Canadian Guide on Medical Management of Radiation Emergencies

Executive Summary

During a radiation emergency, a significant number of emergency responders and the public may become externally exposed to radiation, contaminated with radioactive materials, or both. Timely screening and treatment of the affected population are important components of emergency response and consequence management. This Canadian guide on medical management of radiation emergencies provides a common framework from which hospitals, public health authorities and emergency management organizations can base their response plans.

This guide addresses many radiation emergency scenarios that can lead to mass exposures of people, such as nuclear power reactor accidents or intentional use of radiological dispersal devices. However, catastrophic events, such as the detonation of an improvised nuclear device, are beyond the scope of this guide. In such events, there may be significant loss of infrastructure needed to support a response, and the medical presentation of casualties will be far more complex, resulting from a combination of radiation, thermal and blast injuries.

This guide covers basic information on the following: hazards associated with radiation emergencies, radiation health effects, radiation detection and measurement, protection of workers, and management of radiation emergencies in Canada. It focusses on the early medical management of radiation emergencies during the pre-hospital and Emergency Department responses. In the pre-hospital section, a public health concept for population screening and decontamination in community reception centres developed by the United States Centers for Disease Control and Prevention (US CDC) is presented. In the Emergency Department section, guidance is presented on the preparation of the Emergency Department, protection of hospital workers, triage of radiation casualties, patient decontamination, and medical management of radiation casualties. The Emergency Department section is followed by a brief discussion on the medical follow-up of radiation casualties that takes place outside of the Emergency Department. Details on specialized in-patient care are beyond the scope of this guide. At the end of this guide, special issues for vulnerable populations are discussed.

Annexes provide specific technical information such as procedures for contamination control and decontamination, population screening, casualty decontamination, emergency room set-up, and casualty assessment, and forms for ordering specialized tests. The information contained in these annexes can be adapted by users to create aide-memoires for use during radiation emergencies.

To obtain a copy of the full document, please contact the Director - Radiation Protection Bureau, E-mail:; Telephone: 613-954-6647

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