In the past few months, I've had the opportunity to take the AMA's Basic and Advanced Disaster Life Support classes. This is pretty eye opening stuff. Got to learn how to give smallpox immunizations! But I digress... Summarizing:

Nuclear contamination - This section was delivered by the department head of nuclear medicine. He also gets called out when there is an accident involving nuclear materials in the county. This apparently happens quite often, with traffic accidents being the main cause.

Since the course was mostly for medical personnel, it was stressed that there is no justification for refusing to treat a person contaminated with nuclear material. There is no contamination you can get on you that can injure you in that short a period of time. The trick is to keep it out of you - keep your N95 mask handy. The instructor also carries around a personal set of blockers - Kelp tablets for Iodine, Prussian Blue for Cesium, etc. Be prepared to decontaminate - If hazmat does it for you, you'll wind up naked, hopefully wrapped in a blanket.

Problem with chemical contamination is recognizing the symptoms and having something to counteract it. We learned how to give atropine autoinjectors for nerve agents, but if you don't have any, you may be out of luck. Some of the chems do unrepairable enzyme damage in minutes, so you have that long to treat. Blister agents require decontamination in minutes because the agents fix to tissues rapidly. No antidotes are available, though some things are under investigation, according to the book. No specific antidotes to irritant gasses

One issue we discussed was that hospitals expect hazmat teams to decontaminate chemical victims. However, in Tokyo, most victims of that attack were not totally incapacitated, and transported themselves to the local hospital a few blocks away. The hospital did not identify the agent and did not do any decontamination. Fumes offgassing from the victim's clothing took out a substantial number of the ER staff.

Bare minimum, if you think you've been anywhere near exposure, be prepared to throw your clothing in a sealed plastic bag, and wash down thoroughly with warm (not hot) soap and water. Also, be aware that contact lenses can absorb chemicals, so be prepared to get them out ASAP. I found this out the hard way, while finishing some home built furniture with spray polyurathane.

Our chemicals instructor, who was from a local Hazmat department, said that nerve agent poisoning happens all the time. Farmers work with large quantities of insecticide, which is basically the same thing. He said that post 9-11, many fire depts are carrying atropine autoinjectors.