injuries and poisoning
Radiation Injury
Treatment of Radiation Injury
Treatment of serious, life-threatening injuries first Decontamination of wounds, skin, and hair Treatment of internal contamination Sometimes specific measures for particular radionuclides Treatment of compromised immune system Supportive care Serious physical injuries are treated before irradiation is treated because they are more immediately life-threatening. Irradiation has no emergency treatment, but doctors closely monitor people for the development of the various syndromes and treat the symptoms as they arise. Contamination should be removed promptly to prevent the radioactive material from continuing to irradiate the person and to prevent the radioactive material from being taken up by the body. Contaminated wounds are treated before contaminated skin. Doctors decontaminate wounds by flushing them with a salt water solution and wiping them with a surgical sponge. After decontamination, wounds are covered to prevent recontamination as other sites are washed. Contaminated skin should be gently scrubbed with large amounts of warm (not hot) water and soap. Skin folds and nails need extra attention. Harsh chemicals, brushes, or scrubbing that may break the skin surface should be avoided. If hair cannot be decontaminated with soap and water, clipping it off with scissors is preferable to shaving. Shaving may cut the skin and allow contamination to enter the body. Skin and wound decontamination should continue until the Geiger-Muller counter shows that the radioactivity is gone or almost gone, until washing does not substantially reduce the amount of radioactivity measured, or until further cleaning risks damaging the skin. Burns should be gently rinsed but not scrubbed. Certain measures can decrease internal contamination. If people have recently swallowed a significant amount of radioactive material, vomiting may be induced. Some radioactive materials have specific chemical treatments that can reduce their absorption after being swallowed or help speed their removal from the body. If administered shortly before or soon after internal contamination with radioactive iodine,potassium iodidevery effectively prevents the thyroid gland from absorbing the radioactive iodine, thus reducing the risk of thyroid cancer and thyroid injury.Potassium iodideis effective only for radioactive iodine, not other radioactive elements. Other drugs, such as zinc or calcium diethylenetriamine penta-acetate (DTPA—for plutonium, yttrium, californium, and americium), calcium or aluminum phosphate solutions (for radioactive strontium), and Prussian blue (for radioactive cesium, rubidium, and thallium), can be given intravenously or by mouth to remove a fraction of certain radionuclides after they have entered the body. However, except forpotassium iodide, which is very effective, drugs given to reduce internal contamination reduce exposure by only about 25 to 75%. Nausea and vomiting can be reduced by taking drugs to prevent vomiting (antiemetics). Such drugs are routinely given to people undergoing radiation therapy or chemotherapy. Dehydration is treated with fluids given intravenously. People with the gastrointestinal or hematopoietic syndrome are kept isolated to minimize their contact with infectious microorganisms. Blood transfusions and injections of growth factors that stimulate blood cell production (such as erythropoietin and colony-stimulating factor) are given to increase blood counts. This treatment helps decrease bleeding and Overview of Anemia and helps fight infections. If the bone marrow is severely damaged, these growth factors are ineffective, and sometimes People with the gastrointestinal syndrome require antiemetics, fluids given intravenously, and sedatives. Some people may be able to eat a bland diet. Antibiotics are given by mouth to kill bacteria in the intestine that may invade the body. Antibiotics as well as antifungal and antiviral medications also are given intravenously when necessary. Treatment for the cerebrovascular syndrome is geared toward providing comfort by relieving pain, anxiety, and breathing difficulties. Medications are given to control seizures. Pain caused by radiation-induced sores or ulcers is treated with Treatment of Pain . If these wounds fail to heal satisfactorily over time, they may be repaired surgically with skin grafts or other procedures. People who survive may need regular monitoring for cataracts and thyroid disorders, but no other regular monitoring is needed. 