Once the patient is stabilized and the managing physician is reasonably assured that the patient is out of immediate danger, a total body survey of the patient should be performed. Areas of contamination should be documented with both the location and the amount of activity. The back of the patient should not be neglected. The emergency room staff in the REA can have their gloves and gowns surveyed as well at this time. Should contamination be present, a change of gloves or the removal of the outer gown should be performed.
Once the areas of contamination are documented, specimens should be obtained. Cotton swabs of the eyes, ears, nose, mouth, and any wounds should be obtained. Areas of debrieded tissue and bandages should also be saved as specimens. These can be analyzed at a later time to determine if there is the potential of internal contamination. The characteristic radiation signature of various isotopes can be determined and the chemical composition of the contaminants determined.
The importance of obtaining specimens cannot be overstated. The identification of internal contamination is faciliated considerably by specimen analysis. It is important to maintain a legal document of the areas affected, and the progress that occurs during decontamination efforts.