Biomedical Engineering Reference
In-Depth Information
of time after exposure to contaminated sources
hidden in the community
•
Medical Radiological Advisory Team
(MRAT) at Armed Forces Radiobiology
Research Institute (AFRRI) 301-295-0530
•
Specific syndromes of concern, especially with
a 2-3 week prior history of nausea and
vomiting, are
•
Obtain complete blood count
absolute lymphocyte count < 1000mm
3
suggests moderate exposure
•
•
thermal burn-like skin lesions without docu-
mented heat exposure
•
absolute lymphocyte count < 500mm
3
suggests severe exposure
•
immunological dysfunction with secondary
infections
•
Acute, short-term rise in neutrophil count
•
a tendency to bleed (epistaxis, gingival
bleeding, and petechiae)
•
Swab both nares
•
Collect 24 hour stool if GI contamination is
possible
•
marrow suppression (neutropenia, lympho-
nenia, and thrombocytopenia)
•
Collect 24 hour urine if internal contamination
with radionuclides is possible
•
epilation (hair loss)
Understanding Exposure
•
Decontamination Considerations
•
Exposure may be known and recognized or
clandestine through
Externally irradiated patients are not contami-
nated
•
large radiation exposures, such as a nuclear
bomb or catastrophic damage to a nuclear
power station
•
Treating contaminated patients before decon-
tamination may contaminate the facility: plan
for decontamination before arrival
•
small radiation source emitting continuous
gamma radiation producing chronic inter-
mittent exposures (such as radiological
sources from medical treatment or industrial
devices.)
•
Exposure without contamination requires no
decontamination (RSO measurement)
•
Exposure
with
contamination
requires
Universal Precautions,
removal of patient
clothing,
and decontamination with soap
and water
•
Exposure to RADIATION may result from any
one or combination of the following
•
For internal contamination, contact the RSO
and/or Nuclear Medicine Physician
•
external sources (such as radiation from an
uncontrolled nuclear reaction or radioiso-
tope outside the body)
•
Patient with life-threatening condition: treat,
then decontaminate Patient with non-life-
threatening condition: decontaminate, then treat
•
skin contamination with radioactive material
(“external contamination”)
Treatment Considerations
•
•
internal radiation from absorbed, inhaled,
or ingested radioactive material (“internal
contamination”)
If life-threatening conditions are present, treat
them first
•
If external radioactive contaminants are present,
decontaminate
Confirmation of Cases
•
•
If radioiodine (reactor accident) is present,
consider protecting the thyroid gland with
prophylactic potassium iodide if within first few
hours only (ineffective later) (Table 5.4)
Contact radiation safety officer (RSO) for help
•
For help in projecting clinical effects, contact
•
nuclear medicine physician
