MEDICAL MANAGEMENT ZONE CONTAMINATED WOUND TREATMENT PROTOCOL The victims are admitted after undressing and decontamination. The lesions can be treated anywhere in the healthcare facility (very low risk of contamination). 1. In the case of contamination by actinides, immediately pour a 25% solution of Ca-DTPA (undiluted injectable vials): over any wound or burn to minimise the retention of radionuclides. 2. Trim the wound: to be carried out by a surgeon, if possible in the presence of a person specialised in the detection of radioactivity as this is vital to evaluate the level of decontamination of the wound. 3. If careful trimming has not resulted in total decontamination or if it is not known whether total decontamination has been achieved: establish a complementary. internal decorporating treatment specific to the radionuclide, because the wound is not completely closed up to allow decontamination. 4. Determine the treatment follow-up on a case-by-case basis, taking into account: • the radionuclide(s) involved; • the severity of the local residual contamination; • the risks of diffusion of the radioactivity; • the anatomical location; • the possibilities or difficulties of surgical treatment. No damaging surgical act is justified in an urgent situation for the purpose of decontaminating a contaminated wound. EARLY TREATMENT OF INTERNAL CONTAMINATION If it has not already been done, early treatment of the internal contamination must be undertaken. SEE SHEET 27 The Radionuclide Handbook contains the recommended emergency treatments for the radionuclides of interest, with the radionuclides indicated in alphabetical order. SEE radionuclides handbook PERSONNEL DRESSING AND UNDRESSING SEE SHEET 30 MEDICAL RESPONSE IN NUCLEAR OR RADIOLOGICAL EMERGENCY 95 31 SHEET ACTION TO TAKE IN A 1ST LINE HEALTHCARE FACILITY Receiving and managing the victims
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