MEDICAL RESPONSE IN NUCLEAR OR RADIOLOGICAL EMERGENCY 89 This characterisation makes it possible to indicate whether on-site radioactive decay management is possible or not. If radioactive decay cannot be ensured internally, consult the crisis management centre; it should be able to provide solutions. IN PRACTICE Managing the excreta of victims with internal contamination in a hospital Apart from the first excreta collected and managed as samples for radiotoxicological analysis to evaluate the internal dose SEE SHEETS 37 38 , these excreta are managed as follows: • only the urines that could present a radiation protection risk are collected and directed to the usual drainage routes for hospitals with a nuclear medicine department (by analogy with the urines of patients who have been administered radiopharmaceuticals); • in facilities that do not have a nuclear medicine department, the urines can be collected in sealed recipients (such as empty 20-litre detergent canisters, etc.) and stored in a room dedicated to the management of radioactive waste and effluents (see opposite) pending transfer to a disposal route appropriate for the radiological content. In the exceptional case of a victim suffering internal contamination by ingestion and by alpha-emitting radionuclides, the stools can be collected in suitable containers and managed in the same way as the urines. SHEET ACTION TO TAKE IN A 1ST LINE HEALTHCARE FACILITY Preparing the premises, rehabilitating them and managing the waste 29 Perform radiological characterisation (nature of the radionuclides present) 1 The radioactive waste must be collected in the containers provided by Andra, the French radioactive waste management agency, particularly waste with a half-life exceeding 100 days. These containers are usually present on site if activities involving unsealed sources are conducted in the facility. If not available, use: • recipients such as empty canisters (having contained detergents, for example) to collect the effluents; • containers provided for Infections Clinical Waste (ICW) to collect the solid waste. Collect the radioactive waste 2 A room dedicated to the management of radioactive waste in compliance with the regulations must be used if the facility has one (waste storage bunker of the nuclear medicine department for example). If there is no dedicated room, whenever possible use a room with the following characteristics: Mandatory characteristics • Isolated and secure room (with access control and at least a lock). If necessary, the Radiation Protection Expert (RPE) will delimit zones and put in place the appropriate signs. • Forced mechanical ventilation (the presence of High-Efficiency Particulate Air (HEPA) filters is an added advantage). • Readily decontaminated floor (epoxy resin or plastic covering), with the finish rising up at the plinths. • Fire safety systems. • Receptacle trays for storing the liquid effluent containers. Other characteristics • Washable paints on the walls, lighting complying with ATEX (Explosive Atmosphere standards). The public authorities, in collaboration with the Prefect and the Regional Health Agency, shall specify what is to become of this waste: grouping on a specially created storage site or transfer to an existing disposal facility. SEE SHEET 10 Store the waste 3
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