Can be localized or whole body, internal or external deposition and contamination
Mostly not emergency, just treatment symptoms and supportive care
Consider contacting health physicist and/or<unk>  safety officer for help
Treat wounds symptomatically
Close wounds within 35-48 hours
By direct handling. patient survives even though dose high since exposure drops rapidly with distance
Treat burns with pain control, prophylactic antibiotics, vasodilator treatment, surgery, skin graft,
Extent of penetration important factor in outcome
Close wounds within 35-48 hours
Extent of penetration important factor in outcome
Acute<unk>  Syndrome
Those persons who receive a significant exposure from<unk>  may experience acute<unk>  syndrome (ARS),  a systemic illness caused by exposure to a level of ionizing<unk>  sufficient to cause damage to the hematopoietic, gastrointestinal, cardiovascular or central nervous system
(worsens with increasing dose)
Thrombocytopenia, Anemia - weeks
Within 12hr, nausea/vomiting for 48hr
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/diarrhea, then latent for 1 week, then recurrent nausea and vomiting/diarrhea this time with sepsis and death
Hematopoietic 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 hematopoietic factors
Cutaneous symptoms- damaged skin may interact with other organ damage
Amifostine- prophylactic<unk>  drug- causes hypotension as side effect
Androstenediol- boosts immune system
Bone marrow transplant not helpful
Even if treatment and survive hematopoetic symptoms, still die from<unk>  pneumonitis, denuded GI tract, hepatic and renal dysfunction
Within 12hr, nausea/vomiting for 48hr
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/diarrhea, then latent for 1 week, then recurrent nausea and vomiting/diarrhea this time with sepsis and death
May enter thru burns, wounds, inhale, ingest
Need to know type of radionuclide and chemical form
Need to treatment quickly to be effective
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
Dose- 130mg adults, 65mg 3- 18ys, 32mg 1mo- 3yr, 16mg for age< 1mo
Chelators- calcium, zinc, only for plutonium or americium
Clothes and exp skin- just clean up and prevent spread
Clean with soap and water
If extremis- stabilize first, then decontam
Do not abraid skin while cleaning
Radiation exposure 
Trauma 
Dirty bomb
Hazmat exposure
Bioterrorism
Nonaccidental trauma
Chemical weapons
Drugs of abuse