May 22, 2013 | During a May 17 drill to handle patients from a nuclear accident, UAMS Medical Center Emergency Department physicians and nurses encountered a scenario even veterans of previous drills didn’t anticipate.

The biennial radiological drill is held to ensure safety and efficiency during the treatment of radiation injuries, while Federal Emergency Management Agency evaluators watched to assess how well the medical staff performed.

“Overall it went well,” said Ron Crane, UAMS emergency preparedness manager. “We had one or two bumps, but that’s to be expected. That’s why we do these things. We hold ourselves to quite a high standard.”

It was the fifth drill at UAMS in which Crane participated, and it was different from the previous four.

Instead of treating a simulated patient injured in the reactor area of Arkansas Nuclear One near Russellville, the decontamination team was faced with the scenario of a female adult pedestrian who had been hit by a car that had traveled through a radioactive plume and been contaminated during a general evacuation of the plant and surrounding area. Kim Wiebeck, radiation safety officer for UAMS, led the response.  A team of physicians, nurses and technicians worked collaboratively to decontaminate and treat the mock patient.

Another big difference was that no Arkansas Nuclear One health physicist was present, as there was in past drills.

Danielle Gray, an emergency medical technician with the Arkansas Department of Health, played the patient with a simulated wound to her right leg. After arriving in the Emergency Department in a body bag meant to contain any radiation, she was wheeled in and placed in the contamination room with the team.

The team quickly began taking radiation readings, and the first one was for 20,000 millirems (mRems), a unit used for measuring absorbed doses of radiation.

Gray’s contaminated clothing was removed and disposed of in special bags. Team members cleaned contaminated areas of her body with soap and water. By the fourth round of cleaning, the highest reading had dropped to 1,250 mRems and seemed confined to the wound area. Despite attempts to eliminate the persistent radioactive contamination there with hydrogen peroxide and Lava soap, three more cleanings did nothing to lower the count.

Team members checked each other for contamination at each step, safely discarding gloves and other outerwear that had become tainted.

Finally, it was felt that the wound contamination likely was due to radioactive material embedded in her leg. The decision was made to dress and wrap her wound and transfer her to another room to remove the contaminant and treat the injury.

Crane said each time the UAMS Medical Center Emergency Department goes through a nuclear radiological exercise they try to include one or two department staff members who have had the training but haven’t had a chance to drill yet, just to make sure they have that experience.

It was a first time for some and a refresher for others participating. But the challenging exercise left everyone even more prepared than before, Crane said.