Since many accidents involve some measure of trauma, it is often a trauma surgeon who is involved with the management of these injuries. These specialists may be called upon early in the management as well as later. Management of wounds, burns, and other complications of trauma is often performed by these individuals. Since they may be involved at all stages, they should also be aware of contamination control procedures.
The radiation technologist plays an important part in reconstructing the accident and determining the levels of exposure and if contamination is present. If the exposure is to be determined, the time of exposure, distance from the source, shielding if any, and the activity must be known. Badge readings, if available provide useful information to prepare for future complications. In the event of contamination, samples must be analyzed to determine the isotope. By determining the isotope present, the proper mechanisms of decontamination may be started.
Both specialists are useful in the management of radiation accidents. The nuclear physician is accustomed to dealing with patients who have received internally administered radionuclides. This individual is capable of determining the best methods of internal decontamination for the various isotopes. The radiation therapist is accustomed to dealing with relatively externally adminitered high doses of radiation. The knowlegde and experience of these individuals should prove valuable when predicting the short and long term effects of high exposures.
Although the patient may be at a higher risk for cancer several years after the accident, there is a more immediate need for an oncologist. Oncologists are accustomed to dealing with patients who may be immunocompromised. Protective isolation may be needed if there is significant white cell depression. If bone marrow transplantion is a consideration in a patient who received near lethal radiation doses, these individuals are experienced with this technique.
A patient who has sustained a significant injury may be hospitalized for a lengthy period. If a surgeon is not necessary, an internist may be needed to coordinate the overall care of the patient. Patients who have been exposed to large amounts of radiation may develop fluid and electrolyte imbalances. These may prove fatal if not managed properly. Infections and other complications of long term hospitalization may also require attention and therapy.
In the event of a radiation accident, legal action may result. Preparation by the hospital and staff for this occurrence will undoubtedly allow for the proper materials and documentation to be obtained in advance. This will serve to speed the process should the case ever come to court.