through   the   monitoring   station   to   determine whether  or  not  they  are  contaminated  with radioactive  material.  No  medical  treatment  should be  instituted  in  the  monitoring  station. Generally speaking, only personnel who have had  training  and  experience  as  members  of Radiological Safety and Radiological Decontami- nation teams or as members of Damage Control parties   should   be   assigned   to   the   monitoring station. However, those operating the monitoring station  should  have  a  basic  knowledge  of  and experience with radiac instruments. In this way, individuals can be used in either capacity should the need arise. After  the  patients  are  monitored,  they  are directed  or  taken  down  one  of  four  avenues, depending upon their physical conditions. Those requiring  immediate  lifesaving  measures  should be  assumed  to  be  contaminated  and  routed directly  through  the  monitoring  station  to  the  con- taminated  emergency  treatment  station.  Definitive monitoring  for  these  individuals  may  be  per- formed   at   the   decontamination   station.   Both treatment stations are set up much the same and should have only those facilities necessary for im- mediate lifesaving forms of treatment. Personnel working   in   these   stations   should   be   better versed  in  emergency  first-aid  care  than  those used  for  monitoring  and  for  rescue  teams,  and they need not be trained in radiation monitoring. After  emergency  lifesaving  procedures  have been  attended  to,  casualties  from  the  clean emergency  treatment  station  should  be  taken directly to the sorting station, and those from the contaminated treatment station should be taken to the decent amination station. Casualties  not  requiring  immediate  emergency treatment  should  be  taken  or  sent  from  the monitoring station directly to the sorting station or to the decent amination station, whichever is appropriate. The decontamination station should be  set  up  to  take,  hold,  and  dispose  of  all contaminated   clothing   and   to   supply   clean replacement clothing after the casualty has been decontaminated.  It  will  also  require  monitoring equipment, showering and washing facilities, and some   capability   for   surgical   (e.g.,   wound)   de- contamination  when  necessary. Of  the  personnel  available  to  the  treatment facility,  several  of  those  most  experienced  and knowledgeable  in  radiological  safety  and  radiation protection should be assigned supervisory jobs in the  decontamination  station.  Also,  it  is  highly desirable to have some personnel with operating room experience to decontaminate patients with traumatic injuries. It is not necessary for the other personnel  working  in  the  decontamination  station to  have  any  appreciable  training  or  experience other  than  that  given  when  the  medical  facility is  put  into  operation. DECONTAMINATION Early removal of radioactive “contamination” will  reduce  radiation  burns,  radiation  dosage,  and the  chances  of  inhaling  or  ingesting  radioactive material. There are two rules to be remembered in  the  removal  of  radioactive  contamination: 1.  Removal  of  radioactive  contamination  is best  accomplished  with  soap  and  water. 2.  Contamination  is  easily  spread,  so  “spot” cleaning   must   be   attended   to   before   general decontamination  procedures  are  started. Cotton swabs or gauze maybe used to decon- taminate  moist  areas,  gummed  tapes  to  de- contaminate dry areas. If after the first cleansing decontamination  is  inadequate,  the  process  should be  repeated  three  to  five  times;  then,  if contamination persists, the following preparation may  be  tried: . A mixture of 50 percent detergent and 50 percent  cornmeal  with  enough  water  added  to make a paste. This should be used with additional water  as  necessary  and  the  contaminated  area scrubbed  (preferably  with  a  soft  bristle  surgical brush)  for  5  minutes,  then  rinsed. After  the  hot  spots  have  been  removed,  the second  step  is  to  shower  with  soap  and  water. Scrub the entire body, including the hair and nails. After   the   shower,   monitor   again;   if   any   con- tamination  remains,  again  spot  clean  and  shower. If  the  hair  is  contaminated,  shampoo  it  several times. If it becomes apparent that shampooing has not  removed  the  radioactive  material,  clip  the  hair as close to the scalp as necessary to remove the radioactive  material. If   areas   become   tender   from   excessive washing, it may be necessary to restore some of the skin oils by gently rubbing in a small amount of  lanolin  or  ordinary  hand  or  face  cream.  This will  soothe  the  skin  and  prepare  it  for  further decontamination  if  additional  steps  are  necessary. Decontamination  should  be  continued  until  the radioactivity  has  been  reduced  to  the  “safe” level set by the responsible Medical Department 6-7