24 In the VAA: treating the absolute urgencies The Absolute Urgencies (AU) must receive medical-surgical treatment as rapidly as possible. In the Victim Assembly Area (VAA), they receive all the necessary emergency treatments. Decontamination operations can represent a loss of time and are not considered a priority. The Extreme Urgencies (EU) must be taken care of immediately and before any full decontamination procedures are applied. Responders • Emergency response teams: FRS • Emergency medical teams: SMUR, RRHU Places Controlled zone + AU: perform emergency decontamination before evacuation These victims have potentially severe injuries which limit full decontamination. • Carry out the vital resuscitation actions before transporting the victims. • Evacuate after emergency decontamination and appropriate preparation. The injured victim can be transferred without further decontamination to the operating theatre or scanner of a healthcare facility. The additional decontamination shall be carried out after completing the emergency procedures. Decontamination must never hold back the treatment of an AU. Only the vital resuscitation actions are to be carried out before transporting the victims. Emergency decontamination is carried concomitantly as soon as possible after stabilisation. ACTION TO TAKE ON THE SITE OF THE EVENT SHEET • Clean the face with a damp compress. • Protect the upper airways (to avoid transforming external contamination into internal contamination) and put in place an FFP3 or FFP2 mask or a surgical mask, in that order of preference. • If the contamination takes the form of dust, spray lightly with water to avoid dispersing any dust deposited on clothing. The skin must not be bare or be wet, to avoid letting contamination of clothing lead to skin contamination. Particular attention must be paid to potentially contaminated run-offs. • Whenever possible, remove the outer layers of clothing and put on a surgical cap. Undressing removes up to 90% of the external contamination: follow the same procedure as that applicable to 1st line healthcare facilities. The procedure differs depending on whether the victims are standing or lying down. SEE SHEET 33 Emergency actions and emergency decontamination 1 76 MEDICAL RESPONSE IN NUCLEAR OR RADIOLOGICAL EMERGENCY
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