Timing of Surgery and the Radiation Exposure + Contamination Algorithm
- Radiation exposure + trauma requiring emergency surgery
- Attempt to take surgical emergencies to the operating room
- Within 36-48 hours after high-dose radiation exposure
- Before decline of white blood cell and platelet counts
- Pre-operative administration of white cell cytokines may extend the time window for surgery.
- External contamination + trauma requiring emergency surgery
- Formal external decontamination is appropriate.
- When clinical urgency does not permit formal decontamination
- Removal of contaminated clothing can eliminate about 75-90% of external contamination.
- Traditional surgical skin prep will also help eliminate skin contamination.
- Avoid pre-op shaving, if possible, to help maintain an intact skin barrier against radioactive materials.
- Activate hospital emergency radiation response plans
- If contaminated patients are admitted to the hospital
- To ensure the health and safety of hospital staff and healthcare team
- To manage/minimize potential contamination of hospital spaces, including operating and radiology suites
- This algorithm and supporting material provide guidelines, not mandates.
- See REMM Radiation Effects on Blood Counts for details.