208
17 Medical Response
• Personal protective equipment—use of appropriate PPE will help to keep
contamination from entering the body as well as reducing dose to the skin from
contamination. Wearing surgical gloves and gowns or other protective clothing
when entering the rooms of contaminated patients is one example of appropriate
protective gear. PPE should also include dosimetry where possible, to monitor
radiation exposure so that workers know how much exposure they have received.
– It is important to note that the hospital workers caring for Alexander Litvenenko
did not know that he had been poisoned with radioactivity and was shedding
radioactivity during the three weeks of his hospitalization. In spite of this,
there were no workers who received a significant intake of Po-210; the reason
for this is that the standard precautions taken with all patients suffering from
unknown illness (Universal Precautions, also known as Standard Precautions)
were sufficient to limit exposure to contamination.
There is more, though, that can be done beyond these. Contamination control,
for example, begins before the first patient arrives at the Emergency Room doors—
it begins with controlling contamination on the patients (if their medical condition
permits) before they are brought to the Emergency Room and with setting up the
Emergency Room to receive contaminated patients as discussed in the first part of
this chapter.
In addition to the above, medical personnel should also consider taking additional
actions to help control the spread of contamination. These include:
• Removing protective clothing upon leaving one room and donning new and
uncontaminated protective gear prior to entering the next.
• Establishing contamination control areas at the entry to each patient’s room.
• Using proper procedures for entering and exiting the rooms of patients known to
be contaminated, as described in NCRP Report 161 [24].
17.5 Decorporation of Internal Radionuclides
Internal radioactivity can produce radiation dose for years or decades after intake.
Inhaled highly insoluble plutonium [20], for example, can remain in the lungs for
years, once it enters the bone it will remain for decades, as will americium, and
other actinide elements. But if a medication called Diethylenetriamine pentaacetate
(DTPA) is administered to the patient the amount of plutonium, americium, and other
actinide elements remaining in the body is reduced considerably with a corresponding
reduction in radiation dose over the years. Depending on the radionuclide in question
and the agent used this sort of therapy can reduce radiation exposure considerably—
the administration of potassium ferrocyanide (popularly known as Prussian blue) to
17 Medical Response
• Personal protective equipment—use of appropriate PPE will help to keep
contamination from entering the body as well as reducing dose to the skin from
contamination. Wearing surgical gloves and gowns or other protective clothing
when entering the rooms of contaminated patients is one example of appropriate
protective gear. PPE should also include dosimetry where possible, to monitor
radiation exposure so that workers know how much exposure they have received.
– It is important to note that the hospital workers caring for Alexander Litvenenko
did not know that he had been poisoned with radioactivity and was shedding
radioactivity during the three weeks of his hospitalization. In spite of this,
there were no workers who received a significant intake of Po-210; the reason
for this is that the standard precautions taken with all patients suffering from
unknown illness (Universal Precautions, also known as Standard Precautions)
were sufficient to limit exposure to contamination.
There is more, though, that can be done beyond these. Contamination control,
for example, begins before the first patient arrives at the Emergency Room doors—
it begins with controlling contamination on the patients (if their medical condition
permits) before they are brought to the Emergency Room and with setting up the
Emergency Room to receive contaminated patients as discussed in the first part of
this chapter.
In addition to the above, medical personnel should also consider taking additional
actions to help control the spread of contamination. These include:
• Removing protective clothing upon leaving one room and donning new and
uncontaminated protective gear prior to entering the next.
• Establishing contamination control areas at the entry to each patient’s room.
• Using proper procedures for entering and exiting the rooms of patients known to
be contaminated, as described in NCRP Report 161 [24].
17.5 Decorporation of Internal Radionuclides
Internal radioactivity can produce radiation dose for years or decades after intake.
Inhaled highly insoluble plutonium [20], for example, can remain in the lungs for
years, once it enters the bone it will remain for decades, as will americium, and
other actinide elements. But if a medication called Diethylenetriamine pentaacetate
(DTPA) is administered to the patient the amount of plutonium, americium, and other
actinide elements remaining in the body is reduced considerably with a corresponding
reduction in radiation dose over the years. Depending on the radionuclide in question
and the agent used this sort of therapy can reduce radiation exposure considerably—
the administration of potassium ferrocyanide (popularly known as Prussian blue) to