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Radiation Exposure

Radiation Exposure
Exposure Levels
Exposure Risks
Management
Specimen Collection
Decontamination

Exposure Levels

1.
Rad (radiation absorbed dose): special unit of absorbed dose

2.
Rem (roetgen equivalent man):

Biologic effect of radiation

Unit of radiation dose equivalent

Equal to absorbed dose in rads x relative biologic effectiveness of radiation in question

3.
Gy: measures absorbed dose (1 joule of energy absorbed in 1 kg of material)

4.
Whole-body dose (rem):

5-100: asymptomatic; decr’d leukocytes & platelets; chromosome aberrations

100-200: N/V, anorexia, decr’d lymphocytes within 48 hrs, fatigue <24 hrs

200-400: N/V 2-4 d, skin erythema, epilation, decr'd leukocytes & platelets

400-600: N/V/D, 50% mortality within 30 d, decr'd lymphocytes within 48 hrs

600-1000: acute radiation syndrome, N/V/D, GI hemorrhage, incr'd mortality within 14 d, lymphocyte depression 1000: rapid onset GI, CNS, CVS complications, lymphocytes = 0 <48 hrs, 100% mortality within 72 hrs

5.
Sleeping next to human – 0.1 mR

6.
Flying in aircraft – 0.5 mR

7.
3-mile Island accident – 1.5 mR

8.
Exposure to consumer products e.g. smoke detectors – 3.5 mR/yr

9.
Nuclear weapon fallout – 4.5 mR

10.
Single CXR – 12-17 mR

11.
Working in capitol building – 20 mR

12.
Cosmic rays & terrestrial sources – 25 mR/yr

13.
Medical diagnostics – 93 mR/yr

14.
Radon – 200 mR/yr

15.
Smoking tobacco – 280 mR/pack yr

16.
Radiation worker – 5000 mR/yr

17.
Decrease in sperm count – 15 R

18.
Cancer Rx – 5000 R

Exposure Risks

1.
10 R: incr'd risk of genetic abn between 1 in 1,300 to 1 in 20,000

2.
10 R – can cause prenatal death

3.
1 R over few mins: incr'd risk of cancer between 1 in 2,000 and 1 in 100,000

4.
Max allowable exposure – 100 mR/yr: public member not working with radiation

5.
Exposure to other than background radiation is of short duration and occurs after entering area where there is radiation source

6.
Contamination: radioactive material is on surface – external; entered body – internal

7.
Tissue damage caused by radiation same as thermal or chemical burn

8.
Radiation burns and hair loss doesn't appear acutely

Management

1.
No symptoms 6 hrs post exposure: exposure <50 rems

2.
Symptoms 2-6 hrs post exposure: exposure 200 rems

3.
Symptoms 400 rems – acute radiation syndrome

4.
Follow ABCs; stabilize pt first

5.
CBC, differential, UA, PT/PTT, platelets, total lymphocytes count (TLC)

6.
TLC at 48 hrs predictive of prognosis

7.
Internal contamination: 24 h urine & feces x 4 d

8.
T&C for HLA typing if pt needs BM transplant due to BM depression (may need GCSF/epogen)

9.
Follow ABCs; stabilize pt first

10.
Potassium Iodide may protect thyroid

11.
Consider and treat all blast, fall or chemical injuries

12.
Consult nuclear medicine specialist for geiger counters

13.
Contact Radiation Emergency Assistance Center (REAC/TS)

Specimen Collection

1.
Control contamination: use protective clothing, control ventilation

2.
Conduct total body survey

3.
Document areas of contamination – location and amount of activity

4.
Obtain cotton swabs of eyes, ears, nose, mouth, any wounds

5.
Save areas of debrieded tissue and bandages as specimens

6.
Special attention to body orifices, such as mouth, nose, eyes, and ears because of rapid absorption of radioactive material

Decontamination

1.
Contamination monitoring:

Skin, clothing, shoes (beta & gamma radiation): GM counter

Skin, clothing (alpha radiation): proportional counter

2.
External decontamination: use Betadine, hydrogen peroxide, Phisohex, or Dakins soln

3.
Eyes: rinse with stream of water from inner canthus to canthus; avoid contamination of lacrimal duct

4.
Ear: external rinsing, ear syringe used to rinse auditory canal, provided tympanic membrane intact

5.
Oral cavity: brush teeth with toothpaste, frequent rinsing of mouth with 3% hydrogen peroxide soln

6.
Gastric lavage if radioactive materials swallowed

7.
After decontamination & stabilization – transfer to definitive care unit

8.
Collect all clothes/gowns/gloves etc in one bag

9.
Keep in contact with decon team at scene

10.
Decontaminate staff

11.
Contact Radiation Emergency Assistance Center (REAC/TC)

* Material is taken from the PEPID database
* Copyrighted material – All Rights Reserved
* For more information visit http://www.pepid.com

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