This is received when the radioactive material is external to the body. Emitted radiation travels through space and irradiates the body; however, the radioactive material remains external to the body. Therefore, if one moves away from the source of radiation, the amount of radiation the body is receiving decreases.

Internal radiation hazard, or radioactive contamination as it is often referred to, arises from radioactive material entering the body. The three main routes of entering the body are inhalation, ingestion, and injection. Once inside the body, the radiation from the contamination irradiates the internal organs. Internal problems vary with the type of radiation that is emitted. If a substance is undergoing alpha decay in the gut, then areas of close contact are being exposed to high-energy radiation that will result in immediate cell death. The half-life of the radioactive substance is extremely important, as some isotopes may linger in the body from a time frame of hours to years [6].

The major difference between the two types of radiation hazard is that in one circumstance, getting a distance away from it can considerably reduce one’s radiation dose. With radioactive contamination, the fact that the source is internal, distance from the source would make no difference. To prevent ingestion/inhalation, no eating/drinking or smoking should be allowed until after an individual has left the area and has been decontaminated.

Protective equipment, protocols and procedures should be used for emergency services personnel to eliminate/minimize radioactive contamination. Personal protective equipment provides a physical barrier that allows respiratory protection, and protective clothing that prevents skin contamination. The emergency planning zone for a nuclear reactor incident involves two zones:

It is imperative that life-saving tasks be undertaken before moving the casualty. Once completed, then transportation of these casualties can be divided into two groups: those without radiation exposure and those with radiation exposure. Patients without exposure to radiation require no special transport consideration. Those exposed to radiation require removal of contaminated external clothing and covering with two large sheets. Care must be taken to decontaminate the evacuation vehicle.

An initial response team will usually evacuate the casualty to the initial treatment area where the medical team will be given a status on the type of radiation level of contamination [7]. The casualty is then taken through a decontamination procedure in a “dirty area”, removing all garments and being cleansed with copious amounts of water.

Once this has been achieved, the casualty is then rechecked for radiation. If contaminants still exist, the casualty is further washed with copious amounts of water and a detergent, and the process is repeated. If radiation-free, the individual is then taken to the “clean area” where he/she can undergo further medical treatment.

Treatment should be extremely limited. For example, intravenous cannulation may introduce radioactive products into the general circulation; intubation may cause radioactive substances to be forced into the upper airways and lung parenchymal tissues. The inhalation of these substances will cause substantial internal radiation, as it is extremely difficult to remove once inhaled.