Radiation exposure and safety
Use alongside local Trust SOPs and UKHSA/GOV.UK public guidance. This section summarises ED priorities for ionising‑radiation incidents and contaminated patients: staff and patient safety, triage and resuscitation, practical decontamination, recognition and early management of acute radiation effects, initial investigations and escalation to specialist agencies (UKHSA, NPIS, local Radiation Protection Officer).
At a glance (ED priorities)
- Staff safety first: wear appropriate PPE, carry a personal radiation meter/dosimeter, and follow local dose limits; do not become a secondary casualty.
- Life‑saving care first: ABCDE and major haemorrhage control take priority; do not delay CPR or airway management to decontaminate.
- Rapid containment: remove patient clothing (removes ≈90% of external contamination), bag and seal items, and initiate showering if safe.
- Decontamination checklist for patients/first responders: remove outer clothing, bag and seal personal items, shower with soap and warm water (do not use conditioner), then label and bag contaminated waste.
- Escalate early: contact local UKHSA health protection team and NPIS for isotope identification, decorporation advice and public‑health measures.
Key concepts
Exposure versus contamination
- Exposure (irradiation): the patient has been exposed to penetrating radiation (X‑rays, gamma); there may be no radioactive material on the patient.
- Contamination: radioactive material (particles or liquid) is present on skin, hair, clothing or internally following inhalation/ingestion; external contamination can usually be removed, internal contamination requires specialist decorporation/chelation.