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External Decontamination for Radiation Exposure

Gross and Secondary Decontamination

Gross decontamination is as follows

Remove all patient clothing

Full-body irrigation

Emergent medical care takes priority over decontamination

The image below depicts gross decontamination

Decontamination. Image courtesy of Wikimedia.

Decontamination. Image courtesy of Wikimedia.

Secondary decontamination is as follows

Head-to-toe survey with radiation-detection device

Skin: Irrigation and cleansing of radioactive areas with mild soap and water

Mouth: Swab samples from oral cavity; remove dentures and foreign bodies; brush teeth, gums, and tongue; copious irrigation

Nose: Swab nares, blow nose, copious irrigation

Eyes: Anesthetize eye, swab conjunctiva, copious irrigation

Ears: Swab external canal; examine tympanic membrane for perforation, if intact then irrigate

Open wounds: Swab wounds, remove foreign bodies, copious irrigation, cover with waterproof dressing

Repeat survey with radiation-detection device, and irrigate if above threshold

In March 2015, filgrastim (Neupogen) was approved by the US Food and Drug Administration (FDA) to increase survival in patients acutely exposed to myelosuppressive doses of radiation (suspected or confirmed exposure to radiation >2 Gy).

For more information on radiation injuries and decontamination, see the Medscape topics CBRNE – Radiation Emergencies and Radiation-Exposure Injuries.

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