Nuclear Emergency Medicine        Steven Podnos MD
Intial Steps• Ensure Medical Stability (ACLS,ATLS)• Decontamination• Admit for Severe exposure, otherwise  outpatient mana...
Radiation is the transfer of energy             through space• Ionizing particles:• Beta Particles, low energy , few cm  p...
Two types of clinical effects• Stochastic: increased risk of cancer and  genetic mutations Not necessarily dose  related i...
Measuring Exposure• One Rad=• Rem=effect of absorbing one Rad  (approximate)• Gy=100 Rads• Sv
Types of Exposure• Radiation-no contamination implied• External Contamination• Internal Contamination
Irradiation• Use lymphocyte counts in nomogram to  calculate severity of exposure• Lethal doses of radiation acutely are 2...
Acute Radiation Syndrome• Prodrome-Nausea, Vomiting, Abd pain, fever• Latent-patient feels better, but not making  cells w...
Radiation from Nuclear Plant                 Accidents•   Ionizing Radiation-Immediate and Residual•   Immediate Gamma Ray...
Triage• Onset of vomiting prodrome within 3 hours  suggests serious if not fatal dose. However,  must be differentiated fr...
Upcoming SlideShare
Loading in …5
×

Nuclear emergency medicine

370 views
315 views

Published on

Published in: Technology, Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
370
On SlideShare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
8
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Nuclear emergency medicine

  1. 1. Nuclear Emergency Medicine Steven Podnos MD
  2. 2. Intial Steps• Ensure Medical Stability (ACLS,ATLS)• Decontamination• Admit for Severe exposure, otherwise outpatient management
  3. 3. Radiation is the transfer of energy through space• Ionizing particles:• Beta Particles, low energy , few cm penetration, short lived• Alpha particles-stop at skin, only a problem if internalized• Gamma and Xrays are high energy, pass through tissue, need lead to stop• Neutron, (and Gamma) highly penetrating
  4. 4. Two types of clinical effects• Stochastic: increased risk of cancer and genetic mutations Not necessarily dose related in terms of severity, but is related in terms of likelihood of occurence• Deterministic-dose related clinical effects- hematologic suppression, cataracts, tissue fibrosis, decreased fertility
  5. 5. Measuring Exposure• One Rad=• Rem=effect of absorbing one Rad (approximate)• Gy=100 Rads• Sv
  6. 6. Types of Exposure• Radiation-no contamination implied• External Contamination• Internal Contamination
  7. 7. Irradiation• Use lymphocyte counts in nomogram to calculate severity of exposure• Lethal doses of radiation acutely are 2-400 rads (a head CT is one rad). Average annual radiation exposure is 600mREM
  8. 8. Acute Radiation Syndrome• Prodrome-Nausea, Vomiting, Abd pain, fever• Latent-patient feels better, but not making cells well• Manifest Phase-skin, blood vessels, GI mucosa, Bone Marrow deficiencies, Fibrosis• Recovery or Death Phase-
  9. 9. Radiation from Nuclear Plant Accidents• Ionizing Radiation-Immediate and Residual• Immediate Gamma Ray irradiation• Residual induced radioactivity of soil, etc• Fallout-immediate and delayed
  10. 10. Triage• Onset of vomiting prodrome within 3 hours suggests serious if not fatal dose. However, must be differentiated from psychogenic causes, so use lymphocyte depletion nomogram

×