1. NYC Healthcare Preparedness for Radiological Casualties: Addressing Training and Detection Gaps Katherine Uraneck, MD Sr. Medical Coordinator Healthcare Readiness Unit Office of Emergency Preparedness & Response NYC Department of Health & Mental Hygiene

2. Identifying the Gaps 2004-2005 Conducted site visits to 40/69 NYC Hospitals Less than 17% of NYC hospitals were had equipment to detect radiation contamination in emergency department Only 50% of hospitals had written plan for radiation incidents No identifiable training for hospital staff on responding to a radiation incident available at that time

3. NYC Hospital Resources 65 Hospitals ~21,000 Staffed Beds, 83% occupied ~1,700 ICU Beds, 65% occupied ~230 Pediatric ICU Beds 71 certified burn beds 3,300 hospital admissions/day

4. Lack of Radiation Awareness Hawaii Study NYC Healthcare Worker Willingness to Respond Survey

5. NYC Radiation Incident Preparedness Projects Hospital Radiation Response Working Group 2006-2008 Hospital Radiation Equipment & Training Project 2006- present EMS Radiation Equipment Project 2006- present Hospital Radiation Detection Drills 2010

6. NYC Hospital Radiation Response Working Group 2 year working group developed NYC specific guidance on hospital response to contaminating radiation incidents Available at: http://www.nyc.gov/health /bhpp http://www.nyc.gov/health /bhpp

8. NYC Hospital Radiation Detection Project 52 NYC hospitals currently participating Equipment distributed: Personal digital dosimeters, survey meters, and radiation area monitors Guidance provided on developing a response protocol & plan Training provided to all hospitals Conducted drills of 13/52 hospitals during 2010

9. Radiation Equipment Training Provided Basic and Advanced training on equipment Over 500 hospital personnel trained at basic level Radiation Safety Officers provided with advanced training All training materials, presentations, handouts, tests, available for download and modification http://www.nyc.gov/html/doh/html/bhpp/bhpp-train-cbrne-rad.shtml http://www.nyc.gov/html/doh/html/bhpp/bhpp-train-cbrne-rad.shtml

11. Additional Training Efforts Radiation Response Symposium for Radiation Safety Officers 2008 and 2009 Partnered with REAC/TS for medical management training in 2008

12. Lessons Learned Hospital and healthcare facilities have limited radiation detection equipment, training or plans, Focus on staff safety to encourage participation, Involve Hospital Radiation Safety Officers early,

13. Lessons Learned If you put up radiation detection equipment, you will detect radiation – have your own response protocols in place, Radiation equipment skills are perishable – create easy drills or quick reviews for staff to conduct biannually, and As training on equipment increases, staff anxiety decreases.

14. Questions? Contact information: Kate Uraneck, MD kuraneck@health.nyc.gov