External Decontamination for Radiation Exposure

Updated: Jul 30, 2018
  • Author: Lars J Grimm, MD, MHS; Chief Editor: Zygmunt F Dembek, PhD, MS, MPH, LHD  more...
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Gross and Secondary Decontamination

Gross decontamination is as follows [1, 2, 3, 4] :

  • Remove all patient clothing

  • Full-body irrigation

  • Emergent medical care takes priority over decontamination

  • The image below depicts gross decontamination

    Decontamination. Image courtesy of Wikimedia. Decontamination. Image courtesy of Wikimedia.

Secondary decontamination is as follows [1] :

  • Head-to-toe survey with radiation-detection device

  • Skin: Irrigation and cleansing of radioactive areas with mild soap and water

  • Mouth: Swab samples from oral cavity; remove dentures and foreign bodies; brush teeth, gums, and tongue; copious irrigation

  • Nose: Swab nares, blow nose, copious irrigation

  • Eyes: Anesthetize eye, swab conjunctiva, copious irrigation

  • Ears: Swab external canal; examine tympanic membrane for perforation, if intact then irrigate

  • Open wounds: Swab wounds, remove foreign bodies, copious irrigation, cover with waterproof dressing

  • Repeat survey with radiation-detection device, and irrigate if above threshold

In March 2015, filgrastim (Neupogen) was approved by the US Food and Drug Administration (FDA) to increase survival in patients acutely exposed to myelosuppressive doses of radiation (suspected or confirmed exposure to radiation >2 Gy). [5, 6, 7]

For more information on radiation injuries and decontamination, see the Medscape topics CBRNE - Radiation Emergencies and Radiation-Exposure Injuries.