The sequence and priority of the emergency action plan may vary with the magnitude
and type of accidental conditions and their severity. An initial early assessment of the
incident should focus, first, on treatment of life-threatening physical injuries and,
second, on the radioactive contamination involved. Minor injuries should be treated
A rapid estimate of the amount of internal contamination by plutonium or other
alpha-emitters may not be possible. If a significant intake (meaning one that exceeds
10 times the ALI) is suspected, medical staff should proceed with decorporation
therapy after first treating major injuries.
5.10.3 Responsibilities for Management of Internal Contamination
Responsibilities should be assigned for action in response to an accidental internal
plutonium contamination. The affected worker has the responsibility to inform the
health physicist, RCT, or his immediate supervisor as soon as an intake is suspected.
(More broadly, all radiological workers have the responsibility to report conditions
that could lead to an intake to their immediate supervisor and/or the health physics
organization.) The health physicist or RCT should make an initial survey of the
extent of the contamination and immediately contact his supervisor and, when action
levels are exceeded, contact a member of the medical staff. He should continue to
provide monitoring and radiation safety support to the medical staff and supervisors
during the management of the contamination incident. Care should be taken to limit
the spread of radioactive contamination.
The health physicist should immediately begin to gather data on the time and extent
of the incident. Contamination survey results should be recorded. Radionuclide
identity, chemical form, and solubility classification should be determined. Nasal
smears should be obtained immediately if an intake by inhalation is suspected. When
action levels are exceeded, all urine and feces should be collected and labeled for
analysis. Decontamination should proceed with the assistance of the medical staff.
Contaminated clothing and other objects should be saved for later analysis.
5.10.4 Immediate Medical Care
The medical staff should provide immediate emergency medical care for serious
injuries to preserve the life and well-being of the affected worker. Minor injuries may
await medical treatment until after an initial radiation survey is completed and the
spread of contamination is controlled. However, the individual should be removed
from the contaminated radiation area as soon as possible. Chemical contamination
and acids should be washed immediately from the skin to prevent serious burns and