Personal decontamination for radiation exposure in a hospital setting follows specific protocols to minimize contamination and prevent the spread of radioactive materials. The goal is to safely remove any radioactive substances from the person while protecting healthcare workers and ensuring the individual’s well-being.

Here’s a step-by-step procedure for personal decontamination after radiation exposure in a hospital:

1. Immediate Assessment and Isolation

Triage the patient: Assess the individual for life-threatening injuries first. Stabilize life-threatening conditions before focusing on decontamination.
Isolate the contaminated individual: Move the patient to a designated decontamination area, typically a hospital’s radiation emergency room or another isolated section to prevent contamination of other areas.
Limit spread: Use plastic sheets, absorbent pads, or other barriers to confine the contamination to one area.

2. Protective Measures for Healthcare Workers

Personal Protective Equipment (PPE): All healthcare personnel involved in the decontamination process must wear appropriate PPE, including:
- Full-body gown or coveralls
- Disposable gloves
- Face shields or goggles
- Respiratory protection, depending on the level of airborne contamination risk
Dosimetry: Staff should wear radiation dosimeters to monitor exposure levels.

3. Initial Survey and Monitoring

Radiation survey: Use portable radiation detectors (e.g., Geiger-Mueller counters or scintillation detectors) to assess the level of external contamination on the patient’s body, focusing on areas like the hands, face, hair, and clothing.
Document contamination: Record the extent and areas of contamination to guide the decontamination process.

4. Remove Contaminated Clothing

Careful removal of clothing: Clothing removal can eliminate up to 90% of radioactive contamination.
- Avoid pulling contaminated clothing over the head; instead, cut clothing away from the body.
- Handle the clothing as little as possible and place it in a designated, sealed container for radioactive waste disposal.
Footwear and jewelry: Remove shoes, watches, and jewelry, which may harbor radioactive material.

5. External Decontamination (Skin and Hair)

Gentle washing: Wash contaminated skin areas using mild soap and lukewarm water.
- Avoid scrubbing, as it may cause skin abrasions that allow radioactive material to penetrate deeper.
- Start with the least contaminated areas and move towards more contaminated zones.
Hair decontamination: Shampoo the hair thoroughly but gently, avoiding vigorous scrubbing.
- If necessary, use water-resistant earplugs to prevent radioactive water from entering the ear canal.
Monitor for residual contamination: Recheck the patient with radiation detectors after washing, repeating the process until contamination levels are acceptable.

6. Eye and Mucosal Decontamination

Eye irrigation: If radioactive material has entered the eyes, irrigate the eyes with sterile saline solution or clean water.
- Gently flush from the inner corner outward to avoid spreading contamination across the face.
Mouth and nasal decontamination: If contamination is suspected in the mouth or nasal passages, have the patient rinse their mouth with water and gently blow their nose. Avoid aggressive actions that may cause inhalation or further spread of radioactive material.

7. Internal Contamination Consideration

Internal contamination assessment: If there’s a possibility that the patient has ingested, inhaled, or absorbed radioactive material, further medical evaluation is necessary.
Treatment of internal contamination: Specific treatments, such as the administration of potassium iodide (KI) for radioactive iodine exposure, Prussian blue for cesium or thallium exposure, or chelating agents like DTPA for plutonium, americium, or curium exposure, may be administered depending on the radionuclide involved.

8. Handling Waste and Contaminated Materials

Proper disposal: All contaminated clothing, towels, and materials used during decontamination should be treated as radioactive waste and stored in clearly labeled, sealed containers for proper disposal.
Room decontamination: After the procedure, decontaminate the area where decontamination took place, including equipment and surfaces, following hospital radiation safety protocols.

9. Post-Decontamination Monitoring

Final survey: Perform a comprehensive survey of the patient’s body and clothing to ensure that contamination has been reduced to safe levels.
Medical follow-up: Depending on the level of exposure, the patient may require monitoring for radiation sickness, which includes symptoms like nausea, vomiting, fatigue, and changes in blood cell counts.

10. Documentation and Reporting

Record-keeping: Document all decontamination procedures, contamination levels before and after decontamination, and any treatment provided.
Radiation safety officer (RSO): Notify the hospital’s RSO and any relevant health authorities about the exposure event for proper reporting and management.

Key Points to Consider:

Patient comfort: Ensure the process is done gently and as comfortably as possible to avoid panic or distress.
Secondary contamination: Avoid cross-contamination by frequently changing gloves and disposing of used materials properly.

By following these steps, hospitals can effectively manage radiation exposure incidents, minimizing harm to patients, staff, and the environment.