• KI will only protect the thyroid gland from radioactive iodine; it will not protect other parts of the body.
• For more specific information regarding KI administration, please consult the individual health effects that follow.
People should not take KI if any of the following conditions exist:
• History of thyroid disease
• Presence of iodine allergy
• Presence of certain skin disorders such as dermatitis herpetiformis or urticaria vasculitis
DIETHYLENETRIAMINEPENTAACETATE (DTPA)
DTPA is a calcium or zinc salt that is used to treat internal contamination by plutonium, americium, and curium. It binds to the radioactive material and accelerates the release of these materials in the urine. It is most effective when given within the first 24 hours after internal contamination. DTPA may still be administered effectively within several days or weeks following an exposure.
PRUSSIAN BLUE (RADIOGARDASE)
Prussian blue is used to treat people who have been internally contaminated with radioactive cesium and nonradioactive thallium. Prussian blue acts by containing the radioactive materials in the intestines and prevents them from being absorbed by the body. It can be administered at any point after it is determined that a person is internally contaminated.
ACUTE RADIATION SYNDROME
OVERVIEW
Acute radiation syndrome (ARS) is an acute illness caused by irradiation of the entire body, or most of the body, by a high dose of penetrating radiation in a very short time. The major cause of this syndrome is depletion of immature parenchymal stem cells in specific tissues. Examples of people who suffered from ARS are the survivors of the Hiroshima and Nagasaki atomic bombs and the firefighters that first responded after the Chernobyl nuclear power plant event in 1986. ARS is further divided into three classes (bone marrow, gastrointestinal [GI], and cardiovascular [CV]/central nervous system [CNS]) depending upon the radiation dose, which is measured in Gy (or rad) (Table 7-2).
| From http://www.orau.gov/reacts. | ||
| ∗For acute external exposures only. Gray (Gy) is the SI unit of measurement for radiation-absorbed dose. | ||
| VOMITING POST INCIDENT | ESTIMATED DOSE | DEGREE OF ARS |
|---|---|---|
| Less than 10 minutes | >8 Gy | Lethal |
| 10-30 minutes | 6-8 Gy | Very severe |
| Less than 1 hour | 4-6 Gy | Severe |
| 1-2 hours | 2-4 Gy | Moderate |
| More than 2 hours | <2 Gy | Mild |
EXPOSURES
• Atomic bomb
• Nuclear power plant disaster
• Unintentional exposures to sterilization irradiators
Bone Marrow Syndrome (Dose: 0.7-10 Gy)
Full recovery is expected in most cases.
Death may occur in some individuals at 1.2 Gy (120 rad) (Table 7-3).
| PRODROMAL STAGE | LATENT STAGE | MANIFEST ILLNESS STAGE |
|---|---|---|
| Minutes to days | 1-6 weeks | Few weeks to 2 years |
Anorexia Nausea Vomiting | Patient may appear and feel well | Anorexia Fever Malaise |
The LD50/60 (lethal dose that results in the death of 50% to 60% of the subjects who are exposed to it) is about 2.5 to 5 Gy (250 to 500 rad).
Gastrointestinal Syndrome (Dose: >10 Gy)
Survival is extremely unlikely; death occurs within 2 weeks (Table 7-4).
| PRODROMAL STAGE | LATENT STAGE | MANIFEST ILLNESS STAGE |
|---|---|---|
| 2 days | <1 week | <1 week |
Anorexia Severe nausea Vomiting Cramps Diarrhea | Patient may appear and feel well | Anorexia Fever Malaise Severe diarrhea Dehydration Electrolyte imbalance |
Death is due to infection, dehydration, and electrolyte imbalance.
Cardiovascular/Central Nervous System
No recovery is expected; death occurs within 3 days (Table 7-5).
| PRODROMAL STAGE | LATENT STAGE | MANIFEST ILLNESS STAGE |
|---|---|---|
| Minutes to hours | Hours | <3 days |
Nervousness Confusion Loss of consciousness Severe nausea Vomiting Watery diarrhea Burning sensations of skin | Patient may return to partial functionality | Watery diarrhea Convulsions Coma |
THERAPY
• Based on type of ARS, treat symptomatically, focusing on prevention of infection.
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