Contamination management with a view to rehabilitating the premises differs little from the usual maintenance and cleaning operations. It nevertheless has a few particularities: • wear appropriate Personal Protective Equipment (PPE) SEE SHEET 6 ; • favour specific detergents: with a surfactant activity and sequestering agents commonly used in “hot” laboratories and nuclear medicine departments (TFD decontaminating foam spray, etc.). If not available, use standard detergents; • work at least in pairs and coordinate your actions: one person carries out the decontamination while limiting their movements to avoid dispersing the contamination, while the other person(s) provide(s) support; • determine the boundaries of the contaminated areas (radioactive contaminations on surfaces such as tables or floors are rarely uniform): use high-sensitivity detectors (narrow window and, if possible, wide window, such as a contamination meter or X-ray probe), protected with food-grade plastic film; • decontaminate (with disposable wipes, or possibly paper towel), starting from the outer edge of the contamination stain and working inwards to limit contamination dispersion; • to remove all possible traces of residual contamination: perform a 2nd decontamination step (or a 3rd one depending on the results of the measurements) over the whole surface. For example, the entire floor of a room. Vacuum cleaners should not be used because they generate aerosols; • decontaminate the material and equipment in the usual manner, but working over a receptacle if possible, without making sudden movements. All the decontamination waste products (washing water and materials) are in principle regarded as radioactive waste. IN PRACTICE Declare rehabilitation of the premises The absence of residual contamination must be confirmed by an entity with the appropriate skills and means. • Internal Radiation Protection Service (RPS), • RPS of a neighbouring facility providing back-up assistance, • Inter-facility Radiation Protection Organisation, • or the Radiological Intervention and Environmental Monitoring Service (SIRSE) of the Institute of Radiation Protection and Nuclear Safety (IRSN) – irsn.sirse@irsn.fr. Healthcare facilities that do not have a nuclear medicine department can request assistance from the nuclear medicine department of the Regional Reference Hospital for the RN risk – RRH RN (see pages 138-139). i 88 MEDICAL RESPONSE IN NUCLEAR OR RADIOLOGICAL EMERGENCY Manage the waste The radioactive waste comes from the potentially contaminated victims and from contamination management. The waste can be liquid (washing water, etc.) or solid: vinyl bags, clothing, used PPE, decontamination products, etc. The volume of the waste depends on the nature and scale of the event. The traceability and management of radioactive waste must be organised according to its radiological characterisation. SHEET 29 ACTION TO TAKE IN A 1ST LINE HEALTHCARE FACILITY Preparing the premises, rehabilitating them and managing the waste Rehabilitating the premises
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