Radiation Injury Acute Radiation Toxicity primarily affects rapidly dividing cells based on dosage Hematopoiteic - Pancytopenia, Infection • Dose > 2 Gy • Onset <2 days GI - N/V, Dehydration, GI Bleed • Dose > 6 Gy • Onset Hours Cardio/CNS - Circuatory collapse, CNS damage • Dose > 10 Gy • Onset Minutes LD50 (lethal dose to kill 50% of people) = 4.5 Gy. 1 Gy = ~10,000 CXRs Primary ED goal is containment and decontamination If exposed to radioactive Iodine (power plants and nuclear weapons), consider potassium iodide to prevent thyroid cancer Start broad spectrum Abx, consider antivirals/antifungals, and admit to heme/onc facility capable of bone marrow transplant Lymphopenia is first lab abnormality to develop (absolute lymphocyte count = ALC) and should be checked at 48 hours • ALC > 1000 = good prognosis • ALC < 300 = lethal - MH/CCF/CWRU EM Res @MetroHealth_EM #Radiation #Injury #Toxicity #diagnosis #management
