Radiation exposure (disaster) - Revision history

Rossdonaldson1: /* Disposition */

2026-04-15T20:50:10Z

Disposition

← Older revision		Revision as of 20:50, 15 April 2026
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	==Disposition==		==Disposition==
	*Decontamination before admission to prevent contamination of facility
	**Notify radiation safety officer and health department
	*Admit for:		*Admit for:
	**Acute radiation syndrome (ARS) - prodromal symptoms within 6 hours suggest high dose		**Acute radiation syndrome (ARS) - prodromal symptoms within 6 hours suggest high dose

Rossdonaldson1: /* Disposition */

2026-04-15T20:49:50Z

Disposition

← Older revision		Revision as of 20:49, 15 April 2026
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	==Disposition==		==Disposition==
	*Decontamination before admission to prevent contamination of facility		*Decontamination before admission to prevent contamination of facility
			**Notify radiation safety officer and health department
	*Admit for:		*Admit for:
	**Acute radiation syndrome (ARS) - prodromal symptoms within 6 hours suggest high dose		**Acute radiation syndrome (ARS) - prodromal symptoms within 6 hours suggest high dose
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	**Asymptomatic patients with confirmed low-dose exposure		**Asymptomatic patients with confirmed low-dose exposure
	**Localized contamination successfully decontaminated		**Localized contamination successfully decontaminated
	*Serial CBC at 24h and 48h to assess lymphocyte decline trajectory
	*Notify radiation safety officer and health department

	==See Also==		==See Also==

Rossdonaldson1: /* Medication Dosing */

2026-04-15T20:48:53Z

Medication Dosing

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 *EMS occupational dose of 5 rem per yr dose not apply- allowable dose goes up for lifesaving event
 *At dose of 0.1 gy/hr- ems may go in for short time but dose may be life threatening
 ==Disposition==

Danbot: Add evidence-based Disposition section

2026-03-22T10:04:02Z

Add evidence-based Disposition section

@@ Line 185: / Line 185: @@
 | population = Pediatric
 }}
 ==See Also==

Danbot: Add MedicationDose entries for potassium iodide

2026-03-20T21:20:24Z

Add MedicationDose entries for potassium iodide

@@ Line 167: / Line 167: @@
 *EMS occupational dose of 5 rem per yr dose not apply- allowable dose goes up for lifesaving event
 *At dose of 0.1 gy/hr- ems may go in for short time but dose may be life threatening
 ==See Also==

ClaireLewis at 15:18, 14 October 2019

2019-10-14T15:18:12Z

Show changes

RSarlay: Added evaluation section and updated management section for consideration of contacting radiation safety officer for help

2018-01-22T04:18:48Z

Added evaluation section and updated management section for consideration of contacting radiation safety officer for help

← Older revision		Revision as of 04:18, 22 January 2018
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	==Evaluation==		==Evaluation==
			* Evaluate and stabilize any life threatening physical injuries (ABC's)
			* Decontaminate after stabilized
			* Check for external contamination - document location, dose rate and/or count measurements initial and after decontamination. Document description of decontamination methods and agents used
			* Check for internal contamination - swab both nostrils, collect 24-hour stool and 24-hour urine samples. Identify radionuclide (chemical form), solubility and particle character. Document suspected route of contamination.
			* Treat wounds symptomatically and close wounds within 35-48 hours
			* Obtain baseline serum amylase, complete blood count (CBC) then repeat CBC every 6-8 hours for 2-3 days. Collect second serum amylase at 24 hours post-exposure
			* External exposure to ionizing radiation - document location and position of patient relative to source of radiation at time of exposure. Document time and duration of exposure. Was dosimeter being worn? If so type and where on patient's body? Was dosimeter collected? By whom? Were is dosimeter now?
	==Management==		==Management==
	*Can be localized or whole body, internal or external deposition and contamination		*Can be localized or whole body, internal or external deposition and contamination
	*Mostly not emergency, just treatment symptoms and supportive care		*Mostly not emergency, just treatment symptoms and supportive care
			*Consider contacting health physicist and/or radiation safety officer for help
	===Localized Exposure===		===Localized Exposure===
	*By direct handling. patient survives even though dose high since exposure drops rapidly with distance		*By direct handling. patient survives even though dose high since exposure drops rapidly with distance

Rossdonaldson1: Text replacement - "<" to "<"

2017-01-23T18:44:22Z

Text replacement - "<" to "<"

← Older revision		Revision as of 18:44, 23 January 2017
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	*Reduce absorption, dilute, blockage, displacement by nonradioactive materials, mobilization, chelation		*Reduce absorption, dilute, blockage, displacement by nonradioactive materials, mobilization, chelation
	*Potassium iodine for nuc weapon detonation or reactor breach- prevents radioiodine from accumulating in thyroid. take shortly after exp to be effective- if give too much get iodism		*Potassium iodine for nuc weapon detonation or reactor breach- prevents radioiodine from accumulating in thyroid. take shortly after exp to be effective- if give too much get iodism
	*Dose- 130mg adults, 65mg 3- 18ys, 32mg 1mo- 3yr, 16mg for age~~<~~ 1mo		*Dose- 130mg adults, 65mg 3- 18ys, 32mg 1mo- 3yr, 16mg for age< 1mo
	*Chelators- calcium, zinc, only for plutonium or americium		*Chelators- calcium, zinc, only for plutonium or americium

Rossdonaldson1: Text replacement - ">" to ">"

2017-01-23T18:02:37Z

Text replacement - ">" to ">"

← Older revision		Revision as of 18:02, 23 January 2017
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	\|}		\|}
	**Within 12hr, nausea/vomiting for 48hr		**Within 12hr, nausea/vomiting for 48hr
	**Dose ~~>~~30 gy: cardiovascular and CNS effects - hypotension, cerebral edema, seizure, nausea/vomiting/diarrhea, ataxia, death		**Dose >30 gy: cardiovascular and CNS effects - hypotension, cerebral edema, seizure, nausea/vomiting/diarrhea, ataxia, death
	**Dose 10-30 gy: GI syndrome: nausea and vomiting/D, then latent for 1 wk, then recurrent nausea and vomiting/d this time with sepsis and death		**Dose 10-30 gy: GI syndrome: nausea and vomiting/D, then latent for 1 wk, then recurrent nausea and vomiting/d this time with sepsis and death
	*Hematopoetic symptoms- dose 2gy or higher- lymphocyte reduction within 48 hrs is indicator for rad exposure. get leukopenia and thrombocytopenia- bleeding and infection- may enhance recovery by hematopoetic factors		*Hematopoetic symptoms- dose 2gy or higher- lymphocyte reduction within 48 hrs is indicator for rad exposure. get leukopenia and thrombocytopenia- bleeding and infection- may enhance recovery by hematopoetic factors
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	#Irrigate		#Irrigate
	#Excise only if long acting radionuclides		#Excise only if long acting radionuclides
	#If whole body dose ~~>~~1gy, close wound asap to prevent portal of infc		#If whole body dose >1gy, close wound asap to prevent portal of infc
	#In burns, radioactivity comes off with eschar and exudate		#In burns, radioactivity comes off with eschar and exudate

Neil.m.young: editing for bullet points

2016-10-05T14:53:19Z

editing for bullet points

← Older revision		Revision as of 14:53, 5 October 2016
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	==Background==		==Background==
	“Ionizing” radiation is electromagnetic or particulate ~~in nature and has sufficient energy to cause ejection of an electron from an orbital shell of a target atom, thus creating~~ charged particles or ions. Non-ionizing ~~radiations,~~ ( e.g., light, microwaves, and radiowaves)~~, do~~ not have sufficient energy to eject an electron from another atom. Ionization of biologically important molecules, e.g., DNA, can cause cellular death ~~by several mechanisms.~~ Ionizing radiation at higher doses can cause damage to actively dividing and undifferentiated cell types, e.g., stem and progenitor cells in the bone marrow, gastrointestinal system, and skin.		*“Ionizing” radiation is electromagnetic or particulate which can create charged particles or ions
			*"Non-ionizing radiation" ( e.g., light, microwaves, and radiowaves) does not have sufficient energy to eject an electron from another atom
			*Ionization of biologically important molecules, e.g., DNA, can cause cellular death
			*Ionizing radiation at higher doses can cause damage to actively dividing and undifferentiated cell types, e.g., stem and progenitor cells in the bone marrow, gastrointestinal system, and skin

	===Radiological and Nuclear Scenarios of Concerns===		===Radiological and Nuclear Scenarios of Concerns===
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	====Radiological Exposure Devices (RED)====		====Radiological Exposure Devices (RED)====
	An RED is a device that can cause exposure to ionizing radiation without the knowledge of the person being exposed. Surreptitious placement of a ~~radiation source~~ could ~~cause exposure to any number of persons. In addition, such surreptitious placement of an RED would almost certainly entail delayed~~ discovery and notification of the healthcare community~~. An undiscovered RED could cause serious injuries and illness.~~		*A RED is a device that can cause exposure to ionizing radiation without the knowledge of the person being exposed
			*Surreptitious placement of a RED could delay discovery and notification of the healthcare community
	Injury ~~expression~~ is based on the radiation dose received, whether accidental or intentional in nature~~. Just as with industrial injuries, a~~ concealed RED scenario could result in serious injuries. The numbers of injuries and illnesses will likely be relatively few, but this is variable and depends on the placement and type of the radiation source. Potential pathology could present in a range from cutaneous radiation syndrome (CRS, cutaneous syndrome or CS) with or without damage to subcutaneous tissues (acute local radiation injury or LRI) and with/without acute radiation syndrome (ARS). In CRS, deposition of ionizing radiation energy sufficient to cause damage to the epidermis and/or dermis may result in sloughing or desquamation of the outer layer of skin. Details specific to the injuries will be discussed in a future manuscript within this series.		*Injury is based on the radiation dose received, whether accidental or intentional in nature
			*A concealed RED scenario could result in serious injuries

	====Radiological Dispersal Devices (RDD)====		====Radiological Dispersal Devices (RDD)====