MANAGEMENT OF ACCIDENTAL INTERNAL EXPOSUR E

Radionucleides can penetrate into the body via the lung, the digestive tract, wounds and sometimes through healthy skin. Once they have pene trated the body, they can either remain localized at the site of entry or be rapidly metabolized. The risk is late effects. Radioelements mu st be eliminated as rapidly as possible decreasing the exposure propor tionally. The effectiveness of the treatment depends on early institut ion. Nevertheless, emergency intensive care or surgery may be required . As soon as possible, explorations must be carried out to evaluate th e level of contamination (human spectrometry, radiotoxicological exami nations) and to start treatment. Modalities include non-specific techn iques (lavage, isolubilization, laxatives) and specific techniques suc h as complexation or isotopic dilution (iodine for iodine, Prussian bl ue for cesium, DTPA for plutonium, Diamox or sodium bicarbonate for ur anium). Surgical cleaning of wounds and burns is an excellent means of decontamination. External contamination is often associated. Further contamination must be prevented immediately.