(2) Triage C: Key Principles of Contamination Containment: (a) Hospitals should use contamination containment processes with which the staff are familiar and should apply universal precautions and isolation techniques. Staff should use universal precautions when making direct contact with contaminated patients. (b) Staff should double bag, tie, seal, and label any contaminated material in plastic bags to be stored in a predetermined, secure storage area (labeling should include appropriate identifying information, e.g., patient name, hospital number, date, and time of day). The bagged items should be removed from the patient treatment area as soon as possible to eliminate any further contamination. (c) In a mass casualty emergency, staff should dispose of the water used to decontaminate patients via the sewer system. (It is unlikely hospitals will have an effective water-holding system for any mass casualty event.) The EPA has issued guidance to the effect that: "Contaminated runoff should be avoided whenever possible, but should not impede necessary and appropriate actions to protect human life and health. Once the victims are removed and safe from further harm and the site is secured and stable, the first responders should be doing everything reasonable to prevent further migration of contamination into the environment." (EPA 550-F-00-009, July 2000; www.epa.gov/ceppo). (d) Hospitals should prepare personnel to rapidly identify and notify pre-identified resources who can provide assistance. (e) Hospitals should use appropriately trained staff with properly maintained and tested radiation survey meters to determine contamination. (f) Hospitals should consider purchasing personal dosimeters for rapid response teams or others who might be subject to contact with contaminated patients or materials. Personal dosimeter data for hospital staff provide exposure documentation after the fact. (g) Hospital staff should remember that it may take time before a disaster is recognized as a radiological incident and assume contamination is present; however, the first time radioactive contamination is clearly identified, all staff and first responders must be notified as soon as possible