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.

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.