Medical-surgical urgencies take priority over the treatment of contamination and irradiation. The treatment of external and internal contaminations is most effective when applied as early as possible, as soon as the potential contaminating radionuclide(s) has/have been identified. • In the event of dispersion of radionuclides in the environment, the victim is removed from the contaminated environment and placed in safety. • In the event of external contamination, the treatment is based on undressing (emergency decontamination) and showering (full decontamination) with protection of the airways. SEE SHEETS 7 + 24 to 26 + 34 • In the event of internal contamination, antidotes are administered. SEE SHEETS 7 27 34 + 37 to 40 + radionuclides handbook Treatment of contamination cases as rapidly as possible Any exposure to a source of irradiation must be confirmed and characterised (total or partial irradiation of the body). The irradiation severity must be assessed as quickly as possible because it determines the appropriate medical pathway and treatment. Questioning the victim is an urgent priority in this assessment which leads to the filling out of a radiological risk assessment sheet for each victim. The investigative elements (circumstances of the event, dosimetric survey) are to be looked for on the scene of the accident, otherwise they risk being lost definitively. SEE SHEETS 5 7 11 Treatment of an irradiated victim IN PRACTICE Action to take in the case of irradiated or contaminated lesions When acute irradiation and/or contamination are associated with traumatic lesions (fractures, injuries, wounds, burns), the prognosis of the lesions is aggravated: the injury potentiates the effects of the irradiation and vice versa. Whole-body irradiation increases the risk of cardiovascular shock, infection and haemorrhage, and slows down the healing of wounds and consolidation of fractures. The first aid measures consist in controlling any severe bleeding (if necessary, take a blood sample for HLA tissue typing before transfusing), maintaining the circulatory function and freeing the airways to ensure satisfactory ventilation. After this, decontamination and/or internal contamination treatment must be started. SEE SHEET 17 4 3 MEDICAL RESPONSE STRATEGY Action priorities along the response pathway 03 SHEET 16 MEDICAL RESPONSE IN NUCLEAR OR RADIOLOGICAL EMERGENCY
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