Radioactive Decontamination Introduction Radioactive Decontamination continue 

Introduction The Geisinger-Bloomsburg Hospital is a facility that has been determined by the Pennsylvania Emergency Management Agency (PEMA) to be able to provide medical services to contaminated members of the general public in the event of a nuclear power plant incident. continue 

Introduction A call comes into the emergency department about an accident involving a radiological spill on Interstate 80. The ambulance has brought the patient to the hospital, where he was transferred into the decontamination room. continue 

Introduction You have surveyed Dave, the patient, and found radiological contamination on a few areas of his body, including his ear canal, elbow, and knee. As a health physics technician, your job is to decontaminate these areas according to the correct protocol. continue 

Challenge 1 You need supplies to decontaminate the patient. Which supplies should you grab? Select the correct choice White and yellow herculite,lead trash barrel, radiological survey equipment, dosimeters, sampling and decontamination supplies White and yellow herculite, rope, signs, rolls of masking tape to cordon off the restricted area, dosimeters, lead trash barrel, sampling and decontamination supplies White and yellow herculite, rope, signs, masking tape, lead trash barrel, radiological survey equipment, dosimeters, sampling and decontamination supplies

Consequence 1a continue  You were supposed to cordon the area, but didn’t have the supplies you needed! Now some staff and onlookers accidently entered the restricted area and created a whole new problem by tracking contamination throughout the hospital. Many more people ended up getting contaminated. What a mess! The entire Health Physics team had to be called in for extra help. They had to figure out exactly who got exposed and where they were in the hospital in order to stop them from spreading it further. continue 

Consequence 1b continue  Oh no! You did not get the Geiger meter so you couldn't monitor the contamination. Now I touched a hot area on Dave and got contaminated! Without the meter, I had no idea of my exposure or whether I had contaminated something else by touching it! Other members of Health Physics had to be called in when they shouldn’t have had to be there at all. continue 

Challenge 2 Now that you have your supplies ready, you need to decontaminate the wound on Dave’s knee. This may be a little tricky. How should you do this? Isolate the area with a steri-drape and irrigate the wound with sterile saline. Isolate the area with a steri-drape and irrigate both the wound and adjacent skin with sterile saline. Irrigate both the wound and adjacent skin with sterile saline.

Consequence 2a continue  Oh no! There must have been contamination on the skin around the wound too because Dave touched that area and contaminated his hand. Now he contaminated more of his body and exposed himself to more radiation. You had an extra area to decontaminate and put a glove on Dave to prevent his hands from touching anything else. What a disaster! continue 

Consequence 2b continue  Oh no! Water from irrigating the wound dripped down onto the floor. You stepped on the area and tracked radiation around the decontamination room. You lost your shoes as a result and had to call in the other Health Physics staff to come in to contain the area. This resulted in so much unnecessary contamination and put other people at risk of exposure. continue 

Challenge 3 Now you need to decontaminate the inside of Dave’s ear. How should you do this? Use wetted swabs to clean the area surrounding his ear and then proceed with the inside ear. Use wetted swabs to clean the inside and then proceed with the area surrounding his ear. Use wetted swabs to clean the inside of his ear only.

Consequence 3a continue  Oh no! There must have been contamination on the outside of his ear too. Dave spread it back into his ear and contaminated his hand! Now he contaminated more of his body and exposed himself to more radiation. You had an extra area to decontaminate and had to put a glove on Dave to prevent his contaminated hands from touching anything else. What a disaster! continue 

Consequence 3b continue  Oh no! You re-contaminated Dave’s ear canal when you cleaned the area outside of his ear. Dave spread it back into his ear and contaminated his hand! Now he contaminated more of his body and exposed himself to more radiation. Then you had to decontaminate an extra area and put a glove on Dave’s hand to prevent him from touching anything else. What a disaster! continue 

Challenge 4 Phew! You got the wound decontaminated. You need to get the contamination off of the skin on his elbow, though. How should you do this? Wash the contaminated area with warm water/soap and blot with a gauze pad. Mark the area of skin contamination. Wash contaminated area with warm water/soap and blot with a gauze pad. Mark the area of skin contamination. Wash contaminated area with warm water/soap and scrub vigorously with a gauze pad.

Consequence 4a continue  Oh no! You didn’t mark the area! You spread the contamination to other parts of the skin when you were washing it. You contaminated more of Dave’s arm and exposed him to more radiation On top of that, you had an extra area of skin to decontaminate that was not originally contaminated. What a disaster! continue 

Consequence 4b continue  Oh no! While you were scrubbing, you abraded the skin with the gauze and spread contamination inside the abrasion! Now you have contaminated cut to deal with! Since it was bleeding, you called the nurse to help and put her at risk for exposure. She had to completely dress in the protective suit before even coming into the room. On top of that, you had to decontaminate an extra area and exposed Dave to more radiation. What a disaster! continue 

Challenge 5 What an ordeal! You got everything decontaminated the best that you could. You need to figure out how to get rid of all of this radioactive waste. How should you do this? Secure the waste generated by treating Dave in a locked area. Store the waste in a trash can until it is transferred to the originating facility. Store the waste in a lead-lined trash can and leave it in the Emergency Department until it is transferred to the originating facility. Secure the waste generated by treating Dave in a locked area. Store the waste in a lead-lined trash can until it is transferred to the originating facility

Consequence 5a continue  Oh no! The Radiation Safety Officer found the receptacle unshielded and demanded to know who stored the waste like this because anyone standing near the receptacle was unknowingly exposed to radiation. An incident report was filed naming you as the responsible person for the mistake and became a permanent part of your personnel file. continue 

Consequence 5b continue  Oh no! The Radiation Safety Officer found the receptacle in the Emergency Department and demanded to know who left the waste in an unlocked area because a few staff opened the receptacle and unknowingly exposed themselves to radiation. An incident report was filed naming you as the responsible person for the mistake and became a permanent part of your personnel file. continue 

Successful end of the scenario Dave has been successfully decontaminated and cleared by Health Physics personnel to exit the Radiation Emergency Area for discharge or additional medical treatment as needed. Contamination was confined to Radiation Emergency Area. Health Physics has properly stored radioactive waste until it is transferred to the originating facility.

Bridge Slide End if the wrong choice is made In the event of any type of radioactive disaster you will need to make quick and careful decisions. Your decisions will determine if the radioactive event is contained or spread throughout the hospital. continue 

References http://upload.wikimedia.org/wikipedia/commons/7/7c/Alcatel_gowning_room_2.jpg Retrieved on 4/10/15 http://upload.wikimedia.org/wikipedia/commons/4/4b/Trash_can_line.jpg Retrieved on 4/19/15