1. Sr. Col. Van Mui Nguyen, Sr. Col. Xuan Kien Nguyen, Sr. Col. Van Cu Ho, Sr. Col. Trung Son Nguyen, Sr. Col. Minh Hieu Nguyen et al Military Institute of Medical Radilogy and Oncology, Military Medical Department, Vietnam

2. Introduction Missions, staffs, equipment and operational methods of MRET Exercise Evaluation of the Exercise Experiences drawn from the exercise and proposals for cooperation CONTENT

3. Introduction: Military Institute of Medical Radiology and Oncology (MIMRO) is tasked with establishing the Medical Radiation Emergency Team (MRET) since 2005. MIMRO held an exercise by MRET after a long time of training and practice in Nov 2013. This report aims to evaluate the exercise, draw experiences and propose for cooperation in the field of radiation emergency.

4. Missions, staffs, equipment and operational methods of MRET Missions: MRET has a function of holding medical emergency management for radiation victims. MRET’s missions: 1. Provide emergency rescue damaged victims; Immediately transfer the victims to the nearest hospital. 2. Detect and isolate areas of radioactive contamination. 3. Conduct radiation survey and triage victims; Perform initial decontamination of victims.

5. 4. Provide health counseling and psychological support for victims. Transport and evacuate victims to the facility. 5. Collaborate with the other rescue forces at the scene during deployment process. 6. Decontaminate the staffs’ bodies, equipments and supplies.

6. Staffs: Team personnel are mobilized from departments of MIMRO. Forces of MRET is annually strengthened based on the situation of the actual number of troops mobilized from departments. In 2013, MRET had 25 members.

7. TEAM DIAGRAM Anti- shock group (2 doctors, 2 nurses) Team commander (2 doctors) Radiation survey group (2 engineers, 2 technicians) Triage and evacuation group (3 doctors, 3 nurses, 1 driver) Decontami- nation group (3 doctors, 4 nurses, 1 driver);

8. Missions of the groups Radiation survey group: Conduct radiation survey of victims, establish site for deployment.

9. Missions of the groups Triage and evacuation group: Examine, triage, provide initial aid; transport victims to other groups and to the specialised hospital.

10. Missions of the groups Decontamination group: Decontaminate locally and/or totally. Sample disease productions for diagnosis.

11. Missions of the groups Anti-shock group: Provide anti-shock management.

12. Equipments: For members: personal protective equipments. For groups: o Radiation survey group: radiation monitoring; mark contaminated area, establish deployment site and route for transfering victims. o Triage and evacuation group: examining, fixed, transfering tool; tool for removing contaminated clothing; drugs for initial aid. o Decontamination group: equipments for decontamination and sample on the victim. o Anti-shock group: equipments for emergency rescue.

13. Modes of operation: In normal conditions: The members work at the departments with the regular responsibilities and duties. They are trained and prepared with the knowledge on radiation emergency response. In case of radioactive nuclear incident : Team is ordered to be present, tasked and moved to the scene to conduct initial response.

14. Exercise: Hypothetical situation: There were a fire and an explosion in a room containing radioactive material at the agency X, about 10 km from our Institute. The explosion wounded, contaminated and panicked many; MIMRO was ordered to send urgently MRET team to the scene of fire and explosion, in coordination with other emergency response forces to deploy rescuing and treating victims.

15. MRET’s missions:  Send an advance group to come to agency X for monitoring the situation;  Move the whole forces to agency X, in collaboration with other forces restrict the area of the incident; deployed in the agency X's yard, where radioactive safety is secured to organize emergency rescue, decontamination, radioactive waste to victims and transport them to the next line.

16. Deployment: Step 1: Give an overview on the medical radiation emergency teams and medical response duties to radiation incident; Step 2: Exercise MRET’s operating mechanism in coordination with other response forces; Step 3: Deploy MRET team at the scene. Conduct rescuing and treating victims, manage radiation damages and indicate transportation of victims to the next line; Step 4: Finish the exercise and draw experiences from it.

17. CHART OF EXERCISE DEPLOYMENT OF MEDICAL RADIATION EMERGENCY TEAM 2013

18. Evaluation of the Exercise: Evaluation method: - To monitor and assess directly deployment practice in the scene. - Workshops, drawn experiences immediately after the exercise. - Analysis based on questionnaires to experts attending the exercise.

19. Result: - Practical implementation: The team deployed content in accordance with intention of exercise, situation and exercise scenario; complied with the order of the deployment steps. - Workshop: Most of reviewees agreed that the model included 25 members, the team is capable of responding to radioactive incidents of from 10 to 30 victims.

20. Experiences drawn from the exercise: - Build realistic scenarios, develop operating plans of exercise with details and high feasibility. - Organize training, practice in groups and then practice in full team thoroughly before exercise. - Coordinate closely involved exercise forces and provide effective logistics support for the exercise.

21. Proposals for cooperation: - Train personnel for medical response duties with nuclear radiation incidents, especially in the field of radiation emergency, radiation biology, dosimetry of radiation biology, radiation burn treatment. - Share information and experiences among the medical radiation emergency teams from the military health of other countries.

22. Thank you for listening!