There are several common radionuclides which are seen in disaster settings.
An elementary knowledge of basic radiation physics is helpful.
Most victims will follow a predictable course of symptoms in the Phases of Acute Radiation Syndrome.
Medical personal managing victims of radiation exposure will rarely have any significant occupational exposure to radiation.
Irradiation alone will never result in contamination. Victims who have been irradiated only will need NO protective measures taken.
Shielding with conventional sheilds is rarely usefull: these do not provide protection from gamma-radiation.
EMS decontamination of victims should be limited to removal of clothing and shoes and wrapping the victim in several bed sheets.
Isolation of contamination is the most important step. Placing the contaminated area in a plastic bag will greatly decrease the risk of contamination.
Open wounds should be decontaminated first: they are the site of most rapid absorption.
All attempts should be made to preserve intact skin. Desquamation with bleach, pottasium permanganate, or tape stripping should be discouraged.
Self decontamination should be encouraged.
Consider using dry removal (beating/brushing/vacuuming) or waterless cleansers (hand cleaner) before water decontamination. This can significantly accellerate the decontamination process.
Decontamination can be stopped when no additional contaminants are being removed.
If unable to decontaminate immediately, the involved body portion is isolated, and decontamination chan be scheduled for later.
For inhaled contamination, whole lung lavage under anesthesia may be helpful.
For ingested contaminants, gastric lavage may be helpful. Activated charcoal is likely to be ineffective.
Because of dilution effect, the decontamination liquid can be disposed of into the regular wastewater pathway if need be. Storage in tanks is also reasonable.
The effect of systemic irradiation is best followed by serial absolute lymphocyte counts. The lymphocyte count is usually depressed after 48 hours in significant exposures.