Pediatric emergency medicine trisk 1988 1988
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facilities should try to preserve their valuable resources for patients who need
lifesaving medical treatment. Plans may need to be made to refer uninjured
persons and persons with minor injuries to other facilities. It may be prudent to
prevent hospitals from becoming decontamination centers.
Several simple steps can be taken to treat internal contamination
nonspecifically. The goals of treatment are to prevent the absorption of the
radionuclide and to enhance its excretion. Safe techniques that can prevent the
absorption of radionuclides include the administration of activated charcoal and
alginate-containing antacids. Enhanced excretion can be achieved by hydration
and administration of a purgative. Specific treatment of internal contamination
depends on the radionuclide, its chemical and physical forms, and the route of
internal contamination. Recommendations for many specific treatments can be
found in the NCRP Report 161, titled Management of Persons Contaminated with
Radionuclides. This report should be available in every hospital ED and can be
downloaded for free from the NCRP website ( ) ( Fig.
90.14 ). Initiation of treatments that entail some risk to the patient (e.g.,
pulmonary lavage, intravenous chelating agents) should be undertaken only after
consultation with experts. The benefits of the treatment should be significantly
greater than the risks.
