MAJOR INCIDENTAdministrative and Legal Issues 4634 A ‘white powder’-type incident should be dealt with by external decontami-
nation in an outdoor area by staff wearing full PPE.
(i) All patients after decontamination and initial management must
be observed until the nature of the threat is established by the
appropriate forensic scientific services involved.
Radiological incident
The two forms of radioactivity most likely to be encountered in a radiological
incident are and particles.
1 particles consist of two neutrons and two protons, are able to travel short
distances and are unable to penetrate human skin.
(i) emitters are thus only harmful when inhaled, ingested or
absorbed (e.g. through an open wound).
2 particles are high speed electrons or positrons, and are able to penetrate
human tissue to the level of the dermis.
(i) Prolonged exposure to bare skin may result in a ‘beta burn’, but
clothing and or PPE provide some degree of protection.
(ii) Similarly, emitters are thus only harmful when inhaled,
ingested or absorbed.
3 Two types of radiation-induced injury can occur:
(i) External irradiation, where the patient has been exposed to
radiation from an external source, such as a nuclear blast.
Patients who have been externally irradiated are not radioactive
and do not require decontamination.
(ii) Contact with radiological materials, where the patient has
become contaminated externally, internally, or both, with
radioactive particles. These particles continue to emit or
ionizing radiation leading to cellular radiation injury if not
removed.
4 Patients requiring urgent treatment are taken to the nearest major ED.
(i) Decontamination is required for any patient from a radiological
incident with contact with radiological material.
(ii) Patients must be quarantined to an appropriate outdoor area for
assessment and decontamination.
(iii) Minimum PPE consists of a cap, eye protection, facemask, gown
and shoe covering.
(iv) External decontamination is only required for patients who have
radioactive matter deposited on their skin or clothing.
(v) Management of internal decontamination is highly specialized.
Expert advice should be sought from the from:
(a) Poisons Information Centre on 13 11 26 (Australia), and in
New Zealand on 03 479 7248 (or 0800 764 766 within New
Zealand only)