ПРОВЕДЕНИЕ САНИТАРНОЙ ОБРАБОТКИ НА ЭТАПАХ ОКАЗАНИЯ МЕДИЦИНСКОЙ ПОМОЩИ ПОСТРАДАВШИМ В РАДИАЦИОННОЙ АВАРИИ

Abstract

Purpose: To summarize and analyze the results of research and practical recommendations on the decontamination of victims in the event of radiation accidents, including taking into account the authors’ experience gained in the initial period of the Chernobyl accident (April – August 1986) and in other local radiation accidents (incidents), as well as during emergency exercises.
 Results: The indications for carrying out decontamination and the technique of its implementation were considered, a comparative assessment of the effectiveness of skin decontamination agents was presented. Recommendations were formulated for determining the priority (urgency) of carrying out decontamination, depending on the level of external radioactive contamination of the victims. Criteria, rules and methods for carrying out decontamination were proposed for use in relation to the practice of medical and hygienic measures at the stages of medical evacuation (accident site, enterprise health center, enterprise sanitary inspection department, triage site, hospital admission department). The features of decontamination of victims with combined radiation injuries and contaminated wounds (burns) were considered, issues of ensuring the radiation safety of medical personnel who provide assistance to victims are touched upon.
 Conclusion: Timely and correctly performed decontamination reduces the exposure of the skin, prevents the entry of radioactive substances into the body and the transfer (spread) of radioactive substances to the subsequent stages of medical evacuation. The main criteria for the urgency (priority) of carrying out decontamination are the levels of radioactive contamination of the skin, contamination nature (radionuclide composition, physicochemical form, etc.) and the presence of victim’s skin lesions (wounds, burns). Decontamination of victims with high levels of radioactive contamination should be considered as a part of the first and subsequent emergency health care and should be carried out as prescribed or with the direct participation of a healthcare professional. At the stages of medical evacuation, decontamination can be carried out if the victim’s condition is stabilized. In the case of a serious condition of the victim, the priority is evacuation to a hospital, while in the prehospital period, as a rule, only partial decontamination of skin areas with high levels of contamination can be carried out. The procedure and rules for decontamination, including the use of skin decontaminating agents, should be reflected in the action plans of the personnel of radiation hazardous enterprises and the plans for medical support of medical units of the FMBA of Russia.