Bandage the wound and send the patient to the emergency room for wound management.
Persistant contamination can be handled in several ways. The easiest is to bandage the area, and if time permits, allow natural perspiration and/or wound drainage to help clean the area. This is often useful in areas of intact skin that may have contamination located in the pores. If the contamination is in the wound, it may be in the form of an embedded foreign body or located within crushed tissue. In the case of a foreign body, the embedded particle, if large enough to see, can be removed using a forceps. If it is too small to see, vigorous irrigation with a syringe and normal saline will often remove it.
Contamination that has been crushed into a wound may not be easily removed. After thoroughly cleaning the wound and removal of any crushed and nonviable tissue, the area should be resurveyed. This will often result in removing the contamination from the wound. If contamination persists, an evaluation of the remaining amount and the isotope involved is needed to make the medical decision to continue debridement of tissue or to leave the contamination in place.
You agree to see the patient in the emergency room. At this point, you instruct your staff to: