Mass screening of emergency department visitors for occult radionuclide contamination

To design an effective, efficient, and affordable radiation surveillance system to screen every emergency department (ED) visitor before they enter the ED.

We chose fluoro-2-deoxyglucose as the source of γ-rays. We collected all available radiation dosimeters in the hospital, designed four modules of measurement, and estimated the distance from visitors to the dosimeter. The maximal distances containing 95% (D95%) of visitors were obtained for the sensitivity tests of every dosimeter in each module. The surveillance system was designed as a dual-monitor system to reduce the possibility of machinery failure. We checked system reliability, followed by a 2-year validation test.

Four dosimeters passed the dose-distance tests. For ambulatory visitors, the triage wall-mounted module had the shortest D95%, followed by the triage nurse module. For recumbent visitors, the triage nurse module had the shortest D95%, followed by the triage wall-mounted module. Area monitors showed better sensitivities than personal dosimeters; however, triage nurses could not wear them because of their size and weight. We used an area monitor on the triage post and the individual dosimeter on the triage nurse as our surveillance system. This system worked well in the reliability test. A sentinel event occurred in the validation test, with a peak dose of 49 136 nSv/h.

Radiation threat to the ED, although uncommon, is real. For the safety of everyone in the ED, you can install an effective, efficient, but affordable surveillance system similar to ours if your ED is not exempted from this threat.