TREATMENT OF RADIATION EXPOSURE AND CONTAMINATION

For treatment of radiation accident victims, procedures for handling t rauma patients must be modified to ensure proper care and prevent cont amination of hospital facilities and personnel. The radiation accident management plan should be instituted in advance. Exposure and contami nation victims are treated differently. Exposed patients have sustaine d either partial or whole-body exposure but do not carry radioactive m aterial; contaminated patients have also been exposed, but they have r adioactive material either externally or internally and thus are conti nually exposed to radiation until the contaminant is removed. The trea tment area and personnel must be protected with use of isolation, clea n transfer techniques, and appropriate attire. After clothing has been removed, the patient's medical condition is assessed, stabilized, and treated. Samples from the affected areas, eyes, nose, and mouth are o btained for analysis and planning definitive treatment. For external c ontamination, the skin is washed with normal saline or mild detergent. Treatment of internal contamination is based on the isotopes involved and may include saturation of the crucial organ, dilution therapy, is otope displacement, or use of chelating agents. After a survey to ensu re that no residual contamination remains, the patient is transferred to a care unit. Effects of exposure are seen over periods ranging from days to weeks to years, depending on the total dose received. Knowing the dose allows clinicians to predict what effects may ultimately occ ur.