Expired CME Article

Acute Radiation Syndrome: Assessment and Management

Authors: Elizabeth H. Donnelly, CHP, ME, Jeffrey B. Nemhauser, MD, James M. Smith, PhD, Ziad N. Kazzi, MD, Eduardo B. Farfán, PhD, Arthur S. Chang, MD, Syed F. Naeem, MS

Abstract

Primary care physicians may be unprepared to diagnose and treat rare, yet potentially fatal, illnesses such as acute radiation syndrome (ARS). ARS, also known as radiation sickness, is caused by exposure to a high dose of penetrating, ionizing radiation over a short period of time. The time to onset of ARS is dependent on the dose received, but even at the lowest doses capable of causing illness, this will occur within a matter of hours to days. This article describes the clinical manifestations of ARS, provides guidelines for assessing its severity, and makes recommendations for managing ARS victims.

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References

1.Walker RI, Cerveny TJ (eds). Textbook of Military Medicine: Part 1, Warfare, Weaponry, and the Casualty, Medical Consequences of Nuclear Warfare. Bethesda, MD, Armed Forces Radiobiology Research Institute, 1989.
 
2.Fliedner TM, Friesecke I, Beyrer K (eds). Chapter 3: Organ Specific Manifestations of the Acute Radiation Syndrome in Medical Management of Radiation Accidents: Manual on the Acute Radiation Syndrome. Portland, London, British Institute of Radiology, 2001.
 
3.Hall EJ. Radiobiology for the Radiologist. New York, NY, Lippincott Williams & Wilkins, 2000, ed 5.
 
4.Armed Forces Radiobiology Research Institute (AFRRI). Medical Management of Radiological Casualties Handbook. Bethesda, MD, AFRRI, 2003, ed 2.
 
5.Waselenko JK, MacVittie TJ, Blakely WF, et al; Strategic National Stockpile Radiation Working Group. Medical management of the acute radiation syndrome: recommendations of the Strategic National Stockpile Radiation Working Group. Ann Intern Med 2004;40:1037–1051.
 
6.Prasad KN. Handbook of Radiobiology. New York, NY, CRC Press, Inc., 1995, ed 2.
 
7.Gusev IA, Guskova AK, Mettler FA Jr, (eds). Medical Management of Radiation Accidents. New York, NY, CRC Press, Inc., 2001, ed 2.
 
8.National Council on Radiation Protection and Measurements (NCRP). Management of Terrorist Events Involving Radioactive Material. Bethesda, MD, NCRP, 2001. NCRP Report No. 138.
 
9.Centers for Disease Control and Prevention; Infectious Diseases Society of America; American Society for Blood and Marrow Transplantation. Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients. MMWR Recomm Rep 2000;49:1–125, CE1–CE7. Available at: http://www.cdc.gov/mmwr/PDF/RR/RR4910.PDF. Accessed April 4, 2010.
 
10.Berger ME, Leonard RB, Ricks RC, et al. Hospital triage in the first 24 hours after a nuclear or radiological disaster. Radiation Emergency Assistance Center/Training Site Web site. Available at: http://www.orau.gov/reacts/. Accessed January 29, 2007.
 
11.Goans RE, Holloway EC, Berger ME, et al. Early dose assessment following severe radiation accidents. Health Phys 1997;72:513–518.
 
12.Hughes WT, Armstrong D, Bodey GP, et al. 2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Clin Infect Dis 2002;34:730–751. Available at: http://www.journals.uchicago.edu/CID/journal/issues/v34n6/011605/011605.html. Accessed January 29, 2007.
 
13.Schuening FG, Storb R, Goehle S, et al. Effect of recombinant human granulocyte colony-stimulating factor on hematopoiesis of normal dogs and on hematopoietic recovery after otherwise lethal total body irradiation. Blood 1989;74:1308–1313.