ABSOLUTE URGENCIES TREATMENT ZONE TREAT THE AUs IMMEDIATELY WITHOUT PRIOR RADIOLOGICAL MONITORING 1. Undress the victims to ensure emergency decontamination. Identify and conserve the personnel effects and clothing in case there is a subsequent investigation. 2. Protect the personnel SEE SHEET 30 and the examination tables or beds with vinyl sheeting. 3. Transfer the victims to the zone for treating urgencies (the medical urgency takes priority over the radiological risk). 4. Carry out the life-saving actions. 5. Apply without fail the contamination detection and localisation protocol. 6. After stabilising the lesions and vital functions, carry out full decontamination. Case of low-level external contamination: carry out a cursory decontamination using compresses soaked in liquid soap or a 25% solution of Ca-DTPA. This decontamination is incomplete but remains effective. In addition to the usual personnel of an emergency department, one or two people from the RRH NRs must be brought into this zone as soon as possible. They are capable of using the contamination detection devices. i HOSPITAL DECONTAMINATION UNIT: RELATIVE URGENCIES 1. Carry out radiological triaging of the RUs (detection of external contamination): before entering the hospital full decontamination zone. 2. Carry out a radiological contamination check on the victims. For the triage to be effective, this check must be check must be done with method and rigour. This triage serves to prevent the decontamination zone from becoming congested with non-contaminated victims. If there is no radiation monitoring portal, detection is done using radiation survey meters equipped with alpha – beta probes or hand-held multi-radiation (alpha – beta – gamma) count rate meters. Nevertheless, if there are many victims, they will all go through full decontamination. SEE SHEET 32 EMERGENCY DECONTAMINATION 3. Protect the upper airways. SEE SHEET 20 4. Proceed with undressing. The technique differs depending on whether the victim is lying down or standing. SEE SHEET 33 5. After decontamination: the physician details the lesional assessment of the victim indicating any necessary complementary examinations. 6. If the victim is in a protective bag, the table or examination bed can be covered with a vinyl sheet that extends well down on each side. FULL DECONTAMINATION This supplements the emergency decontamination (to remove any traces of residual contamination), in order to prevent the transfer of contamination within the facility (to patients, hospital personnel or infrastructure). Non-contaminated victim: route the victim directly to the emergency department without passing via the decontamination zone. Contaminated victim: route the victim to the Hospital Decontamination Unit (HDU) and carry out emergency decontamination followed by full decontamination. 94 MEDICAL RESPONSE IN NUCLEAR OR RADIOLOGICAL EMERGENCY SHEET 31 ACTION TO TAKE IN A 1ST LINE HEALTHCARE FACILITY Receiving and managing the victims
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