Managing Radiation Emergencies
Guidance for Hospital Medical Management
Treatment of Internal Contamination
Once radioactive materials cross cell membranes, they are said to be incorporated. Incorporation is a time-dependent, physiological phenomenon related to both the physical and chemical natures of the contaminant. Incorporation can be quite rapid, occurring in minutes, or it can take days to months. Thus, time can be critical and prevention of uptake is urgent. Several methods of preventing uptake (e.g., catharsis, gastric lavage) might be applicable and can be prescribed by a physician. Some of the medications or preparations used in decorporation might not be available locally and should be stocked when a decontamination station is being planned and equipped. Examples of specific agents used for selected radionuclides can be seen in the table below. Expert guidance is available from NCRP 65, poison control centers, or call REAC/TS (865-576-3131) or the 24-hour emergency number (865-576-1005).
If internal contamination is suspected or has occurred, the physician or radiation safety officer should request samples of urine, feces, vomitus, wound secretion, etc. Whole-body counting and radioassay can help evaluate the magnitude of the problem and the effect of any treatment. The contaminated patient admitted with an airway or endotracheal tube must be considered to be internally contaminated.
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