102 MEDICAL RESPONSE IN NUCLEAR OR RADIOLOGICAL EMERGENCY When victims have missed the prehospital screening, the hospital decontamination aims to allow their medical care and to protect the hospital personnel and infrastructure. The protocol indicated below applies after undressing the victim. Responders • Hospital decontamination teams + Decontaminating the victims ACTION TO TAKE IN A 1ST LINE HEALTHCARE FACILITY 34SHEET SEE SHEET 32 Detect the contamination (localise the skin contamination) 1 Undressing greatly reduces the external contamination. SEE SHEET 33 The external contamination is localised on the exposed parts of the body and on wounds. Caution, long hair is likely to retain a lot of contamination. Carry out emergency decontamination 2 Carry out full decontamination (showering that is not aggressive for the skin) 3 See treatment protocol on next page. • After drying: check the decontaminated zones carefully with a detection probe that is appropriate for the type of radiation emitted by the contaminant. • Detecting alpha radiation is a very difficult and long process. The short path of alpha radiation requires the surface to be absolutely dry. Alpha emitters also emit X-rays or gamma rays whose detection is always easier and morereliable. • If the check is positive: perform a 2nd decontamination, then a contamination check applying the same rules. If the check is still positive, these operations are repeated the following days. After two decontaminations, the residual external contamination is perfectly fixed and presents no risk of dispersion. Carry out a contamination check 4 • Dress in hospital pyjamas or gown or scrub suit. • Continue the medical pathway. At this stage, there is no risk of the victim transferring external contamination. Redressing the victim 5
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