Wang Tao,Li Rong,Wang Junping,et al.Discussion on decorporation strategies for internal radionuclides contamination during medical rescue in the nuclear and radiological emergency[J].Chinese Journal of Radiological Medicine and Protection,2024,44(5):404-409
Discussion on decorporation strategies for internal radionuclides contamination during medical rescue in the nuclear and radiological emergency
Received:September 04, 2023  
DOI:10.3760/cma.j.cn112271-20230904-00074
KeyWords:Nuclear and radiation emergency  Internal contamination of radionuclides  Medical rescue  Decorporation  Intervention level  National standard
FundProject:军队后勤科研项目(ZLJ22J020);陆军军医大学教育训练改革研究课题(2022B07)
Author NameAffiliation
Wang Tao State Key Laboratory of Trauma and Chemical Poisoning, Department of Anti-Radiation Medicine, Institute of Combined Injury, School of Preventive Military Medicine, Army Medical University(Third Military Medical University), Chongqing 400038, China 
Li Rong State Key Laboratory of Trauma and Chemical Poisoning, Department of Anti-Radiation Medicine, Institute of Combined Injury, School of Preventive Military Medicine, Army Medical University(Third Military Medical University), Chongqing 400038, China 
Wang Junping State Key Laboratory of Trauma and Chemical Poisoning, Department of Anti-Radiation Medicine, Institute of Combined Injury, School of Preventive Military Medicine, Army Medical University(Third Military Medical University), Chongqing 400038, China 
Ran Xinze State Key Laboratory of Trauma and Chemical Poisoning, Department of Anti-Radiation Medicine, Institute of Combined Injury, School of Preventive Military Medicine, Army Medical University(Third Military Medical University), Chongqing 400038, China 
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Abstract::
      Internal radionuclide contamination is one of important issue in medical response to nuclear or radiological emergency, which is the key of medical rescue. The medical uses of both preventive absorption drugs and acceleration elimination drugs are crucial means to control internal contamination. Usually the earlier use of such drugs could result in the better effects. Chinese national standards formulate that both preventive absorption of radionuclides and decorporation treatment should be applied as soon as possible in the event of there bing definite or highly suspected excessive intake of radionuclides. However, there are differences and inconsistencies in use of acceleration elimination drugs and strategies of acceleration elimination drugs between many national standards to some degree, easily causing confusion. Thus, this paper proposes the applicable time for applying decorporation drugs on the basis of comparison of the applicable scope and conditions between relevant national standards in combination with the related foreign advancements. It suggests that the ideas of decorporation strategies in both domestic on-site emergency response for nuclear accidents and abroad "urgent approach" are worth to advocate. According to the strategies, it is prudent and advisable to start decorporation treatment immediately even when radionuclide incorporation is just suspected, and treatment should be discontinued once internal dosimetric result are below intervention level. Meanwhile, the issues in need of attention in the application of the above-mentioned strategies for internal contamination are discussed.
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