Medical treatment of radiological casualties: Current concepts

被引:140
作者
Koenig, KL
Goans, RE
Hatchett, RJ
Mettler, FA
Schumacher, TA
Noji, EK
Jarrett, DG
机构
[1] MJW Corp, Occupat & Radiat Med, Clinton, TN 37716 USA
[2] Univ Calif Irvine, Orange, CA 92668 USA
[3] Tulane Univ, Sch Publ Hlth & Trop Med, Clinton, TN USA
[4] Duke Univ, Med Ctr, Dept Med, Div Clin Oncol, Durham, NC USA
[5] New Mexico Fed Reg Med Ctr, Dept Radiol, Albuquerque, NM USA
[6] Richard L Roudebush VA Med Ctr, VA Med Emergency Radiol Response Team, Indianapolis, IN USA
[7] Pentagon, US Dept Def, Off Secretary, Chem & Biol Def Program, Washington, DC USA
[8] Uniformed Serv Univ Hlth Sci, Armed Forces Radiobiol Res Inst, Bethesda, MD USA
关键词
D O I
10.1016/j.annemergmed.2005.01.020
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
The threat of radiologic or nuclear terrorism is increasing, yet many physicians are unfamiliar with basic treatment principles for radiologic casualties. Patients may present for care after a covert radiation exposure, requiring an elevated level of suspicion by the physician. Traditional medical and surgical triage criteria should always take precedence over radiation exposure management or decontamination. External contamination from a radioactive cloud is easily evaluated using a simple Geiger-Muller counter and decontamination accomplished by prompt removal of clothing and traditional showering. Management of surgical conditions in the presence of persistent radioactive contamination should be dealt with in a conventional manner with health physics guidance. To be most effective in the medical management of a terrorist event involving high-level radiation, physicians should understand basic manifestations of the acute radiation syndrome, the available medical countermeasures, and the psychosocial implications of radiation incidents. Health policy considerations include stockpiling strategies, effective use of risk communications, and decisionmaking for shelter-in-place versus evacuation after a radiologic incident.
引用
收藏
页码:643 / 652
页数:10
相关论文
共 30 条
[1]   SYMPTOMATOLOGY OF ACUTE RADIATION EFFECTS IN HUMANS AFTER EXPOSURE TO DOSES OF 0.5-30 GY [J].
ANNO, GH ;
BAUM, SJ ;
WITHERS, HR ;
YOUNG, RW .
HEALTH PHYSICS, 1989, 56 (06) :821-838
[2]  
[Anonymous], 1995, MED EFFECTS IONIZING
[3]  
*ARM FORC RAD RES, BIOD ASS TOOL BAT SO
[4]  
BERGER ME, 2002, MED BASIC RAD ACCIDE
[5]   CLINICAL AND HEMATOLOGICAL ASPECTS OF CS-137 - THE GOIANIA RADIATION ACCIDENT [J].
BRANDAOMELLO, CE ;
OLIVEIRA, AR ;
VALVERDE, NJ ;
FARINA, R ;
CORDEIRO, JM .
HEALTH PHYSICS, 1991, 60 (01) :31-39
[6]  
*COMM ASS DISTR AD, 2003, DISTR ADM POT IOD EV, P114
[7]  
DAINIAK N, 2001, HEMATOLOGY AM SOC HE, P473
[8]  
Fajardo LF., 2001, Radiation pathology
[9]   Combined administration of recombinant human megakaryocyte growth and development factor and granulocyte colony-stimulating factor enhances multilineage hematopoietic reconstitution in nonhuman primates after radiation-induced marrow aplasia [J].
Farese, AM ;
Hunt, P ;
Grab, LB ;
MacVittie, TJ .
JOURNAL OF CLINICAL INVESTIGATION, 1996, 97 (09) :2145-2151
[10]   Ex vivo expansion of human adult stem cells capable of primary and secondary hemopoietic reconstitution [J].
Gammaitoni, L ;
Bruno, S ;
Sanavio, F ;
Gunetti, M ;
Kollet, O ;
Cavalloni, G ;
Falda, M ;
Fagioli, F ;
Lapidot, T ;
Aglietta, M ;
Piacibello, W .
EXPERIMENTAL HEMATOLOGY, 2003, 31 (03) :261-270