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Rex Healthcare has initiated a Code Beta Management of Radiation Patients Instructions: FORMS:  Incoming Patient Form (Initial Notification for a Radiological IncidentRex Hospital Radiation Contamination Body Diagram Incoming Patient DashboardDisaster Plan - Code Beta Instructions: Staff Responsibilities Protective Services Executive Staff Responsibilites Executive on Call Checklist Executive on Call DashboardAdministrative Coordinator Responsibilites Emergency Services, Radiology Services Services, Physicians, Marketing Services, and Facility Services Responsibilities Decontamination Team Roles and Responsibilities Decontamination Team Member Duties CODE BETA DRILL EVALUATION FORMStaff Responsibilities A. Any staff person receiving notification of a patient transport to Rex Healthcare who has been contaminated by a radiological source, will notify immediately the Emergency Services Director or designee. B. Protective Services will also be called at extension 3333 or 919-784-3333. Protective Services Responsibilities A. The Protective Services communications officer will immediately notify the Protective Services Director or designee. B. The Protective Services Director or designee will immediately notify the: 1. Executive on Call or designee 2. Protective Services Director (Contact the director when initial contact was made with the designee.) The Protective Services Director or designee will notify the Facility Services Director or designee. 3. Protective Services Safety Officer C. The Protective Services Director or designee will coordinate the placement of the protective plastic on the walkway, hallway, and treatment room. D. The Protective Services Director or designee will establish traffic control as needed. E. The Protective Services Director or designee will update the Executive on Call pertaining to media inquiries or media on the premises. F. The Protective Services Director or designee will have all media routed to Assembly Room 1209. G. The Protective Services Director or designee will control access to Emergency Services. Only patient(s) and authorized staff will be allowed into the area directly affected by the intake process. Executive Staff Responsibilities Executive on Call Checklist A. The Executive on Call will make the decision to initiate Code Beta. B. The Executive on Call will notify and direct the PBX operator to announce Code Beta three times, then twice more at 30 second intervals. C. The Executive on Call will contact the President/Chief Executive Officer (CEO), the Administrative Coordinator, and the on-call Marketing Services representative. D. The Executive on Call will initiate contact with the Emergency Services Director or designee. E. The Executive on Call will provide overall supervision and coordination of activities during the plan. F. The Executive on Call will assess the emergency situation on a regular basis and determine when Code Beta will be concluded. G. The Executive on Call will notify and direct the PBX operator to announce Code Beta Clear Three times, then twice more at 30 second intervals when the emergency situation is concluded. Administrative Coordinator Responsibilities A. The Administrative Coordinator will be the designee for the Executive on Call or designee in the event that immediate contact cannot be made with the Executive on Call or designae. B. The Administrative Coordinator will obtain an available bed list from Patient Reservations and identify other areas in the hospital that may be available for admissions. Emergency Services, Radiology Services Services, Physicians, Marketing Services, and Facility Services Responsibilities A. Only Emergency Services registered nurses, radiologic technologists, and physicians trained in the decontamination procedure will be able to provide medical treatment. B. Upon receiving notification or hearing the Code Beta announcement, the above staff will immediately begin the Code Beta implementation. (Refer to Section IX of the Emergency Radiation Exposure Intake Procedure.) C. Marketing will accommodate and communicate with the media in Assembly Room 1209. D. At least one Facility Services staff member will respond to Emergency Services to assist Protective Services with preparations to receive patient(s). Decontamination Team Roles and Responsibilities A. The Emergency Services Physician will perform as necessary in the role of team leader. (Refer to Attachment 1.) The physician will: 1. Ensure each patient is met at the ambulance. 2. Establish triage for each patient. 3. Direct medical care and decontamination procedures. B. The nurse designated as Nurse Number 1, is the patient care nurse. This nurse will: 1. Ensure each patient is met at the ambulance. 2. Assess each patient and monitor vital signs. 3. Collect specimens and moist swab samples of the contaminated areas. 4. Assist the physician with decontamination procedures. 5. Perform nursing procedures that may include irrigation of contaminated wounds and provide other nursing care. C. The nurse designated as Nurse Number 2 is the circulating nurse and the recorder. This nurse will: 1. Assist Nurse Number 1 as needed. 2. Record data given by the physician, Nurse Number 1, and the RSO. 3. Label all specimens. Pass specimens to the Buffer Zone Nurse. 4. Receive supplies from the Buffer Zone Nurse. D. The nurse designated as Nurse Number 3 is the float nurse in the Buffer Zone. This nurse will: 1. Remain in the Buffer Zone. a) If Nurse Number 1 requires patient care assistance, Nurse Number 3 will assist inside the Decontamination Area. b) The Administrative Nurse will assign a new Buffer Zone Nurse as necessary. 2. Make calls to the Laboratory, Radiology Services, and other service areas as needed. 3. Obtain supplies for initial room set-up and throughout the decontamination procedures. (Refer to Attachment 3.) 4. Accept specimens from the Decontamination Area. E. The Administrative Nurse is the Emergency Services Director or the Administrative Coordinator. This nurse will: 1. Coordinate overall logistics with the Executive on Call. 2. Remain immediately outside the Buffer Zone. 3. Wear proper surgical attire if entry into the Buffer Zone is required. F. The RSO or designee will perform as necessary in the event of a Code Beta implementation. (Refer to Attachment 2.) The RSO or designee will: 1. Coordinate activities of the radiation monitors. 2. Check needed supplies and equipment. 3. Verify the presence of the supply cart in Emergency Services. 4. Ensure documentation of the initial background levels of radiation. 5. Ensure documentation of the post-decontamination survey readings. 6. Calibrate and record the initial dosimeter readings. 7. Record the dosimeter issuance to the Decontamination Team members. 8. Take collected specimens to the Laboratory. 9. Store specimens after completion of the Laboratory analysis. 10. Dispose of contaminated items appropriately. 11. Provide instructions for decontamination of the ambulance and the ambulance attendants. 12. Instruct Environmental Services personnel on terminal cleaning of the Decontamination Area(s). 13. Determine that decontamination is complete for all equipment and individuals involved. 14. RSO or designee will monitor patient, equipment and staff when leaving the area. G. The Radiology staff person designated as Radiation Monitor Number 1 is the primary patient monitor. This staff person will: 1. Ensure each patient is met at the ambulance with a decontamination tray and stretcher. 2. Respond to the ambulance in full surgical/protective attire. 3. Ensure that the decontamination tray and stretcher is in place for patient transport. 4. Survey each patient to verify contamination exposure. 5. Accompany each patient, the Team Leader, and Nurse Number 1 to the Decontamination Area. 6. Survey each patient during the decontamination procedure as directed. 7. Call out readings to Radiation Monitor Number 2 for recording purposes. 8. Survey the specimens, supplies, equipment, and staff as needed. H. The Radiology staff person designated as Radiation Monitor Number 2 is the Buffer Zone Monitor. This staff person will: 1. Dress in full surgical/protective attire. 2. Record survey readings reported by Radiation Monitor Number 1 on the anatomical diagram. 3. Survey specimens as directed. 4. Survey clean stretchers used for patient transport out of the Decontamination Area. 5. Report the reading to the RSO. 6. Survey the Decontamination Team at the completion of the procedure or as needed. 7. Report the readings to the RSO. 8. Assist the RSO as needed. I. The Radiology staff person(s) designated as Radiation Monitor Number 3 (usually two people) will verify that the Decontamination Area is prepared. This staff person will: 1. Assist covering the walkway from the ambulance site to and including the Decontamination Room floor and the Buffer Zone. 2. Place barricades and signs as needed. 3. Ensure air vents are covered and that the ventilation system has been turned off by Facility Services. 4. Instruct the ambulance attendants to return to the ambulance and go to the Lake Boone Trail Fire Station for monitoring and decontamination as needed. These instructions are provided after the patient is transported to the Decontamination Area. 5. Advise the RSO that the attendants have been briefed concerning monitoring and decontamination. 6. Progress through the walkway, fold the ground cover to the inside. a) The edges and adjacent area to the covering will be monitored for contamination. b) Each folded section of covering is placed in a plastic bag labeled Radioactive, Do Not Discard. c) Store the ground cover in a designated restricted area that meets waste and access regulations. d) Notify the RSO after the coverings have been removed. 7. Survey supplies and equipment leaving the Decontamination Area as needed. 8. Survey personnel, visitors, and outside participants as needed. 9. Report all readings to the RSO for instructions. 10. Assist the RSO as directed. |
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