through the monitoring station to determine whether or not they are contaminated with radioactive material. No medical treatment should be instituted in the monitoring station.
Generally speaking, only personnel who have had training and experience as members of Radiological Safety and Radiological Decontamination teams or as members of Damage Control parties should be assigned to the monitoring station. However, those operating the monitoring station should have a basic knowledge of and experience with radiac instruments. In this way, individuals can be used in either capacity should the need arise.
After the patients are monitored, they are directed or taken down one of four avenues, depending upon their physical conditions. Those requiring immediate lifesaving measures should be assumed to be contaminated and routed directly through the monitoring station to the contaminated emergency treatment station. Definitive monitoring for these individuals may be performed at the decontamination station. Both treatment stations are set up much the same and should have only those facilities necessary for immediate lifesaving forms of treatment. Personnel working in these stations should be better versed in emergency first-aid care than those used for monitoring and for rescue teams, and they need not be trained in radiation monitoring.
After emergency lifesaving procedures have been attended to, casualties from the clean emergency treatment station should be taken directly to the sorting station, and those from the contaminated treatment station should be taken to the decent amination station.
Casualties not requiring immediate emergency treatment should be taken or sent from the monitoring station directly to the sorting station or to the decent amination station, whichever is appropriate. The decontamination station should be set up to take, hold, and dispose of all contaminated clothing and to supply clean replacement clothing after the casualty has been decontaminated. It will also require monitoring equipment, showering and washing facilities, and some capability for surgical (e.g., wound) decontamination when necessary.
Of the personnel available to the treatment facility, several of those most experienced and knowledgeable in radiological safety and radiation protection should be assigned supervisory jobs in the decontamination station. Also, it is highly desirable to have some personnel with operating room experience to decontaminate patients with traumatic injuries. It is not necessary for the other personnel working in the decontamination station to have any appreciable training or experience other than that given when the medical facility is put into operation.
Early removal of radioactive contamination will reduce radiation burns, radiation dosage, and the chances of inhaling or ingesting radioactive material. There are two rules to be remembered in the removal of radioactive contamination:
1. Removal of radioactive contamination is best accomplished with soap and water.
2. Contamination is easily spread, so spot cleaning must be attended to before general decontamination procedures are started.
Cotton swabs or gauze maybe used to decontaminate moist areas, gummed tapes to decontaminate dry areas. If after the first cleansing decontamination is inadequate, the process should be repeated three to five times; then, if contamination persists, the following preparation may be tried:
A mixture of 50 percent detergent and 50 percent cornmeal with enough water added to make a paste. This should be used with additional water as necessary and the contaminated area scrubbed (preferably with a soft bristle surgical brush) for 5 minutes, then rinsed.
After the hot spots have been removed, the second step is to shower with soap and water. Scrub the entire body, including the hair and nails. After the shower, monitor again; if any contamination remains, again spot clean and shower. If the hair is contaminated, shampoo it several times.
If it becomes apparent that shampooing has not removed the radioactive material, clip the hair as close to the scalp as necessary to remove the radioactive material.
If areas become tender from excessive washing, it may be necessary to restore some of the skin oils by gently rubbing in a small amount of lanolin or ordinary hand or face cream. This will soothe the skin and prepare it for further decontamination if additional steps are necessary. Decontamination should be continued until the radioactivity has been reduced to the safe level set by the responsible Medical Department