Due to the absence of a centralized national storage facility for high level waste, nuclear power plants must keep their spent fuel on site. Spent fuel is kept in a large pool of boronated water. The water and boron act to absorb any neutron radiation that may be emitted from the fuel. The pool has a bridge across the middle of it to facilitate moving spent fuel.
Two fuel handlers are performing maintainance on the equipment. They are both wearing full protective equipment. As one handler is walking along the side of the pool, he trips on the equipment tracks, hits his head on the bridge and falls into the pool unconcious.
The other handler immediately reaches in and pulls the victim to the surface. After 2 minutes of struggling, he manages to pull the victim out of the pool. The victim coughs up about 100 cc of pool water. He is breathing, but remains unconcious. Both handlers are thoroughly soaked from the contaminated pool water. The concious handler then calls the the control room. The control room then notifies the plant first aid team, the local paramedics and the emergency room at which you are a physician.
The first aid team arrives within several minutes. The concious fuel handler is taken to the decontamination area of the plant. The first aid team determines that the victim is breathing and has a strong regular pulse. There is a 3 cm laceration above the left eye with profuse venous bleeding. While keeping the cervical spine stable, the victim is cut out of his protective clothing leaving him only in his underwear.
The paramedics arrive, apply cervical stabilization, wrap the patient in clean sheets and transport him on a backboard and gourney to the ambulance. Radiation technicians notifiy the paramedics that the victim has low level contamination of between 5,000 and 10,000 counts per minute over his entire body.
The paramedics contact your emergency room and report on the status of the victim. He is a 32 year old male with no previous medical or surgical history. He is beginning to regain conciousness. Pupils are equally round and reactive to light. His pulse is 86 beats per minute; respirations 24 per minute, and blood pressure 142/94 mm Hg. The wound is now oozing a small amount of blood. The paramedics report that they will arrive in 15 minutes.
By this time the nurses and emergency room staff have set up your REA for the arrival of a contaminated patient. All necessary personnel are in appropriate attire.