Version: Release 1.1
December 2011
vCRC Training Module - Accessible Version
Overview
The flow diagram shows a step-by-step process of how to direct people through a community reception center. The reception center has seven different stations:
- Initial Sorting
- First Aid
- Contamination Screening
- Wash
- Registration
- Radiation Dose Assessment, and
- Discharge.
The reception center is divided into a contamination control zone and a clean zone. Staff working in the contamination control zone wear personal protective equipment to control cross-contamination. Staff working in the clean zone do not have to wear personal protective equipment. The Safety Officer works with radiation protection professionals to determine what protective gear workers should wear at each station.
The Initial Sorting station is where we greet people when they arrive. The goal here is to place people on the right path as they move through the reception center. Staff at this station:
- look for people in need of urgent medical care
- screen for high levels of contamination, and
- accommodate those who have special needs.
A person with an urgent medical need will be taken to the First Aid Station, where First Aid staff and Contamination Screening staff will assist the patient. In serious cases, patients will be transported to a hospital or alternate care site for medical treatment.
Everyone who enters the reception center will be screened for external contamination. Most screenings take place at the Contamination Screening Station. If Contamination Screening staff find radioactive material on a person’s skin, hair, or clothing, that person will be sent to the Wash Station. People who are not contaminated with radioactive material will be sent to Registration.
The Wash Station is where contaminated people go to clean off. Each person receives instructions on how to remove contamination. Some people may need full showers, while others may be able to decontaminate by carefully removing an article of clothing or simply washing their hands. After a person finishes washing, Contamination Screening Staff will perform a full body screening to ensure the person is clean and can proceed to the Registration Station.
People follow different paths through the reception center depending on their individual needs. Whether they come from the Wash Station or from the Contamination Screening Station, each person eventually goes to Registration to complete a brief questionnaire and get interviewed by reception center staff. After registering, some people may be referred to the Radiation Dose Assessment Station for immediate medical follow-up. People who do not need immediate medical follow-up are sent to the Discharge Station.
During the interview, Registration staff identify people who may have received a high radiation dose or have ingested or inhaled radioactive material. These people are sent to the Radiation Dose Assessment Station for immediate medical follow-up. This medical follow-up may include:
- screening people for internal contamination
- collecting blood and urine specimens for laboratory testing, and
- examining the patient for signs of acute radiation sickness.
After visiting this station, patients are sent to the Discharge Station to receive additional information before leaving the reception center.
The last station each person visits is the Discharge Station. Here, Discharge Staff are available to:
- help people find a place in a public shelter,
- assist with medical referrals, and
- offer counseling services.
Initial Sorting
About Initial Sorting
At the Initial Sorting Station, staff welcome and direct people where they need to go in the reception center. Initial Sorting staff will determine whether a person:
- has an urgent medical need,
- is highly contaminated with radioactive material,
- requires special assistance, or
- has already showered or been decontaminated before coming to the reception center.
Initial Sorting staff may also assign identification numbers to people as they enter the reception center. These identification numbers can be used for record keeping purposes and to track people and their belongings through the center.
High Contamination Screening
Contamination Screening staff may be assigned to the Initial Sorting area to screen people for high levels of radioactive contamination. This screening should be quick and non-intrusive, and can be done with a variety of radiation detection instruments. Planners should consult the radiation control authorities in their jurisdictions to determine radiation screening protocols.
People with Special Needs
People who have special needs should be accompanied through the reception center by a staff member or a caregiver, and children should not be separated from their parents. Some processes may need to be modified to accommodate children, people with special needs, or pets. PPE: Initial Sorting Staff at the Initial Sorting Station may need to wear personal protective equipment to control cross-contamination. The site safety officer should work with radiation protection professionals to conduct a hazard assessment and issue the appropriate personal protective equipment to staff members in this area.
Line Control
Line Control staff help maintain order and efficiency in the reception center. Line Control staff need to know the process well so they can:
- answer questions correctly and
- give instructions that are clear and easy to understand.
Initial Sorting Resources
| Resource Title | Resource URL |
|---|---|
| Initial Sorting Station Executive Summary (Word Document) | FirstAidExecSum508.doc |
| Initial Sorting Station Job Action Sheet (Word Document) | InitialSortingStationJAS508.doc |
| High Contamination Screening Job Aid (PDF) | HighContaminationScreeningJobAid508.pdf |
First Aid
About First Aid
A person with an urgent medical need should be taken directly to the First Aid Station to receive medical care. First Aid staff and Contamination Screening staff work together to assess the patient's medical needs and quickly screen the patient for contamination. If the patient needs advanced medical care, First Aid staff should call 9-1-1 or request medical transport through their chain of command. If the patient is contaminated with radioactive material, First Aid staff can perform a gross decontamination by carefully removing the patient's outer layer of clothing before transport. Life-saving care should not be delayed due to concerns of cross-contamination.
PPE: First Aid
First Aid staff should wear universal medical precautions to guard against the spread of diseases. When used properly, these precautions also effectively control cross-contamination. To ensure First Aid staff are adequately protected, the site safety officer should work with radiation protection professionals to conduct a hazard assessment and determine if additional personal protective equipment is necessary.First Aid Resources
| Resource Title | Resource URL |
|---|---|
| First Aid Station Executive Summary (Word Document) | FirstAidExecSum508.doc |
| First Aid Station Job Action Sheet (Word Document) | FirstAidStationJAS508.doc |
| First Aid Log Form (Excel Spreadsheet) | FirstAidLogForm508.xls |
Wash Station
About Wash Station
Contaminated people go to the Wash Station for decontamination. Depending on the resources available, CRC managers may decide to use existing indoor shower facilities or an outdoor decontamination unit. Wash staff review contamination screening results to determine the best method of decontamination for each person.
Clothing and Personal Belongings
Contaminated clothing should be bagged and labeled with the person's name and identification number assigned to them upon entering the reception center. Contaminated clothing may be required later for epidemiological or law enforcement investigations. Bagged clothes should be stored in a secure, remote location at the reception center. Other personal belongings such as wallets, keys, jewelry, and glasses, should be:
- decontaminated,
- bagged together,
- labeled with the owner’s name and identification number, and
- returned to the owner when he or she exits the Wash Station.
PPE: Wash Station
Wash staff work directly with contaminated people and need personal protective equipment to control cross-contamination. This equipment should provide splash protection when working near showers or decontamination units. The site safety officer should work with radiation protection professionals to conduct a hazard assessment and issue the appropriate personal protective equipment to staff members in this area.
Partial-Body Cleaning
Some people may need only minimal decontamination, such as removing an article of clothing or washing their hands. Partial body cleaning stations help to keep showers or decontamination units open for those who need full body decontamination.
Post-Decontamination Screening
After a person finishes washing, Contamination Screening staff perform a full-body screening to ensure the person is clean and can proceed to Registration. People who are still contaminated after a second shower may have contamination inside their bodies. These people should proceed to Registration and then be evaluated for internal contamination at the Radiation Dose Assessment Station.
Wash Station Resources
| Resource Title | Resource URL |
|---|---|
| Wash Station Executive Summary (Word Document) | WashExecSum508.doc |
| Wash Station Job Action Sheet (Word Document) | WashStationJAS508.doc |
| Decontamination Job Aid (PDF) | DecontaminationJobAid508.pdf |
Contamination Screening
About Contamination Screening
The Contamination Screening Station is where people get monitored for radioactive contamination. Depending on the resources and staff available, a combination of partial-body and full-body contamination screenings can be used to identify contaminated people, and an express lane can be established for people who have showered or been decontaminated before coming to the reception center.
Partial-Body Contamination Screening
A partial-body contamination screening focuses on the hands, face, shoulders, and head. Staff use handheld radiation detection instruments to identify contaminated people and then direct them to the Wash Station for decontamination. The partial-body screening is an optional contamination control measure that protects other people waiting in line as well as the staff.
Full-Body Contamination Screening
Each person must undergo a full-body contamination screening before entering the clean zone. The full-body screening should be conducted by trained staff using either:
- handheld radiation detection instruments or
- portal monitors.
If contamination is detected during this screening, that person will be sent to the Wash Station. If not, that person will proceed to Registration. Planners should consult the radiation control authorities in their jurisdictions to determine radiation screening protocols and release criteria.
PPE: Contamination Screening
Staff working at the Contamination Screening Station may need to wear personal protective equipment to control cross-contamination. The site safety officer should work with radiation protection professionals to conduct a hazard assessment and issue the appropriate personal protective equipment to staff members in this area.
Contamination Screening Resources
| Resource Title | Resource URL |
|---|---|
| Contamination Screening Station Executive Summary (Word Document) | ContaminationScreeningExecSum508.doc |
| Contamination Screening Station Job Action Sheet (Word Document) | ContamScreenStationJAS508.doc |
| GM Detector Job Aid (PDF) | GMDetectorJobAid508.pdf |
| Portal Monitor Job Aid (PDF) | PortalMonitorJobAid508.pdf |
| High Contamination Screening Job Aid (PDF) | HighContaminationScreeningJobAid508.pdf |
| CRC Processing Forms (Word Document) | CRCProcessingForms508.doc |
| CRC Contamination Assessment Form (Word Document) | CRCRadiationDoseAssessmentForm508.doc |
Registration
About Registration
Registration staff collect demographic and event-specific information from people who have been screened for radioactive contamination and cleared to enter the clean zone. Registration staff use this information to determine whether someone needs immediate follow-up at the Radiation Dose Assessment Station. This information will also be used for possible long-term follow-up. Because people reporting to this area are free of external contamination, staff here require only minimal personal protective equipment.
Data Management
Information collected at the reception center needs to be accurate and accessible for follow-up interviews and epidemiological or law enforcement investigations. Procedures for managing data need to be clear and easy for staff to understand. Planners should consider modifying existing tools to capture information unique to radiological or nuclear incidents.
Registration Resources
| Resource Title | Resource URL |
|---|---|
| Registration Station Executive Summary (Word Document) | RegistrationExecSum508.doc |
| Registration Station Job Action Sheet (Word Document) | RegistrationStationJAS508.doc |
| CRC Processing Forms (Word Document) | CRCProcessingForms508.doc |
| CRC Registration Form (Word Document) | CRCRegistrationForm508.doc |
| Epi Survey and Lab Prioritizations Tool (Word Document) | EpidemiologyLabPrioritizationTool508.doc |
Radiation Dose Assessment
About Radiation Dose Assessment
The Radiation Dose Assessment Station requires specialized staff and equipment to:
- screen people for internal contamination
- assess each person’s radiation exposure
- collect blood or urine specimens for laboratory analysis
- assess each person’s need for treatment, and
- prioritize people for further care.
Planning to provide these services should be scalable and flexible, incorporating additional services as they become available. If possible, community reception center managers should assign a physician and a health physicist to oversee the Radiation Dose Assessment Station. Clinicians and radiation health professionals will need to work together to determine the patient’s radiation dose and need for additional medical intervention or follow-up.
Internal Contamination Screening
Screening people for internal contamination may not be possible in all situations; however, the information gathered from this process can help clinicians prioritize patients for additional medical care. Health physicists or medical radiation specialists should oversee internal contamination screening and provide guidance to appropriate clinical staff.
Bioassay Collection
Collecting blood or urine specimens for bioassay is another way to assess a patient’s radiation dose or degree of internal contamination. Trained laboratory staff should oversee sample collection and ship specimens to appropriate laboratories for processing.
Rad Dose Resources
| Resource Title | Resource URL |
|---|---|
| Radiation Dose Assessment Station Executive Summary (Word Document) | RadiationDoseAssessmentExecSum508.doc |
| Radiation Dose Assessment Station Job Action Sheet (Word Document) | RadDoseAssessStationJAS508.doc |
| Acute Radiation Syndrome: A Fact Sheets for Physicians | http://www.bt.cdc.gov/radiation/arsphysicianfactsheet.asp |
| Cutaneous Radiation Injury: A Fact Sheets for Physicians | http://www.bt.cdc.gov/radiation/criphysicianfactsheet.asp |
| Prenatal Radiation Exposure: A Fact Sheets for Physicians | http://www.bt.cdc.gov/radiation/prenatalphysician.asp |
| CRC Radiation Dose Assessment Form (Word Document) | CRCRadiationDoseAssessmentForm508.doc |
Discharge
About Discharge
Discharge Staff provide people with additional information as they exit the reception center. People leaving the reception center may be:
- referred for additional care, or
- discharged to their home, to the home of a friend or family member, or to a public shelter.
Planners should work closely with partner agencies, such as the American Red Cross, to streamline the transition from reception center to public shelter and to ensure adequate relocation services are provided.
Mental Health Professionals
While all reception center staff should receive training in Psychological First Aid, mental health professionals should be on hand to:Rad Dose Resources
| Resource Title | Resource URL |
|---|---|
| Discharge Station Executive Summary (Word Document) | DischargeExecSum508.doc |
| Discharge Station Job Action Sheet (Word Document) | DischargeStationJAS508.doc |
