(4) Healthcare Provider Protection and Resources A: Employee Protection (Physical): (a) Initially obtaining as much information as possible is proactive protection. Obtain as much patient and site information as feasible from first responders. (b) The first step in protecting employees is to establish an assessment center removed from the emergency department to rapidly screening victims for injury and contamination and to provide for decontamination. Radiation control zones, where potential radioactive contamination exists, should be established within the hospital and the administration should ensure that there is someone in charge of access to/from the control zones, and that they have a law enforcement representative present. (c) Suggested personnel protection equipment that also facilitates the ease of clean-up includes: (c-1) Universal precautions clothing (facemask, goggles, gowns, double-gloves with inner one taped and outer glove removed after each contact). (c-2) Plastic wrap (e.g., disposable trash bags, Saran Wrap, ZipLocTM bags, etc.) to cover and protect instruments and equipment. (c-3) Disposable shoe coverings. (c-4) Butcher paper or equivalent on floor. (c-5) If possible, personal dosimeters (see Appendix C) for staff members who might have frequent contact with contaminated patients. (d) Hospitals should purchase and maintain radiation survey meters for detection procedures. (d-1) Each hospital should have at least three actively working and maintained radiation survey meters, one each at points of egress and ingress and the third in circulation. (d-2) Large hospitals might consider a portal monitor for 24/7 monitoring and protection. (See Appendix C). (d-3) Hospitals should ensure that designated personnel are properly trained on the use of the survey meters, and that the meters are maintained and calibrated according to the manufacturer. (e) Protective clothing does not always reduce risk of exposure since penetrating beta and gamma radiation may go through it. However, it prevents personal contamination of radioactive substances and limits the spread of contamination. (f) Hospitals should take extra precautions to protect special populations, especially pregnant employees. (g) Hospitals should provide employees with immediate and accurate communication, such as public announcements, media packets, information packets for the Emergency department waiting area, and web site updates. (h) Hospitals should consider providing copies of the North American Emergency Response Guide for staff (www.envectra.com/env/erg/erg.htm). (i) Issues to consider in funding or obtaining needed equipment include: (i-1) Considering a billable patient surcharge for disaster preparedness. Federal or state government grants may be available for PPE and radiation detection devices. (i-2) Considering other resources in the community that also have survey meters and equipment. (j) Employees are best protected when hospitals activate the radiological component of their emergency response plan when there is any probability of a radiological mass casualty event. (k) Employees should remember, in the event of a radiological emergency, apply time, distance, and shielding principles (i.e., limit time spent near contamination; keep as much distance from the contaminated area as practicable; and shield with any available material)