1
|
Paleiron N, Karkowski L, Bronstein AR, Amabile JC, Delarbre D, Mullot JU, Cazoulat A, Entine F, le Floch Brocquevieille H, Dorandeu F. [The role of the pulmonologist in an armed conflict]. Rev Mal Respir 2023; 40:156-168. [PMID: 36690507 DOI: 10.1016/j.rmr.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/20/2022] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Recent news points to the eventuality of an armed conflict on the national territory. STATE OF THE ART In this situation, pulmonologists will in all likelihood have a major role to assume in caring for the injured, especially insofar as chest damage is a major cause of patient death. PERSPECTIVES The main injuries that pulmonologists may be called upon to treat stem not only from explosions, but also from chemical, biological and nuclear hazards. In this article, relevant organizational and pedagogical aspects are addressed. Since exhaustiveness on this subject is unattainable, we are proposing training on specific subjects for interested practitioners. CONCLUSION The resilience of the French health system in a situation of armed conflict depends on the active participation of all concerned parties. With this in mind, it is of prime importance that the pneumological community be sensitized to the potential predictable severity of war-related injuries.
Collapse
Affiliation(s)
- N Paleiron
- HIA Sainte-Anne, service de pneumologie, Toulon, France.
| | - L Karkowski
- HIA Sainte-Anne, service de médecine interne-maladies infectieuses, Toulon, France
| | - A-R Bronstein
- HIA Sainte-Anne, service de pneumologie, Toulon, France
| | - J-C Amabile
- Service de protection radiologique des armées, Paris, France
| | - D Delarbre
- HIA Sainte-Anne, service de médecine interne-maladies infectieuses, Toulon, France
| | - J-U Mullot
- Service de santé des armées, Paris, France
| | - A Cazoulat
- Service de santé des armées, service médical de la base opérationnelle de l'Île Longue, Lanveoc Poulmic, France
| | - F Entine
- Service de santé des armées, service médical de la base opérationnelle de l'Île Longue, Lanveoc Poulmic, France
| | | | - F Dorandeu
- Service de santé des armées, Institut de recherche biomédicale des armées, Brétigny, France
| |
Collapse
|
2
|
Entine F, Garnier G, Dondey M, Rizzi Y, Gobert A, Bassinet C, Papin S, Pennacino I, Cazoulat A, Amabile JC, Huet C. SEED: An Operational Numerical Tool for Dosimetric Reconstruction in Case of External Radiological Overexposure. Health Phys 2022; 122:271-290. [PMID: 34995220 DOI: 10.1097/hp.0000000000001483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
ABSTRACT In the event of a radiological accident involving external exposure of one or more victims and potential high doses, it is essential to know the dose distribution within the body in order to sort the victims according to the severity of the irradiation and then to take them to the most suitable medical facilities. However, there are currently few techniques that can be rapidly deployed on field and capable of characterizing an irradiation. Therefore, a numerical simulation tool has been designed. It can be implemented by a doctor/physicist pairing, projected within a limited time as close as possible to the irradiation accident and emergency response teams. Called SEED (Simulation of External Exposures & Dosimetry), this tool (dedicated to dose reconstruction in case of external exposure) allows a rapid modeling of the irradiation scene and a visual exchange with the victims and witnesses of the event. The user can navigate in three dimensions in the accident scene thanks to a graphical user interface including a "first person" camera. To validate the performance of the SEED tool, two dosimetric benchmarking exercises were performed. The first consisted in comparing the dose value provided by SEED to that given by a reference calculation code: MCNPX. The purpose of the second validation was to perform an experiment irradiating a physical dummy equipped with dosimeters and to reconstruct this irradiation using SEED. These two validation protocols have shown satisfactory results with mean difference less than 2% and 12% for the first and second exercises, respectively. They confirm that this new tool is able to provide useful information to medical teams in charge of dosimetric triage in case of a major external exposure event.
Collapse
Affiliation(s)
| | - G Garnier
- French Defense Radiation Protection Service (SPRA), 1 bis rue du lieutenant Raoul Batany - CS500 - 92141 CLAMART Cedex, France
| | - M Dondey
- French Defense Radiation Protection Service (SPRA), 1 bis rue du lieutenant Raoul Batany - CS500 - 92141 CLAMART Cedex, France
| | - Y Rizzi
- Institute for Radiation Protection and Nuclear Safety (IRSN), 31 avenue de la Division Leclerc - 92260 FONTENAY-AUX-ROSES, France
| | - A Gobert
- Institute for Radiation Protection and Nuclear Safety (IRSN), 31 avenue de la Division Leclerc - 92260 FONTENAY-AUX-ROSES, France
| | - C Bassinet
- Institute for Radiation Protection and Nuclear Safety (IRSN), 31 avenue de la Division Leclerc - 92260 FONTENAY-AUX-ROSES, France
| | - S Papin
- French Defense Radiation Protection Service (SPRA), 1 bis rue du lieutenant Raoul Batany - CS500 - 92141 CLAMART Cedex, France
| | - I Pennacino
- French Defense Radiation Protection Service (SPRA), 1 bis rue du lieutenant Raoul Batany - CS500 - 92141 CLAMART Cedex, France
| | - A Cazoulat
- French Defense Radiation Protection Service (SPRA), 1 bis rue du lieutenant Raoul Batany - CS500 - 92141 CLAMART Cedex, France
| | - J C Amabile
- Armed Forces Medical Service Head quarters (DCSSA), 60 boulevard du général Martial Valin - CS 21 623 - 75509 PARIS Cedex 15, France
| | - C Huet
- Institute for Radiation Protection and Nuclear Safety (IRSN), 31 avenue de la Division Leclerc - 92260 FONTENAY-AUX-ROSES, France
| |
Collapse
|
3
|
Entine F, Bensimon Etzol J, Bettencourt C, Dondey M, Michel X, Gagna G, Gellie G, Corre Y, Ugolin N, Chevillard S, Amabile JC. Deployment of the DosiKit System Under Operational Conditions: Experience From a French Defense National Nuclear Exercise. Health Phys 2018; 115:185-191. [PMID: 29787445 DOI: 10.1097/hp.0000000000000863] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Estimation of the dose received by accidentally irradiated victims is based on a tripod: clinical, biological, and physical dosimetry. The DosiKit system is an operational and mobile biodosimetry device allowing the measurement of external irradiation directly on the site of a radiological accident. This tool is based on capillary blood sample and hair follicle collection. The aim is to obtain a whole-body and local-surface dose assessment. This paper is about the technical evaluation of the DosiKit; the analytical process and scientific validation are briefly described. The Toulon exercise scenario was based on a major accident involving the reactor of a nuclear attack submarine. The design of the scenario made it impossible for several players (firefighters, medical team) to leave the area for a long time, and they were potentially exposed to high dose rates. The DosiKit system was fully integrated into a deployable radiological emergency laboratory, and the response to operational needs was very satisfactory.
Collapse
Affiliation(s)
- F Entine
- French Defense Radiation Protection Service (SPRA), 1 Bis, Rue du Lieutenant Raoul Batany, CS500 57, 92141 Clamart Cedex, France
| | | | - C Bettencourt
- Acubens, 15 Rue Pierre Gilles de Gennes, 92160 Antony, France
| | - M Dondey
- French Defense Radiation Protection Service (SPRA), 1 Bis, Rue du Lieutenant Raoul Batany, CS500 57, 92141 Clamart Cedex, France
| | - X Michel
- French Defense Radiation Protection Service (SPRA), 1 Bis, Rue du Lieutenant Raoul Batany, CS500 57, 92141 Clamart Cedex, France
| | - G Gagna
- French Defense Radiation Protection Service (SPRA), 1 Bis, Rue du Lieutenant Raoul Batany, CS500 57, 92141 Clamart Cedex, France
| | - G Gellie
- French Defense Radiation Protection Service (SPRA), 1 Bis, Rue du Lieutenant Raoul Batany, CS500 57, 92141 Clamart Cedex, France
| | - Y Corre
- French Alternative Energies and Atomic Energy Commission (CEA) 18, Route du Panorama, 92260, Fontenay-aux-Roses, France
| | - N Ugolin
- French Alternative Energies and Atomic Energy Commission (CEA) 18, Route du Panorama, 92260, Fontenay-aux-Roses, France
| | - S Chevillard
- French Alternative Energies and Atomic Energy Commission (CEA) 18, Route du Panorama, 92260, Fontenay-aux-Roses, France
| | - J-C Amabile
- French Defense Radiation Protection Service (SPRA), 1 Bis, Rue du Lieutenant Raoul Batany, CS500 57, 92141 Clamart Cedex, France
| |
Collapse
|
7
|
Dörr H, Abend M, Blakely WF, Bolduc DL, Boozer D, Costeira T, Dant T, De Amicis A, De Sanctis S, Dondey M, Drouet M, Entine F, Francois S, Gagna G, Guitard N, Hérodin F, Hoefer M, Lamkowski A, La Sala G, Lista F, Loiacono P, Majewski M, Martigne P, Métivier D, Michel X, Pateux J, Pejchal J, Reeves G, Riccobono D, Sinkorova Z, Soyez L, Stricklin D, Tichy A, Valente M, Woodruff Jr. CR, Zarybnicka L, Port M. Using Clinical Signs and Symptoms for Medical Management of Radiation Casualties – 2015 NATO Exercise. Radiat Res 2017; 187:273-286. [DOI: 10.1667/rr14619.1] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- H. Dörr
- Bundeswehr Institute of Radiobiology affiliated to the University Ulm, Munich, Germany
| | - M. Abend
- Bundeswehr Institute of Radiobiology affiliated to the University Ulm, Munich, Germany
| | - W. F. Blakely
- Armed Forces Radiobiology Research Institute (AFRRI), Uniformed Services, University of the Health Sciences (USUHS), Bethesda, Maryland
| | - D. L. Bolduc
- Armed Forces Radiobiology Research Institute (AFRRI), Uniformed Services, University of the Health Sciences (USUHS), Bethesda, Maryland
| | - D. Boozer
- Armed Forces Radiobiology Research Institute (AFRRI), Uniformed Services, University of the Health Sciences (USUHS), Bethesda, Maryland
| | - T. Costeira
- Armed Forces Radiobiology Research Institute (AFRRI), Uniformed Services, University of the Health Sciences (USUHS), Bethesda, Maryland
| | - T. Dant
- Applied Research Associates, Inc. (ARA), on behalf of (U.S.) Defense Threat Reduction Agency (DTRA), Arlington, Virginia
| | - A. De Amicis
- Army Medical and Veterinary Research Center, Roma, Italy
| | - S. De Sanctis
- Army Medical and Veterinary Research Center, Roma, Italy
| | - M. Dondey
- French Defense Radiation Protection Service (SPRA), Clamart, France
| | - M. Drouet
- Institut de Recherche Biomedicale des Armees, Bretigny-sur-Orge, France
| | - F. Entine
- French Defense Radiation Protection Service (SPRA), Clamart, France
| | - S. Francois
- Institut de Recherche Biomedicale des Armees, Bretigny-sur-Orge, France
| | - G. Gagna
- French Defense Radiation Protection Service (SPRA), Clamart, France
| | - N. Guitard
- Institut de Recherche Biomedicale des Armees, Bretigny-sur-Orge, France
| | - F. Hérodin
- Institut de Recherche Biomedicale des Armees, Bretigny-sur-Orge, France
| | - M. Hoefer
- Armed Forces Radiobiology Research Institute (AFRRI), Uniformed Services, University of the Health Sciences (USUHS), Bethesda, Maryland
| | - A. Lamkowski
- Bundeswehr Institute of Radiobiology affiliated to the University Ulm, Munich, Germany
| | - G. La Sala
- Army Medical and Veterinary Research Center, Roma, Italy
| | - F. Lista
- Army Medical and Veterinary Research Center, Roma, Italy
| | - P. Loiacono
- Army Medical and Veterinary Research Center, Roma, Italy
| | - M. Majewski
- Bundeswehr Institute of Radiobiology affiliated to the University Ulm, Munich, Germany
| | - P. Martigne
- Institut de Recherche Biomedicale des Armees, Bretigny-sur-Orge, France
| | - D. Métivier
- French Defense Radiation Protection Service (SPRA), Clamart, France
| | - X. Michel
- French Defense Radiation Protection Service (SPRA), Clamart, France
| | - J. Pateux
- Institut de Recherche Biomedicale des Armees, Bretigny-sur-Orge, France
| | - J. Pejchal
- Department of Radiobiology, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czech Republic
| | - G. Reeves
- Applied Research Associates, Inc. (ARA), on behalf of (U.S.) Defense Threat Reduction Agency (DTRA), Arlington, Virginia
| | - D. Riccobono
- Institut de Recherche Biomedicale des Armees, Bretigny-sur-Orge, France
| | - Z. Sinkorova
- Department of Radiobiology, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czech Republic
| | - L. Soyez
- Institut de Recherche Biomedicale des Armees, Bretigny-sur-Orge, France
| | - D. Stricklin
- Applied Research Associates, Inc. (ARA), on behalf of (U.S.) Defense Threat Reduction Agency (DTRA), Arlington, Virginia
| | - A. Tichy
- Department of Radiobiology, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czech Republic
| | - M. Valente
- Institut de Recherche Biomedicale des Armees, Bretigny-sur-Orge, France
| | - C. R. Woodruff Jr.
- Armed Forces Radiobiology Research Institute (AFRRI), Uniformed Services, University of the Health Sciences (USUHS), Bethesda, Maryland
| | - L. Zarybnicka
- Department of Radiobiology, Faculty of Military Health Sciences, University of Defence, Hradec Králové, Czech Republic
| | - M. Port
- Bundeswehr Institute of Radiobiology affiliated to the University Ulm, Munich, Germany
| |
Collapse
|