External, wound and internal contamination, decontamination

Question 1

What is BUMEDINST 6470.10C

Answer 1

INITIAL MANAGEMENT OF IRRADIATED OR RADIOACTIVELY CONTAMINATED PERSONNEL

Question 2

What is the basic Philosophy regarding irradiated and contaminated personnel?

Answer 2

1. Use of radiation sources (NAVY and USMC) continues to expand.
2. Exposure rarely constitues a medical emergency.
3. If exposure occurs, care to reduce patient fears should be considered.

Question 3

What is the BUMEDINST 6470.10C used for?

Answer 3

Provide guidance to applicable Navy and Marine Corps commands for assessment, management and treatment of personnel.

Question 4

What takes priority over radiological considerations?

Answer 4

Treatment of life, limb or eyesight

Question 5

Enclosure 1 of BUMEDINST 6470.10C contains what?

Answer 5

List of references used within the instruction.

Question 6

What enclosures in BUMEDINST 6470.10C provides general guidance?

Answer 6

Enclosures 2 through 11

Question 7

What does Enclosure 12 of BUMEDINST 6470.10C cover?

Answer 7

Provides specific information and guidance for the isotopes most likely to be involved in a contaminating or exposure event in the Navy and Marine Corps.

Question 8

Enclosure 13 provides what guidance?

Answer 8

Guidance to commands on supplies for personnel decontamination.

Question 9

Which enclosure of BUMEDINST 6470.10C provides a contact list?

Answer 9

Enclosure 14

Question 10

An individual’s survival should not be in question unless?

Answer 10

(a) Dose to the entire body exceeds 200 rad (2Gy).
(b) Dose to a major segment of the body, e.g., head or thoracic region, is on the order of several hundred to thousands of rad.
(c) There is a combination of serious physical injury and dose, “combination injury.”

Question 11

What are the 4 ways a person might be exposed to ionizing Radiation?

Answer 11

External Irradiation, External Contamination, Wound Contamination, Internal Contamination.

Question 12

What are the stages of management of exposed persons?

Answer 12

(a) Medical Assessment.
(b) External contamination assessment.
(c) External decontamination.
(d) Patient evacuation and emergency care.
(e) Internal contamination assessment.

Question 13

What is the Clinical Decision Guidance?

Answer 13

(a) CDG is the maximum once in a lifetime intake of a radionuclide that would result in stochastic (25 rem) or non-stochastic (100 rad) effects prescribed for emergency situations. Physicians can use this to decide whether or not medical treatment is
necessary given the situation.
(b) Medical management.
(c) Follow-up medical care.

Question 14

What are some transportation of contaminated personnel and injured/contaminated personnel
considerations?

Answer 14

(a) Removing contaminated clothing generally removed 80-90% of contamination.

(b) Put patient in anti-C or wrap in a blanket to contain contamination.

(c) Protect ambulance or other mechanized transportation vehicle with herculite.

(d) Use established egress routes.

(e) Line egress routes with barriers e.g. rope, and herculite.

(f) Do not use contaminated vehicles or equipment for non-contaminated personnel
whenever possible.

(g). Use a “hot” stretcher to transport a patient to a RCA boundary, transfer to a clean stretcher for transport to hospital. Wrap patient in a blanket prior to transfer to “clean” stretcher.

Question 15

What would a fully functional decontamination facility have?

Answer 15

(a) Convenient equipment to wash both ambulatory and injured persons.

(b) Provisions for collecting contaminated waste water and other contaminated
materials.

(c) Floor plan that would permit convenient decontamination with minimal opportunity for cross contamination.

Question 16

List 5 documentation requirements for contaminated personnel (NAVMED forms)?

Answer 16

NAVMED 6470/1 Exposure to Ionizing Radiation
NAVMED 6470/10 External Monitoring
NAVMED 6470/11 Internal Monitoring
NAVMED 6470/13 Ionizing Radiation Medical Examination
NAVMED 6470/18 Personnel Monitoring and Decontamination
NAVMED 6470/19 Detailed Personnel Monitoring Survey

Question 17

Are any personnel to be denied medical care?

Answer 17

No personnel will ever be denied medical treatment.

Question 18

What is External Irradiation?

Answer 18

External irradiation is exposure to radiation that originates external to and usually not in direct contact with the body

Question 19

What is External Contamination?

Answer 19

An area of the body is considered to be externally contaminated if it contains in excess of 450μμCi of beta-gamma emitters by direct frisk or 50μμCi of alpha emitting contamination by direct frisk, i.e., 100ccpm of beta gamma emitting contamination as measured under the area of a DT-304 probe or 50 ccpm of alpha emitting contamination as measured under the area of a DT-681 probe.

Question 20

What is Wound Contamination?

Answer 20

Wound contamination is defined as radioactive material present inside or at the border of a break in the skin, increased potential for access to or retention in local tissues or, in rare instances, metabolized and deposited in target organs and tissues.

Question 21

NAVMED 6470/1

Answer 21

Exposure to Ionizing Radiation.

Question 22

NAVMED 6470/10

Answer 22

External monitoring.

Question 23

NAVMED 6470/11

Answer 23

Internal Monitoring.

Question 24

NAVMED 6470/13

Answer 24

Ionizing Radiation Medical Examination.

Question 25

NAVMED 6470/18

Answer 25

Personnel Monitoring and Decontamination.

Question 26

NAVMED 6470/19

Answer 26

Detailed Personnel Monitoring Survey.

Question 27

NAVMED 6470/20

Answer 27

Detailed Face Monitoring Survey

Question 28

NAVMED 6470/21

Answer 28

Detailed Hand Monitoring Survey.

Question 29

NAVMED 6470/22

Answer 29

General Contamination, Radiation, Airborne Survey.

Question 30

The planning guidelines that must be developed by each command having potential for exposure or contamination?

Answer 30

NCRP 161

Question 31

What is the primary goal of skin decontamination?

Answer 31

To reduce the risk of internal contamination