Page 221 - PJ MED OPS Handbook 8th Ed

Nuclear/radiation exposure can be divided into several different categories. In all cases, it is im-
portant to recognize that the patient themselves DO NOT become radioactive from exposure to
radiation (only neutron bombardment can do this, which is highly unlikely outside the core of a
nuclear reactor).

NOTE: In some cases, patients can become contaminated with dust or other material that is
radioactive. Once this is removed, the patient is cared for in the normal manner.

Radiation Protection for the Pararescueman:
Prevention of exposure depends on the type of threat in the area. In all cases, remember that radi-
ation protection is dependent on:
1. TIME OF EXPOSURE
2. DISTANCE FROM THE SOURCE
3. SHIELDING
To minimize personal risk, spend the shortest time in the contaminated area and stay as far from
the radiation source as possible. If able, keep some shielding (dirt, rocks, etc.) between you and
the radiation source. When working in an area contaminated with radioactive material in dust
or particulate form, wear the chemical protective mask to prevent inhalation of dust, and wear a
disposable over garment (MOPP suit works well) with hood and gloves. Discard this equipment in
the decontamination area.
• For a fixed radiation source that is not in particulate form:
○ It is best to limit exposure during rescue. Move the patient as rapidly as possible, keeping
as far away from the radiation source as possible.
• For a particulate radiation source with external contamination (dust/debris containing ra-
dioactive material is on the patient):
○ Wear a chemical protective mask with war filters in place to prevent inhalation of dust.
Wear an over garment that can be discarded after leaving the contaminated area. Decon-
taminate the patient by removing all clothing and washing off any dust.
• For a patient with internal contamination (radioactive material either ingested or driven
into wounds):
○ Wear protective clothing as noted above. Once out of the contaminated area, decontami-
nate the patient as above. Debride the wounds to remove any particulate matter, if possi-
ble. Cover the wounds and evac the patient, making sure the next echelon of medical care
knows that an internally contaminated patient is on the way. Patients who have inhaled,
or ingested radioactive material should be evacuated to the next echelon of care.

NOTE: Illness and death from radiation exposure occur based on dose. High radiation dose
will result in death from brain swelling with CNS injury, a lower dose will affect the G.I. system
and result in bloody diarrhea which can result in death, finally bone marrow suppression
which would result in longer-term complications over days to weeks to include infection,
bleeding and anemia.

Chapter 18. Weapons of Mass Destruction (WMD) n 219