, neurological exam is normal Vitals; RR 20/min PR 88/min BP 132/52mmHg SpO2 99% GCS E3V5M6
DELAYED
31
Bilateral arm burn and abdominal bruise External contamination Internal contamination Dose received < 1 Sv
Age 43, Male Abdominal pain, burnt arms, can't walk Vitals; RR14/min, CRT 1 sec Can follow simple commands
Age 43, Male Abdominal pain, FAST; negative, burnt arms (SDB, BSA14%) Vitals; RR 14/min PR 80/min BP 116/60mmHg SpO2 99% GCS E4V5M6
DELAYED
32
Chest bruise External contamination Internal contamination Dose received < 1 Sv
Age 19, Female Feel hard to breath, chest pain, can’t walk Vitals; RR22/min, CRT 1 sec Can follow simple commands
Age 19, Female Chest pain, FAST; negative, X-p; no fracture Vitals; RR 22/min PR 76/min BP 122/62mmHg SpO2 99% GCS E4V5M6
DELAYED
33
Bilateral arm burn and right tympanic membrane rupture External contamination Internal contamination Dose received < 1 Sv
Age 39, Male Burnt arms and right ear pain, can't walk Vitals; RR18/min, CRT 1 sec Can follow simple commands
Age 39, Male Burnt arms (SDB, BSA 10%), hearing disorder of right ear, tympanic membrane rupture Vitals; RR 18/min PR 70/min BP 118/56mmHg SpO2 99% GCS E4V5M6
DELAYED
34
Left ankle sprain External contamination Internal contamination Dose received < 1 Sv
Age 51, Female Left ankle pain, swelling, can’t walk Vitals; RR 16/min, CRT 1 sec Can follow simple command
Age 51, Female Left ankle pain and swelling, X-p; no fracture Vitals; RR 16/min PR 66/min BP 126/62mmHg SpO2 99% GCS E4V5M6
DELAYED
35
Head bruise External contamination Internal contamination Dose received < 1 Sv
Age 63, Male Dizziness and headache, can't walk Vitals; RR14/min, CRT 1 sec Can follow simple commands
Age 63, Male Dizziness and headache, neurological exam is normal Vitals; RR 14/min PR 76/min BP 114/52mmHg SpO2 99% GCS E3V5M6
DELAYED
36
Left ribs fracture External contamination Internal contamination Dose received < 1 Sv
Age 49, Male Chest pain, can't walk Vitals; RR18/min, CRT 1 sec Can follow simple commands
Age 49, Male Left chest pain, X-p; left ribs fracture Vitals; RR 18/min PR 70/min BP 130/62mmHg SpO2 99% GCS E4V5M6
DELAYED
37
Head bruise External contamination Internal contamination Dose received < 1 Sv
Age 30, Female Headache and nausea, can't walk Vitals; RR12/min, CRT 1 sec Can follow simple commands
Age 30, Female Headache, nausea, neurological exam is normal Vitals; RR 14/min PR 88/min BP 108/52mmHg SpO2 99% GCS E4V5M6
DELAYED
41
# Consequence On-site card Hospital card Category
38
Abdominal bruise External contamination Internal contamination Dose received < 1 Sv
Age 49, Male Abdominal pain, can't walk Vitals; RR24/min, CRT 1 sec Can follow simple commands
Age 49, Male Abdominal pain, FAST; negative, physical exam is normal Vitals; RR 24/min PR 68/min BP 112/58mmHg SpO2 99% GCS E4V5M6
DELAYED
39
Chest bruise External contamination Internal contamination Dose received < 1 Sv
Age 67, Female Chest pain, can’t walk Vitals; RR16/min, CRT 1 sec Can follow simple commands
Age 67, Female Chest pain, FAST; negative, physical exam is normal Vitals; RR 16/min PR 66/min BP 124/68mmHg SpO2 99% GCS E4V5M6
DELAYED
40
Left tympanic membrane rupture External contamination Internal contamination Dose received < 1 Sv
Age 8, Male Left ear pain, can't walk Vitals; RR24/min, CRT 1 sec Can follow simple commands
Age 8, Male Hearing disorder of left ear, tympanic membrane rupture Vitals; RR 24/min PR 70/min BP 102/48mmHg SpO2 99% GCS E4V5M6
DELAYED
41
Laceration on hands and arms External contamination Internal contamination Dose received < 1 Sv
Age 29, Male Right leg pain, can walk Vitals; RR14/min, CRT 1 sec Can follow simple commands
Age 29, Male Laceration on hands and arms Vitals; RR 14/min PR 70/min BP 112/48mmHg SpO2 99% GCS E4V5M6
MINOR
42
Laceration on hands and arms External contamination Internal contamination Dose received < 1 Sv
Age 33,Female Laceration on hands and arms, can walk Vitals; RR16/min, CRT 1 sec Can follow simple commands
Age 33, Female Laceration on hands and arms Vitals; RR 16/min PR 66/min BP 108/52mmHg SpO2 99% GCS E4V5M6
MINOR
43
Laceration on hands and arms External contamination Internal contamination Dose received < 1 Sv
Age 35, Male Laceration on hands and arms, can walk Vitals; RR18/min, CRT 1 sec Can follow simple commands
Age 35, Male Laceration on hands and arms Vitals; RR 18/min PR 76/min BP 120/60mmHg SpO2 99% GCS E4V5M6
MINOR
44
Laceration on hands and arms External contamination Internal contamination Dose received < 1 Sv
Age 7,Female Laceration on hands and arms, can walk Vitals; RR 22/min, CRT 1 sec Can follow simple commands
Age 7, Female Laceration on hands and arms Vitals; RR 22/min PR 112/min BP 108/52mmHg SpO2 99% GCS E4V5M6
MINOR
42
# Consequence On-site card Hospital card Category
45
Laceration on hands and arms External contamination Internal contamination Dose received < 1 Sv
Age 10, Male Laceration on hands and arms, can walk Vitals; RR26/min, CRT 1 sec Can follow simple commands
Age 10, Male Laceration on hands and arms Vitals; RR 26/min PR 110/min BP 108/52mmHg SpO2 99% GCS E4V5M6
MINOR
46
Laceration on hands and face External contamination Internal contamination Dose received < 1 Sv
Age 5,Female Laceration on hands and face, can walk Vitals; RR 22/min, CRT 1 sec Can follow simple commands
Age 5, Female Laceration on hands and face Vitals; RR 22/min PR 120/min BP 108/52mmHg SpO2 99% GCS E4V5M6
MINOR
47
Laceration on hands and face External contamination Internal contamination Dose received < 1 Sv
Age 54, Male Laceration on hands and face, can walk Vitals; RR14/min, CRT 1 sec Can follow simple commands
Age 54, Male Laceration on hands and face Vitals; RR 14/min PR 68/min BP 128/64mmHg SpO2 99% GCS E4V5M6
MINOR
48
Laceration on hands and legs External contamination Internal contamination Dose received < 1 Sv
Age 58,Female Laceration on hands and legs, can walk Vitals; RR 16/min, CRT 1 sec Can follow simple commands
Age 58, Female Laceration on hands and legs Vitals; RR 16/min PR 98/min BP 142/52mmHg SpO2 99% GCS E4V5M6
MINOR
49
Laceration on legs External contamination Internal contamination Dose received < 1 Sv
Age 29, Male Laceration on legs, can walk Vitals; RR14/min, CRT 1 sec Can follow simple commands
Age 29, Male Laceration on legs Vitals; RR 14/min PR 60/min BP 122/72mmHg SpO2 99% GCS E4V5M6
MINOR
50
Laceration on hands and legs External contamination Internal contamination Dose received < 1 Sv
Age 44,Female Laceration on hands and legs, can walk Vitals; RR 16/min, CRT 1 sec Can follow simple commands
Age 44, Female Laceration on hands and legs Vitals; RR 16/min PR 86/min BP 122/66mmHg SpO2 99% GCS E4V5M6
MINOR
43
6.2 Witnesses
# Consequences
1 to 12
Helping the victims External contamination Laceration on legs and arms Very small internal contamination W-6,7,8 are females
13 to 31
Helping the victims External contamination Very small internal contamination No injury W-14,17-21,27 are females
32 to 45
Helping the victims External contamination No injury W-35,43 are females
46 to 48
Making video recording External contamination No injury
49 to 50
Making video recording No external contamination No injury
EMS 1
EMS 2
EMS 3
EMS 4
EMS 5
EMS 6
EMS 7
EMS 8
EMS 9
EMS 10
Medical Transport 1
Medical Transport 2
Medical Transport 3
Medical Transport 4
Medical Transport 5
Medical Transport 6
Medical Transport 7
Medical Transport 8
Medical Transport 9
Medical Transport 10
Figures for On-site team
Security Staff
Radiation Technician 1
Radiation Technician 2
Radiation Technician 3
Triage Physician 1
Triage Physician 1
Triage nurse 2
Triage nurse 1
Medical Officer
Social Assistant
Administrator
Head of hospital
Emergency Medical Manager
Emergency Physician
Emergency Physician
Surgeon
Internist
Internist
orthopedist
Radiation Protection Personnel
Radiation Protection Personnel
Radiation Protection Personnel
Radiation Protection Personnel
Radiation Protection Personnel
Administrator
Laboratory Technician
Laboratory Technician
Figures for Hospital A
Nurse Nurse
Nurse Nurse
Head of hospital
Emergency Medical Manager
Emergency Physician
Emergency Physician
Emergency Physician
Brain Surgeon
Internist
General Surgeon
Radiation Protection Personnel
Radiation Protection Personnel
Radiation Protection Personnel
Radiation Protection Personnel
Administrator
Laboratory Technician
Laboratory Technician
Figures for Hospital B
Nurse
Nurse
Nurse
Nurse
Nurse
Figures for OthersFirst aid Kit First aid Kit First aid Kit
□ Can’t move ambulatory
□ CRT > 2sec □ Can’t Do□ > 30/min or need head tilt
□ Can move ambulatory
R P M□ ≤ 29/min □ CRT < 2sec □ Can Do
□ No after head tilt
S L U D G E MSalivation Lacrimation Urination Defecation GI Distress Emesis Miosis
Circle Nature of Contaminant Dry DeconGross DeconTechnical Decon
Decon Solution
Radionuclide Contamination After Decon; No contaminationStill Contaminated
Need medical exam. of rad. exposure?
DECEASED
IMMEDIATE
DELAYED
MINOR
Name
Age Sex MF
No.
AddressPhone
Weight Lbkg
Zip
Bio Rad Toxin
Location of Triage Date/Time
No. 000001
No. 000001
No. 000001
No. 000001
No. 000001
DECEASED IMMEDIATE DELAYED MINOR
No contamination
NoVomit
YesDiarrhoeaNausea Headache( )Others
DECEASED
IMMEDIATE
DELAYED
MINOR
O2 Sat.Resp.PulseB/PTime
RateDoseMedicationTime
OtherTransOtherTransOtherTriage
No. 000001
No. 000001
No. 000001
No. 000001
No. 000001
IV Location Solution: Rate:Airway Adjunct Size: Depth:
□ Can’t move ambulatory
□ CRT > 2sec □ Can’t Do□ > 30/min or need head tilt
□ Can move ambulatory
R P M□ ≤ 29/min □ CRT < 2sec □ Can Do
□ No after head tilt
S L U D G E MSalivation Lacrimation Urination Defecation GI Distress Emesis Miosis
Circle Nature of Contaminant Dry DeconGross DeconTechnical Decon
Decon Solution
Radionuclide Contamination After Decon; No contaminationStill Contaminated
Name
Age Sex MF
No.
AddressPhone
Weight Lbkg
Zip
Bio Rad Toxin
Location of Triage Date/Time
No. 000001
DECEASED IMMEDIATE DELAYED MINOR
No contamination
Need medical exam. of rad. exposure? NoVomit
YesDiarrhoeaNausea Headache( )Others
V – 1 (On-site)
Age 54, Male
Right chest pain, Can’t walk
Vitals; RR 40/min CRT 1sec
can follow simple command
V – 1 (Hospital)
Age 54, Male
Right chest pain, varicose jugular vein,
Breath sounds decreased in right, Trachea
deviated to left
Vitals; RR 40/min PR 120/min
BP 76/40mmHg SpO2 84% GCS E3V5M6
V – 2 (On-site)
Age 32, Male
Unconsciousness, Can’t walk
Vitals; RR 16/min CRT 1sec
Can't follow simple command
V – 2 (Hospital)
Age32 , Male
Unconsciousness, anisocoric
Vitals; RR 12/min PR 50/min
BP 180/100mmHg SpO2 96% GCS
E1V2M3
V – 3 (On-site)
Age 45, Female
Bilateral leg pain, Can’t walk
Vitals; RR 20/min CRT 3 sec
Can follow simple command
V – 3 (Hospital)
Age45 , Female
Deformation of bilateral thigh, X-p; bilateral
femur fracture
Vitals; RR 26/min PR 126/min
BP 70/40mmHg SpO2 98% GCS E3V5M6
V – 4 (On-site)
Age 36, Male
Severe burn on face, body, arms, Can’t walk
Vitals; RR 38/min CRT 1Sec
Can follow simple command
V – 4 (Hospital)
Age36 , Male
II+III burn (BSA 40%), dyspnea
Vitals; RR 40/min PR 118/min
BP 136/70mmHg SpO2 86% GCS E3V5M6
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
V – 5 (On-site)
Age 12, Female
Severe burn on face, body, arms, Can’t walk
Vitals; RR 38/min CRT 1sec
Can follow simple command
V – 5 (Hospital)
Age 12, Female
DDB+DB burn (BSA 40%) , dyspnea
Vitals; RR 38/min PR 112/min BP
126/68mmHg SpO2 88% GCS E3V4M5
V – 6 (On-site)
Age 60, Male
Abdominal pain, Face is pale, Can’t walk
Vitals; RR 20/min CRT 3 sec
Can follow simple command
V – 6 (Hospital)
Age 60, Male
Abdominal pain, FAST; positive, X-p; pelvic
fracture, anemic palpebral conjunctiva
Vitals; RR 24/min PR 136/min BP
74/40mmHg SpO2 96% GCS E3V5M6
V – 7 (On-site)
Age 46, Male
Intestine prolapse, abdominal pain, burnt
face, Can’t walk
Vitals; RR 20/min CRT 3 sec
Can follow simple command
V – 7 (Hospital)
Age 46, Male
Intestine prolapse, abdominal pain, difficulty
in breathing
Vitals; RR 24/min PR 122/min BP
60/40mmHg SpO2 94% GCS E3V5M6
V – 8 (On-site)
Age 26, Female
neck pain, total paralysis, abdominal
breathing, Can’t walk
Vitals; RR 12/min CRT 3 sec
Can follow simple command
V – 8 (Hospital)
Age 26, Female
Neck pain, total paralysis, abdominal
breathing, X-p; C3-4 fractures
Vitals; RR 12/min PR 40/min BP
80/40mmHg SpO2 99% GCS E4V5M6
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
V – 9 (On-site)
Age 38, Male
Severe burnt face, body, arms, legs
Vitals; RR 36/min CRT 3sec
Can follow simple command
V – 9 (Hospital)
Age 38, Male
Severe burnt (DDB+DB, BSA 30%)
Vitals; RR 40/min PR 130/min BP
74/40mmHg SpO2 96% GCS E3V5M6
V – 10 (On-site)
Age 40, Female
Unconsciousness
Vitals; RR 20/min CRT 1sec
Can't follow simple command
V – 10 (Hospital)
Age 40, Female
Unconsciousness, anisocoric
Vitals; RR 20/min PR 88/min BP
150/70mmHg SpO2 96% GCS E1V2M4
V – 11 (On-site)
Age 24, Male
Left leg deformation, bleeding and pain
Vitals; RR 20/min CRT 3sec
Can follow simple command
V – 11 (Hospital)
Age 24, Male
Left femur open fracture
Vitals; RR 20/min PR 138/min BP
70/54mmHg SpO2 96% GCS E3V5M6
V –12 (On-site)
Age 62, Male
Abdominal pain, right upper arm
deformation, bleeding, Can’t walk
Vitals; RR 20/min CRT 4sec
Can follow simple command
V – 12 (Hospital)
Age 62, Male
Right upper arm bleeding, abdominal pain,
FAST; positive, X-p; pelvic fracture, right
upper arm open fracture
Vitals; RR 20/min PR 138/min BP
74/44mmHg SpO2 96% GCS E3V5M6
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
V – 13 (On-site)
Age 27, Male
Right upper arm traumatic amputation,
bleeding and pain, Can’t walk
Vitals; RR 20/min CRT 3sec
Can follow simple command
V – 13 (Hospital)
Age 27, Male
Right upper arm traumatic amputation,
bleeding
Vitals; RR 20/min PR 144/min BP
74/56mmHg SpO2 96% GCS E4V5M6
V – 14 (On-site)
Age 31, Female
Left chest pain, Can’t walk
Vitals; RR 36/min CRT 1sec
Can follow simple command
V – 14 (Hospital)
Age 31, Female
Left chest pain, varicose jugular vein, Breath
sounds decreased in left, Trachea deviated
to right
Vitals; RR 40/min PR 138/min BP
84/40mmHg SpO2 84% GCS E4V5M6
V – 15 (On-site)
Age 42, Male
Abdominal pain, Can’t walk
Vitals; RR 32/min CRT 1sec
Can follow simple command
V – 15 (Hospital)
Age 42, Male
Abdominal involuntary guarding,
tenderness, FAST; positive, intestinal
perforation
Vitals; RR 32/min PR 138/min BP
110/60mmHg SpO2 96% GCS E4V5M6
V –16 (On-site)
Age 78, Male
Chest pain, Can’t walk
Vitals; RR20/min CRT 4 sec
Can follow simple command
V – 16 (Hospital)
Age 78, Male
Chest pain, FAST; positive, Cardiac
tamponade
Vitals; RR 20/min PR 138/min BP
60/40mmHg SpO2 96% GCS E3V5M6
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
V – 17 (On-site)
Age 18, Female
Right leg pain, can't walk
Vitals; RR20/min CRT 1 sec
Can follow simple command
V – 17 (Hospital)
Age 18, Female
Right tibia disformation, swelling, X-p; right
tibia fracture
Vitals; RR 20/min PR 100/min BP
120/74mmHg SpO2 96% GCS E3V5M6
V – 18 (On-site)
Age 80, Female
Bilateral leg pain, can't walk
Vitals; RR18/min, CRT 1 sec
Can follow simple command
V – 18 (Hospital)
Age 80, Female
Bilateral tibia disformation, swelling, X-p;
Bilateral tibia fracture
Vitals; RR 18/min PR 88/min BP
118/56mmHg SpO2 92% GCS E4V5M6
V – 19 (On-site)
Age 44, Male
Left femur bleeding, can't walk
Vitals; RR16/min, CRT 1 sec
Can follow simple command
V – 19 (Hospital)
Age 44, Male
Left femur bleeding, soft tissue injury
Vitals; RR 18/min PR 88/min BP
138/68mmHg SpO2 92% GCS E4V5M6
V –20 (On-site)
Age 16, Male
Right arm bleeding, right leg injury and pain,
can't walk
Vitals; RR16/min, CRT 1 sec
Can follow simple command
V – 20 (Hospital)
Age 16, Male
Right arm bleeding, right leg wound and
bleeding
Vitals; RR 18/min PR 78/min BP
120/70mmHg SpO2 100% GCS E4V5M6
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
V – 21 (On-site)
Age 35, Female
Left upper arm and leg pain, can’t walk
Vitals; RR14/min, CRT 1 sec
Can follow simple command
V – 21 (Hospital)
Age 35, Female
Left upper arm and leg disformation,
swelling, pain X-p; left humerus and tibia
fracture
Vitals; RR 14/min PR 68/min BP
108/52mmHg SpO2 99% GCS E4V5M6
V – 22 (On-site)
Age 33, Male
Left upper arm injury and bleeding, can't
walk
Vitals; RR12/min, CRT 1 sec
Can follow simple command
V – 22 (Hospital)
Age 33, Male
Left upper arm bleeding and pain
Vitals; RR 14/min PR 66/min BP
132/88mmHg SpO2 99% GCS E4V5M6
V – 23 (On-site)
Age 29, Male
Right leg pain, can't walk
Vitals; RR14/min, CRT 1 sec
Can follow simple command
V – 23 (Hospital)
Age 29, Male
Right femur disformation, swelling, pain, X-
p; right femur fracture
Vitals; RR 14/min PR 70/min BP
108/52mmHg SpO2 99% GCS E4V5M6
V –24 (On-site)
Age 15, Female
Left chest pain, feel hard to breath, can’t
walk
Vitals; RR 22/min, CRT 1 sec
Can follow simple command
V – 24 (Hospital)
Age 15, Female
Left chest pain, feel hard to breath, X-p; left
ribs fracture
Vitals; RR 24/min PR 68/min BP
126/54mmHg SpO2 99% GCS E4V5M6
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
V – 25 (On-site)
Age 17, Female
Left upper arm bleeding, left leg pain, can’t
walk
Vitals; RR16/min, CRT 1 sec
Can follow simple command
V – 25 (Hospital)
Age 17, Female
Left upper arm bleeding, left tibia
disformation, X-p; left tibia fracture
Vitals; RR 16/min PR 88/min BP
112/64mmHg SpO2 99% GCS E4V5M6
V – 26 (On-site)
Age 54, Female
Right chest pain, feel hard to breath, can't
walk
Vitals; RR14/min, CRT 1 sec
Can follow simple command
V – 26 (Hospital)
Age 54, Female
Right chest pain, feel hard to breath, X-p;
right ribs fracture
Vitals; RR 24/min PR 92/min BP
118/52mmHg SpO2 99% GCS E4V5M6
V – 27 (On-site)
Age 29, Male
Right femur pain, lower leg bleeding, can't
walk
Vitals; RR12/min, CRT 1 sec
Can follow simple command
V – 27 (Hospital)
Age 29, Male
Right femur disformation, swelling, pain, X-
p; right femur fracture, right lower leg
bleeding
Vitals; RR 14/min PR 70/min BP
128/54mmHg SpO2 99% GCS E4V5M6
V –28 (On-site)
Age 15, Male
Right ear pain, fight femur bleeding, can't
walk
Vitals; RR 18/min, CRT 1 sec
Can follow simple command
V – 28 (Hospital)
Age 15, Male
Hearing disorder of right ear, right tympanic
membrane rupture, right femur wound
Vitals; RR 18/min PR 92/min BP
110/54mmHg SpO2 99% GCS E4V5M6
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
V – 29 (On-site)
Age 21, Female
Left ear pain, vertigo, can't walk
Vitals; RR14/min, CRT 1 sec
Can follow simple command
V – 29 (Hospital)
Age 21, Female
Hearing disorder of left ear, left tympanic
membrane rupture, vertigo
Vitals; RR 14/min PR 76/min BP
106/48mmHg SpO2 99% GCS E3V5M6
V – 30 (On-site)
Age 57, Female
Headache and dizziness, can’t walk
Vitals; RR20/min, CRT 1 sec
Can follow simple command
V – 30 (Hospital)
Age 57, Female
Dizziness and headache, neurological exam
is normal
Vitals; RR 20/min PR 88/min BP
132/52mmHg SpO2 99% GCS E3V5M6
V – 31 (On-site)
Age 43, Male
Abdominal pain, burnt arms, can't walk
Vitals; RR14/min, CRT 1 sec
Can follow simple command
V – 31 (Hospital)
Age 43, Male
Abdominal pain, FAST; negative, burnt arms
(SDB, BSA14%)
Vitals; RR 14/min PR 80/min BP
116/60mmHg SpO2 99% GCS E4V5M6
V –32 (On-site)
Age 19, Female
Feel hard to breath, chest pain, can’t walk
Vitals; RR22/min, CRT 1 sec
Can follow simple command
V – 32 (Hospital)
Age 19, Female
Chest pain, FAST; negative, X-p; no fracture
Vitals; RR 22/min PR 76/min BP
122/62mmHg SpO2 99% GCS E4V5M6
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
V – 33 (On-site)
Age 39, Male
Burnt arms and right ear pain, can't walk
Vitals; RR18/min, CRT 1 sec
Can follow simple command
V – 33 (Hospital)
Age 39, Male
Burnt arms (SDB, BSA 10%), hearing
disorder of right ear, tympanic membrane
rupture
Vitals; RR 18/min PR 70/min BP
118/56mmHg SpO2 99% GCS E4V5M6
V – 34 (On-site)
Age 51, Female
Left ankle pain, swelling, can’t walk
Vitals; RR 16/min, CRT 1 sec
Can follow simple command
V – 34 (Hospital)
Age 51, Female
Left ankle pain and swelling, X-p; no fracture
Vitals; RR 16/min PR 66/min BP
126/62mmHg SpO2 99% GCS E4V5M6
V – 35 (On-site)
Age 63, Male
Dizziness and headache, can't walk
Vitals; RR14/min, CRT 1 sec
Can follow simple command
V – 35 (Hospital)
Age 63, Male
Dizziness and headache, neurological exam
is normal
Vitals; RR 14/min PR 76/min BP
114/52mmHg SpO2 99% GCS E3V5M6
V –36 (On-site)
Age 49, Male
Chest pain, can't walk
Vitals; RR18/min, CRT 1 sec
Can follow simple command
V – 36 (Hospital)
Age 49, Male
Left chest pain, X-p; left ribs fracture
Vitals; RR 18/min PR 70/min BP
130/62mmHg SpO2 99% GCS E4V5M6
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
V – 37 (On-site)
Age 30, Female
Headache and nausea, can’t walk
Vitals; RR12/min, CRT 1 sec
Can follow simple command
V – 37 (Hospital)
Age 30, Female
Headache, nausea, neurological exam is
normal
Vitals; RR 14/min PR 88/min BP
108/52mmHg SpO2 99% GCS E4V5M6
V – 38 (On-site)
Age 49, Male
Abdominal pain, can't walk
Vitals; RR24/min, CRT 1 sec
Can follow simple command
V – 38 (Hospital)
Age 49, Male
Abdominal pain, FAST; negative, physical
exam is normal
Vitals; RR 24/min PR 68/min BP
112/58mmHg SpO2 99% GCS E4V5M6
V – 39 (On-site)
Age 67, Female
Chest pain, can’t walk
Vitals; RR16/min, CRT 1 sec
Can follow simple command
V – 39 (Hospital)
Age 67, Female
Chest pain, FAST; negative, physical exam
is normal
Vitals; RR 16/min PR 66/min BP
124/68mmHg SpO2 99% GCS E4V5M6
V –40 (On-site)
Age 8, Male
Left ear pain, can't walk
Vitals; RR24/min, CRT 1 sec
Can follow simple command
V – 40 (Hospital)
Age 8, Male
Hearing disorder of left ear, tympanic
membrane rupture
Vitals; RR 24/min PR 70/min BP
102/48mmHg SpO2 99% GCS E4V5M6
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
V – 41 (On-site)
Age 29, Male
Laceration on hands and arms, can walk
Vitals; RR14/min, CRT 1 sec
Can follow simple command
V – 41 (Hospital)
Age 29, Male
Laceration on hands and arms
Vitals; RR 14/min PR 70/min BP
112/48mmHg SpO2 99% GCS E4V5M6
V – 42 (On-site)
Age 33,Female
Laceration on hands and arms, can walk
Vitals; RR16/min, CRT 1 sec
Can follow simple command
V – 42 (Hospital)
Age 33, Female
Laceration on hands and arms
Vitals; RR 16/min PR 66/min BP
108/52mmHg SpO2 99% GCS E4V5M6
V – 43 (On-site)
Age 35, Male
Laceration on hands and arms, can walk
Vitals; RR18/min, CRT 1 sec
Can follow simple command
V – 43 (Hospital)
Age 35, Male
Laceration on hands and arms
Vitals; RR 18/min PR 76/min BP
120/60mmHg SpO2 99% GCS E4V5M6
V – 44 (On-site)
Age 7,Female
Laceration on hands and arms, can walk
Vitals; RR 22/min, CRT 1 sec
Can follow simple command
V – 44 (Hospital)
Age 7, Female
Laceration on hands and arms
Vitals; RR 22/min PR 112/min BP
108/52mmHg SpO2 99% GCS E4V5M6
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
V – 45 (On-site)
Age 10, Male
Laceration on hands and arms, can walk
Vitals; RR26/min, CRT 1 sec
Can follow simple command
V – 45 (Hospital)
Age 10, Male
Laceration on hands and arms
Vitals; RR 26/min PR 110/min BP
108/52mmHg SpO2 99% GCS E4V5M6
V – 46 (On-site)
Age 5, Female
Laceration on hands and face, can walk
Vitals; RR 22/min, CRT 1 sec
Can follow simple command
V – 46 (Hospital)
Age 5, Female
Laceration on hands and face
Vitals; RR 22/min PR 120/min BP
108/52mmHg SpO2 99% GCS E4V5M6
V – 47 (On-site)
Age 54, Male
Laceration on hands and face, can walk
Vitals; RR14/min, CRT 1 sec
Can follow simple command
V – 47 (Hospital)
Age 54, Male
Laceration on hands and face
Vitals; RR 18/min PR 68/min BP
128/64mmHg SpO2 99% GCS E4V5M6
V – 48 (On-site)
Age 58, Female
Laceration on hands and legs, can walk
Vitals; RR 16/min, CRT 1 sec
Can follow simple command
V – 48 (Hospital)
Age 58, Female
Laceration on hands and legs
Vitals; RR 16/min PR 98/min BP
142/52mmHg SpO2 99% GCS E4V5M6
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
V – 49 (On-site)
Age 29, Male
Laceration on legs, can walk
Vitals; RR14/min, CRT 1 sec
Can follow simple command
V – 49 (Hospital)
Age 29, Male
Laceration on legs
Vitals; RR 14/min PR 60/min BP
122/72mmHg SpO2 99% GCS E4V5M6
V – 50 (On-site)
Age 44, Female
Laceration on hands and legs, can walk
Vitals; RR 16/min, CRT 1 sec
Can follow simple command
V – 50 (Hospital)
Age 44, Female
Laceration on hands and legs
Vitals; RR 16/min PR 86/min BP
122/66mmHg SpO2 99% GCS E4V5M6
V – (On-site) V – (Hospital)
V – (On-site) V – (Hospital)
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
Please turn over when you start
medical assessments
W – 1 (On-site)
Helping the victims
Age 32, Male
Laceration on legs and arms
Can walk
Helping the victims
Age 26, Male
Laceration on legs and arms
Can walk
W – 3 (On-site)
Helping the victims
Age 48, Male
Laceration on legs and arms
Can walk
Helping the victims
Age 55, Male
Laceration on legs and arms
Can walk
W – 5 (On-site)
Helping the victims
Age 47, Male
Laceration on legs and arms
Can walk
Helping the victims
Age 22, Female
Laceration on legs and arms
Can walk
W – 7 (On-site)
Helping the victims
Age 36, Female
Laceration on legs and arms
Can walk
Helping the victims
Age 47, Female
Laceration on legs and arms
Can walk
W – 2 (On-site)
W – 4 (On-site)
W – 6 (On-site)
W – 8 (On-site)
W – 9 (On-site)
W – 11 (On-site)
W – 13 (On-site)
Helping the victims
Age 25, Male
No injury
Can walk
Helping the victims
Age 35, Female
No Injury
Can walk
W – 15 (On-site)
Helping the victims
Age 33, Male
No injury
Can walk
Helping the victims
Age 47, Male
No injury
Can walk
W – 10 (On-site)
W –12 (On-site)
W – 14 (On-site)
W – 16 (On-site)
Helping the victims
Age 50, Male
Laceration on legs and arms
Can walk
Helping the victims
Age 44, Male
Laceration on legs and arms
Can walk
Helping the victims
Age 44, Male
Laceration on legs and arms
Can walk
Helping the victims
Age 50, Male
Laceration on legs and arms
Can walk
W – 17 (On-site)
Helping the victims
Age 43, Female
No injury
Can walk
Helping the victims
Age 26, Female
No injury
Can walk
W – 19 (On-site)
Helping the victims
Age 34, Female
No injury
Can walk
Helping the victims
Age 52, Female
No injury
Can walk
W – 21 (On-site)
Helping the victims
Age 27, Female
No injury
Can walk
Helping the victims
Age 37, Male
No Injury
Can walk
W – 23 (On-site)
Helping the victims
Age 45, Male
No injury
Can walk
Helping the victims
Age 52, Male
No injury
Can walk
W – 18 (On-site)
W – 20 (On-site)
W – 22 (On-site)
W – 24 (On-site)
W – 25 (On-site)
Helping the victims
Age 34, Male
No injury
Can walk
Helping the victims
Age 19, Male
No injury
Can walk
W – 27 (On-site)
Helping the victims
Age 48, Female
No injury
Can walk
Helping the victims
Age 51, Male
No injury
Can walk
W – 29 (On-site)
Helping the victims
Age 23, Male
No injury
Can walk
Helping the victims
Age 34, Male
No Injury
Can walk
W – 31 (On-site)
Helping the victims
Age 44, Male
No injury
Can walk
Helping the victims
Age 52, Male
No injury
Can walk
W – 26 (On-site)
W – 28 (On-site)
W – 30 (On-site)
W – 32 (On-site)
W – 33 (On-site)
Helping the victims
Age 21, Male
No injury
Can walk
Helping the victims
Age 17, Male
No injury
Can walk
W – 35 (On-site)
Helping the victims
Age 40, Female
No injury
Can walk
Helping the victims
Age 23, Male
No injury
Can walk
W – 37 (On-site)
Helping the victims
Age 29, Male
No injury
Can walk
Helping the victims
Age 33, Male
No Injury
Can walk
W – 39 (On-site)
Helping the victims
Age 41, Male
No injury
Can walk
Helping the victims
Age 49, Male
No injury
Can walk
W – 34 (On-site)
W – 36 (On-site)
W – 38 (On-site)
W – 40 (On-site)
W – 41 (On-site)
Helping the victims
Age 26, Male
No injury
Can walk
Helping the victims
Age 59, Male
No injury
Can walk
W – 43 (On-site)
Helping the victims
Age 38, Female
No injury
Can walk
Helping the victims
Age 46, Male
No injury
Can walk
W – 45 (On-site)
Helping the victims
Age 49, Male
No injury
Can walk
Taking the video
Age 49, Male
No Injury
Can walk
W – 47 (On-site)
Taking the video
Age 26, Male
No injury
Can walk
Taking the video
Age 21, Male
No injury
Can walk
W – 42 (On-site)
W – 44 (On-site)
W – 46 (On-site)
W – 48 (On-site)
W – 49 (On-site)
Taking the video
Age 18, Male
No injury
Can walk
Taking the video
Age 35, Male
No injury
Can walk
W – (On-site)
W – (On-site)
W – (On-site)
W – 50 (On-site)
W – (On-site)
W – (On-site)
W – (On-site)
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