J Korean Soc Clin Toxicol.  2011 Dec;9(2):39-48.

Radiological Accident and Acute Radiation Syndrome

Affiliations
  • 1Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Korea. keunroh@gachon.ac.kr

Abstract

In mass casualty situation due to radiological accidents, it is important to start aggressive management with rapid triage decisions. External contamination needs immediate decontamination and internal contamination should be treated with special expertise and equipment to prevent the rapid uptake of radionuclides by target organs. Acute radiation syndrome shows a sequence of events that varies with the severity of the exposure. More severe exposures generally lead to more rapid onset of symptoms and severe clinical findings. After the massive exposure, various systems of the body reflect their severe damages that can lead to death within hours or up to several months. The disease progression has classically been divided into four stages: prodromal, latent, manifest illness, and recovery or death. Three characteristic clusters of symptoms including the hematopoietic syndrome, the gastrointestinal syndrome and the cerebrovascular syndrome are all associated with the acute radiation syndrome. The standard medical management of the patients with a potentially survivable radiation exposure includes good medical, surgical and supportive measures. Specific treatment with cytokines and bone marrow transplantation should be considered. The management of internal contamination is much the same as the treatment of poisoning. The standard decontamination should be applied to reduce uptake, and the chelating agents can be administered to enhance the clearance of radioisotopes. Radioactive iodine (131I) as one of the nuclear fission products can increase the incidence of thyroid cancer in children. Potential benefit of potassium iodide prophylaxis is greater especially in neonates, infants and small children.

Keyword

Radiation; Acute; Syndrome; Lodine

MeSH Terms

Acute Radiation Syndrome
Bone Marrow Transplantation
Chelating Agents
Child
Cytokines
Decontamination
Disease Progression
Etodolac
Humans
Incidence
Infant
Infant, Newborn
Iodine
Mass Casualty Incidents
Nuclear Fission
Potassium Iodide
Radioisotopes
Thyroid Neoplasms
Triage
Chelating Agents
Cytokines
Etodolac
Iodine
Potassium Iodide
Radioisotopes
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