Treatment of radiation exposure and contamination

For treatment of radiation accident victims, procedures for handling trauma patients must be modified to ensure proper care and prevent contamination of hospital facilities and personnel. The radiation accident management plan should be instituted in advance. Exposure and contamination victims are treated differently. Exposed patients have sustained either partial or whole-body exposure but do not carry radioactive material; contaminated patients have also been exposed, but they have radioactive material either externally or internally and thus are continually exposed to radiation until the contaminant is removed. The treatment area and personnel must be protected with use of isolation, clean 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 obtained for analysis and planning definitive treatment. For external contamination, 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, isotope displacement, or use of chelating agents. After a survey to ensure 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 occur.