Treatment of Contaminated Personnel

[Ken Smith <ksmith@cats.ucsc.edu>]

Hi Jim, RadSafer's -

Funny you should mention that. At our latest ERT training this same issue 
arose. I haven't figured it out yet so I'd be very interested in any 
response your get. I was thinking of meeting with the local ambulance 
company, a hospital er representative and a member of the hospital nuclear 
medicine staff (hopefully to support my views) to discuss the issue.

I am of the opinion that from our University radiation activities here that 
no person could have on them a significant degree of contamination as to 
present a hazard to a first responder / EMT.  The responding personnel will 
all be following body substance isolation (BSI) protocols which are 
excellent in addressing contamination control.

As I think it stands now is that the ambulance company relies on the 
incident commander to declare if the person is de-coned or not. If the IC 
says yea - they transport, if the IC says no - they don't.

If we take the  the "minor" injury case (e.g. laceration to the leg) 
combined with radioactive contamination (e.g. 100 uCi of P-32) - It's not 
unreasonable to ask the responder to wash the contaminated area with water 
(and may be soap) for a few minutes -AFTER first aid has been rendered and 
their is no reason for a rapid transport (Code 2 in EMT lingo). This would 
be in the interest of ALARA for the patient.

If we were to take a "serious" medical situation - (e.g. unconscious 
person, heart attack) requiring a rapid transport (code 3) - any delay due 
in transport from attempts at decontamination are definitely NOT in the 
interest of the patient. ER personnel are trained (and rightfully so) never 
to put themselves in danger for the patients sake. My argument here is that 
the contamination (in this example 100 uCi of P-32) would not jeopardize 
the safety of the responding personnel, nor the er staff at the hospital.

I'm sure there would be some details to be worked out -spread of 
contamination for the clothes, minor contamination of the ambulance etc. 
But the goal would be to provide the best medical care for the patient and 
not to have a "perceived" but false risk stop this care.

Everyone please fell free to comment - I too would like to know what others 
are doing in this area.

Ken



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[]Ken Smith, Radiation Safety Officer

Environmental Health and Safety (EH&S)          voice: (831) 459-3911
University of California                                fax: (831) 459-3209
1156 High St.                                   e-mail: ksmith@cats.ucsc.edu
Santa Cruz, CA  95064                           web: www.ehs.ucsc.edu 
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