Materiały źródłowe

• #1 Radiation sickness Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/injury/radiation-sickness

  Radiation sickness is illness and symptoms resulting from excessive exposure to ionizing radiation. […] Radiation sickness results when humans (or other animals) are exposed to very large doses of ionizing radiation. […] Radiation sickness is generally associated with acute exposure and has a characteristic set of symptoms that appear in an orderly fashion. […] The severity of symptoms and illness (acute radiation sickness) depends on the type and amount of radiation, how long you were exposed, and which part of the body was exposed. Symptoms of radiation sickness may occur right after exposure, or over the next few days, weeks, or months. […] Your health care provider will advise you how best to treat these symptoms. Medicines may be prescribed to help reduce nausea, vomiting, and pain. Blood transfusions may be given for anemia (low counts of healthy red blood cells). Antibiotics are used to prevent or fight infections.

• #1 Radiation sickness

  https://sales-demo.adam.com/content.aspx?productid=582&pid=1&gid=000026&tab=childborn

  Radiation sickness is illness and symptoms resulting from excessive exposure to ionizing radiation. […] Radiation sickness results when humans (or other animals) are exposed to very large doses of ionizing radiation. […] The severity of symptoms and illness (acute radiation sickness) depends on the type and amount of radiation, how long you were exposed, and which part of the body was exposed. Symptoms of radiation sickness may occur right after exposure, or over the next few days, weeks, or months. Bone marrow and the gastrointestinal tract are especially sensitive to radiation injury. Children and babies still in the womb are more likely to be severely injured by radiation. […] Your health care provider will advise you how best to treat these symptoms. Medicines may be prescribed to help reduce nausea, vomiting, and pain. Blood transfusions may be given for anemia (low counts of healthy red blood cells). Antibiotics are used to prevent or fight infections.

• #1 Radiation Sickness: Facts, Symptoms, Treatment

  https://www.webmd.com/cancer/radiation-sickness-facts

  Radiation damages your stomach and intestines, blood vessels, and bone marrow, which makes blood cells. Damage to bone marrow lowers the number of disease-fighting white blood cells in your body. As a result, most people who die from radiation sickness are killed by infections or internal bleeding. […] Your doctor will try to help you fight off infections. They might give you blood transfusions to replace lost blood cells. Or they may give you medications to try to help your bone marrow recover. Or they may try a transplant. […] They also will give you fluids and treat other injuries like burns. Recovery from radiation sickness can take up to 2 years. But you’ll still be at risk of other health problems after recovery. For example, your odds of getting cancer are higher.

• #1

  https://www.nbcnews.com/health/health-news/amid-japan-crisis-hunt-better-radiation-care-flna1c9463352

  Japan’s nuclear emergency highlights a big medical gap: Few treatments exist to help people exposed to large amounts of radiation. […] Today, there are only a few proven therapies for radiation injuries. Good supportive care lots of fluids, infusions of blood-clotting platelets, and infection-fighting antibiotics is key for acute radiation syndrome, an overall poisoning that can begin causing symptoms days to weeks after a super-high exposure. […] Part of the challenge is radiation’s variety of injuries burns, bone marrow and gastrointestinal damage, lung scarring, the later-in-life cancer risk. […] „Before you can start to treat people, you need to know what radiation doses they got,” Brenner says. „If you take a guess and get it wrong, you might do more harm than good.” […] Cells in the bone marrow and GI tract are extremely vulnerable to radiation. They overreact to what should be reparable damage and commit cellular suicide, says Dr. Andrei Gudkov of the Roswell Park Cancer Institute.

• #1 Radiation and Health

  https://www.health.ny.gov/publications/4402/

  Radiation Sickness – At doses of about 60 rem, 5% of exposed individuals may vomit. This increases to about 50% at 200 rem. At doses between 300 and 400 rem and without medical treatment, there is a 50% chance that a person will die within 60 days. With proper medical care, however, some people exposed to 1,000 rem could survive. […] High doses of radiation received in a short period of time result in effects that are noticeable soon after exposure. These are known as threshold effects. A certain dose range must be exceeded before they can occur. These effects include radiation sickness and death, cataracts, sterility, loss of hair, reduced thyroid function and skin radiation burns. The severity of these effects increases with the size of the dose.

• #1 Radiation Exposure and Contamination – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/radiation-exposure-and-contamination/radiation-exposure-and-contamination

  Ionizing radiation injures tissues vary based on radiation dose, rate of exposure, type of radiation, and part of the body exposed. […] Management focuses on associated traumatic injuries, decontamination, supportive measures, and minimizing exposure of health care professionals. Patients with severe acute radiation sickness receive reverse isolation, antimicrobial and anti-inflammatory agents, and bone marrow support. […] Treatment of severe traumatic injuries or life-threatening medical conditions first. […] Associated trauma is more immediately life threatening than radiation exposure and must be treated expeditiously. […] Supportive care is provided as needed and includes managing shock and hypoxia and relieving pain and anxiety. […] Management of the hematopoietic syndrome is similar to that of bone marrow hypoplasia and pancytopenia of any cause. Blood products should be transfused to treat anemia and thrombocytopenia, and hematopoietic growth factors (granulocyte colony-stimulating factor and granulocyte macrophage colony-stimulating factor) when absolute neutrophil count 9 cells/L.

• #1 Radiation sickness – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/radiation-sickness/diagnosis-treatment/drc-20377061

  When a person has experienced known or probable exposure to a high dose of radiation from an accident or attack, medical personnel take a number of steps to determine the absorbed radiation dose. This information is essential for determining how serious the illness is likely to be, which treatments to use and whether a person is likely to survive. […] The treatment goals for radiation sickness are to prevent further radioactive contamination; treat life-threatening injuries, such as from burns and trauma; reduce symptoms; and manage pain. […] Decontamination involves removing external radioactive particles. Removing clothing and shoes eliminates about 90% of external contamination. Gently washing with water and soap removes additional radiation particles from the skin. […] A protein called granulocyte colony-stimulating factor, which promotes the growth of white blood cells, may counter the effect of radiation sickness on bone marrow. Treatment with this protein-based medicine, which includes filgrastim (Neupogen), sargramostim (Leukine) and pegfilgrastim (Neulasta), may increase white blood cell production and help prevent subsequent infections.

• #1 Understanding Radiation Sickness: Symptoms, Causes, and Treatment of Acute Radiation Syndrome – Raybloc X-ray Protection

  https://raybloc.com/radiation-sickness/

  Management and treatment of radiation sickness, particularly acute radiation syndrome (ARS), are essential in minimising its severe health consequences. This section explores the comprehensive approaches necessary for effectively addressing ARS, emphasising both immediate and long-term care strategies. These strategies are vital in mitigating the damage caused by radiation exposure and in supporting the patient’s recovery journey. […] The diagnosis of ARS is a critical first step and involves a detailed assessment of symptoms, a thorough history of exposure, and various diagnostic tests. Blood tests are particularly crucial, as they can reveal the extent of damage to the bone marrow and other organs. Clinicians may also use dosimetry and radiation survey meters to ascertain the level of exposure, aiding in determining the appropriate course of treatment.

• #1 Single Drop of Blood Could Help Rapidly Detect Radiation Sickness | Today’s Clinical Lab

  https://www.clinicallab.com/single-drop-of-blood-could-help-rapidly-detect-radiation-sickness-23315

  Radiation sickness, or acute radiation syndrome (ARS), is a condition caused by irradiation of major volume or the entire body by a high dose of penetrating radiation in a very short time periodusually a matter of minutes. […] The condition can rapidly weaken a person through its side effects and lead to death without intervention. […] Rapid identification of exposure levels is critical for responding and triaging patient treatments. […] This new test uses a single drop of bloodcollected from a simple finger prickand results are ready in a few hours. […] He noted this tool would have critical relevance in responding to mass casualty disaster scenario like that Chernobyl, to identify at-risk military personnel and civilians who need immediate treatment. […] Some patients develop major issues like thrombocytopenia and neutropenia as the result of radiation treatment. […] With additional research, this new testing method could potentially help oncologists measurein real timeabsorbed radiation and intervene before radiation sickness occurs.

• #1 Radiation Sickness (Acute Radiation Syndrome)

  https://my.clevelandclinic.org/health/diseases/24328-radiation-sickness

  Radiation sickness (acute radiation syndrome) or radiation poisoning is a life-threatening condition that results from significant exposure to ionizing radiation. Its severity depends on: […] The treatment for radiation sickness varies based on its severity. As significant exposure usually results from radiological or nuclear emergencies, healthcare providers and first responders prioritize care based on the severity of symptoms and injuries. […] General treatment strategies include: Decontamination. Removing clothing and washing your body protects others from further exposure. […] Supportive care. This may involve getting fluids and electrolytes, taking medications to manage pain associated with burns or other injuries, and getting treated for any signs of infection with antibiotics.

• #1 Understanding Radiation Sickness: Symptoms, Causes, and Treatment of Acute Radiation Syndrome – Raybloc X-ray Protection

  https://raybloc.com/radiation-sickness/

  Decontamination is an immediate response that involves removing any clothing that might be contaminated with radioactive materials and thoroughly washing the skin. This process is crucial in reducing further radiation absorption and in preventing the spread of contamination. Decontamination should be done as soon as possible after exposure to minimise the radiation dose received by the body. […] Treatment for damaged bone marrow includes blood transfusions and the administration of medications that stimulate blood cell production. These treatments are essential in addressing the hematopoietic effects of radiation exposure, helping to restore normal blood cell levels and function. In severe cases, bone marrow transplantation may be considered. […] Supportive treatment is vital in managing the symptoms of ARS and in preventing secondary infections. This includes administering anti-nausea medications, pain relievers, antibiotics, and other supportive care measures. Maintaining hydration and nutrition, managing pain, and preventing infections are key aspects of supportive care.

• #1 Radiation sickness: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000026.htm

  Your health care provider will advise you how best to treat these symptoms. Medicines may be prescribed to help reduce nausea, vomiting, and pain. Blood transfusions may be given for anemia (low counts of healthy red blood cells). Antibiotics are used to prevent or fight infections. […] Giving first aid to radiation victims may expose rescue personnel to radiation unless they are properly protected. Victims must be decontaminated so that they do not cause radiation injury to others. […] If symptoms occur during or after medical radiation treatments: Tell the provider or seek medical treatment right away. Handle affected areas gently. Treat symptoms or illnesses as recommended by the provider. […] Preventive measures include: Avoid unnecessary exposure to radiation, including unnecessary CT scans and x-rays. People working in radiation hazard areas should wear badges to measure their exposure level. Protective shields should always be placed over the parts of the body not being treated or studied during x-ray imaging tests or radiation therapy.

• #1 Guidelines for medical management of nuclear/radiation emergencies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5771710/

  Management of victim of radiation injury poses a wide spectrum of challenges to the health care provider starting with the evaluation of the damage, the kind of hospitalization and treatment and the regular monitoring of the patient. […] Health care institutions must develop protocols to respond to radiation exposure related emergencies in tandem with the local response teams. Multidisciplinary approach between clinical specialists, nursing staff and psychological experts is of critical significance. […] Reverse isolation, antacids, H2 blockers, use of reverse barrier nursing and prophylactic antimicrobials are part of the treatment plan. […] A well-structured and coordinated care by various specialties supported by good nursing care for inpatients, especially those admitted in ICU will be the bedrock for successful outcomes. […] If severe Granulocytopenia is observed, reverse barrier nursing, prophylactic antimicrobials should be given.

• #1 Acute Radiation Syndrome: What Every Nurse Needs to Know

  https://nursingcecentral.com/acute-radiation-syndrome/

  Acute radiation syndrome is commonly treated with Potassium Iodide. […] The initial treatment for acute radiation should center around treating injuries and burns and maintaining hydration. […] As healthcare professionals, initial treatment for Acute Radiation Syndrome (ARS) requires a focus on maintaining hydration and treating injuries and burns. […] Health care professionals should focus on treating injuries and burns, as well making sure that hydration is maintained during the initial treatment of this illness.

• #1 Radiation Exposure and Contamination – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/radiation-exposure-and-contamination/radiation-exposure-and-contamination

  There is no specific treatment for the cerebrovascular syndrome. It is universally fatal; care should address patient comfort. […] The gastrointestinal syndrome is treated with aggressive fluid resuscitation and electrolyte replacement. Parenteral nutrition should be initiated to promote bowel rest. In febrile patients, broad-spectrum antibiotics should be initiated immediately. […] Radiation-induced sores or ulcers that fail to heal satisfactorily may be repaired by skin grafting or other surgical procedures.

• #1

  https://flutrackers.com/forum/forum/health-humanitarian-issues/105241-recognizing-and-treating-radiation-sickness

  A protein called granulocyte colony-stimulating factor, which promotes the growth of white blood cells, may counter the effect of radiation sickness on bone marrow. Treatment with this protein-based medication, which includes filgrastim (Neupogen) and pegfilgrastim (Neulasta), may increase white blood cell production and help prevent subsequent infections. If you have severe damage to bone marrow, you may also receive transfusions of red blood cells or blood platelets. […] If you have radiation sickness, you may receive additional medications or interventions to treat bacterial infections, headache, fever, diarrhea, nausea and vomiting, and dehydration. […] A person who has absorbed large doses of radiation (6 Gy or greater) has little chance of recovery. Depending on the severity of illness, death can occur within two days or two weeks. People with a lethal radiation dose will receive medications to control pain, nausea, vomiting and diarrhea. They may also benefit from psychological or pastoral care.

• #1 Radiation symptom management – Oncology Nursing

  https://allnurses.com/radiation-symptom-management-t672200/

  Every patient is given a site specific (eg H+N, prostate, gynae) information booklet at their initial consult with their RO. Side effects and what to expect with treatment are outlined in this booklet. […] On the day of the patients SIM CT appt they have a 45 minute individual education session with one of the ro nurses(we have 2 nurses each day allocated to sim education). At this session we recommend products for skin and mouth care, along with how to manage any other additional short term side effects (eg loose bowels, nausea etc). […] Our general recommendations for skin care are: – use a gentle soap free, pH balanced wash on the treatment field when showering (no soap or fragranced products) -use warm water rather than hot or cold, pat dry with a towel post shower. NO SCRUBBING! – moisturise with a basic aqueous cream (unfragranced) at least twice a day- but not in the 2 hrs leading up to treatment as cream must be absorbed prior to arriving for treatment – no sunscreen in the tx field – no deodorant (if treating auxilla) or perfumes in the tx field -avoid underwire bras (if treating breast) – avoid hair removal in the tx field, no shaving, waxing or hair removal creams. It is acceptable to use an electric razor on facial hair.

• #1 Radiation symptom management – Oncology Nursing

  https://allnurses.com/radiation-symptom-management-t672200/

  If there is any signs of erythema, desquamation or pain the patient will then be seen at least weekly by the nurses for regular skin follow ups from then on. If we have to start dressings then they see nurses daily. […] For skin reactions in the perineal/ lady parts area we use a combination of – sitz baths with saline – saline compresses – 5% xylocaine gel mixed 50/50 with solosite wound gel (an aqueous wound gel) – padded dressings and non adherent pads to prevent skin from sticking to clothing. […] We DO NOT use any form of barrier cream as the majority contain zinc which is contraindicated with radiotherapy. […] To manage mucositis we recommend – using a saliva substitute (eg biotene, oral balance) – regular saline mouthwashes -regular bicarbonate soda mouth washes -cephasol – use of mouth swabs rather than tooth brushes.

• #1 Radiation symptom management – Oncology Nursing

  https://allnurses.com/radiation-symptom-management-t672200/

  In terms of pain relief our initial tx is soluble paracetamol 1g QID gargled and then swallowed. […] When this is no longer enough then we use a combination of: Fentanyl patches Oxycodone elixir Xylocaine viscous prior to meals. […] Patients are seen by their RO on a fortnightly basis throughout treatment, and know that they can see nurses as needed. […] Once they complete treatment every patient is given a 1 week follow up phone assessment by the nurses to check in and make sure they are ok. If they are having concerns they can then attend the clinic to see nursing or their ROs.

• #1 Management of radiation injury – UpToDateRx_guide_radiation_exposure.htm

  https://www.uptodate.com/contents/management-of-radiation-injury/print

  Management of radiation exposure, for an individual or a community, requires knowledge of the principles of radiation safety, advance preparation, and planning at both the regional and health care facility levels. […] Important considerations for facility preparation for a radiation emergency are provided below but are not sufficient to serve as a detailed facility plan. […] While caring for patients with radiologic contamination, health care providers should always wear personal protective equipment to prevent radioactive substances from contacting or entering the body. […] Recommended personal protective equipment depends upon the type of hazard that is likely to be encountered. […] The plan should explicitly direct that patients with immediately life-threatening conditions be brought directly to the emergency department resuscitation area prior to radiologic survey and decontamination.

• #1 Management of radiation injury – UpToDateRx_guide_radiation_exposure.htm

  https://www.uptodate.com/contents/management-of-radiation-injury/print

  For stable patients with serious illness or injury, radiologic decontamination consists of removal of all clothing and thorough washing of the skin and hair with tepid water and soap in the emergency decontamination area before the patient is brought into the clean area of the emergency department or other parts of the hospital. […] Patients who are known to have received a lethal dose of gamma radiation (eg, ≥10 gray [Gy]) or with multiorgan failure should receive pain control, antiemetics, antiepileptics, and other aspects of palliative care in a proper inpatient or outpatient setting. […] All patients, including those who have insignificant or no exposure, may have significant psychosocial needs, and reassurance and counseling should be offered to all individuals. […] The approach to initial and ongoing management of children with radiation injury is similar to adults, with a few notable exceptions.

• #1 Radiation sickness – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/radiation-sickness/diagnosis-treatment/drc-20377061

  If you have radiation sickness, you may receive additional medicines or interventions to treat: bacterial infections, headache, fever, diarrhea, nausea and vomiting, dehydration, burns, sores or ulcers. […] A person who has absorbed very large doses of radiation has little chance of recovery. Depending on the severity of illness, death can occur within two days or two weeks. People with a lethal radiation dose receive medicine to control pain, nausea, vomiting and diarrhea. They also may benefit from psychological or pastoral care.

• #1 Radiation Injury Treatment Network | Blood Stem Cell

  https://bloodstemcell.hrsa.gov/about/radiation-injury-treatment-network

  As part of the C.W. Bill Young Cell Transplantation Program (CWBYCTP), contractors must have an emergency response process in place. Additionally, the CWBYCTP has created a specialized group, the Radiation Injury Treatment NetworkSM (RITNSM). The RITN is a national network of medical centers with expertise in the management of bone marrow failure and works with partners from other medical specialties to assist with managing acute radiation syndrome (ARS) and its health-related consequences. […] Many of the casualties with radiation injury from such an incident will be salvageable but will require intensive supportive care in an outpatient and/or inpatient setting. […] RITN hospitals develop treatment guidelines for managing hematologic toxicity among victims of radiation exposure and educate health care professionals about pertinent aspects of radiation exposure management through training and disaster exercises.

• #1 Disease risk rises for health care workers exposed to radiation on the job | STAT

  https://www.statnews.com/2016/04/12/radiation-health-care-workers/

  Health care professionals who have been exposed to radiation over the long term face a higher risk of disease, according to a study published Tuesday in the journal Circulation. […] This study suggests health care professionals who work in labs that use radiation for procedures such as coronary angiography and angioplasty face an elevated risk of a number of health problems beyond cancer. […] Researchers also reported higher rates of thyroid disease, anxiety, depression, high blood pressure, and high cholesterol. […] Protective measures like leaded aprons, thyroid collars, leaded glasses, and overhead radiation shields can be used to reduce workers radiation exposure, but unfortunately, in many catheterization laboratories, these measures do not exist or are not employed routinely, said lead investigator Maria Grazia Andreassi of the Italian National Research Council. […] Education and awareness are key, said Andreassi. Health care workers should understand the risks theyre exposed to in catheterization labs and other settings, and take protective measures.

• #1 Deficits in Radiation Health Affects Knowledge among Emergency Nurses in Japan’s Nuclear Emergency Core Hospitals

  https://opennursingjournal.com/VOLUME/17/ELOCATOR/e18744346272802/FULLTEXT/

  In the wake of the Fukushima Daiichi Nuclear Power Station disaster in 2011, Japan established Nuclear Emergency Core Hospitals (NECHs) to prepare for future nuclear incidents. […] This study investigates the knowledge and health anxiety related to radiation among nurses working in emergency units at NECHs in Kagoshima Prefecture. […] Results revealed that only 30% had studied radiation health effects at educational institutions, and 95% expressed a desire for further training. […] It highlights the urgent need for comprehensive training programs to improve nurses’ knowledge and alleviate their health anxieties about radiation. […] For many years, the nursing curriculum in Japan has included little or no content about radiation, and many nurses conduct their work without understanding the related health effects.

• #1 Radiation sickness: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000026.htm

  Radiation sickness is illness and symptoms resulting from excessive exposure to ionizing radiation. […] Radiation sickness results when humans (or other animals) are exposed to very large doses of ionizing radiation. […] Radiation sickness is generally associated with acute exposure and has a characteristic set of symptoms that appear in an orderly fashion. […] The severity of symptoms and illness (acute radiation sickness) depends on the type and amount of radiation, how long you were exposed, and which part of the body was exposed. Symptoms of radiation sickness may occur right after exposure, or over the next few days, weeks, or months. […] Children who receive radiation treatments or who are accidentally exposed to radiation will be treated based on their symptoms and their blood cell counts. Frequent blood studies are necessary and require a small puncture through the skin into a vein to obtain blood samples.

• #1 Management of radiation injury – UpToDateRx_guide_radiation_exposure.htm

  https://www.uptodate.com/contents/management-of-radiation-injury/print

  Radiation injury can affect multiple organ systems, most notably the skin, hematopoietic system, gastrointestinal tract, and cerebrovascular system. Toxicity is influenced by the type and amount of radiation exposure and the nature of the exposure event. […] This topic will address the management of radiation injury in adults and children. Clinical manifestations of acute radiation exposure and long-term consequences of radiation exposure and the management of victims of chemical terrorism are discussed separately. […] Protection from radiation exposure is primarily accomplished through: Maximizing the distance from the source, Minimizing the time of exposure, Shielding from exposure. […] For all patients with radiation exposure and/or contamination, evacuation from the source or incident site and reducing further exposure (eg, radiation fallout, contaminated soil or food, or radiation from medical imaging) are of prime importance.

• #1 New Portal in Spanish on the Safe Use of Radiation in Health Care

  https://www.iaea.org/newscenter/news/spanish-portal-safe-use-ionizing-radiation-health

  Ionizing radiation is extensively used worldwide to analyze, diagnose, monitor, or treat a wide range of medical conditions. […] However, ionizing radiation also has potentially harmful effects. Therefore, with around nine million health care professionals worldwide involved in medical uses of ionizing radiation, to minimize unnecessary and unintended exposure, these health workers must know how to safely administer its use. […] The IAEA has a mandate to support countries in the safe and beneficial use of ionizing radiation and its most common use globally is in medicine, said Holmberg. Comprehensive, relevant and up-to-date information and guidance on the safe use of radiation in medicine is of great benefit to patients and health professionals, and providing this service to groups in their native languages is an important way in which the IAEA can help facilitate the safe use of ionizing radiation within health care settings.

• #1 Radiation Isolation and the Impact of Care: Nursing Knowledge and Perception of Radiation Risks

  https://academicworks.cuny.edu/sph_etds/82/

  The findings revealed that nurses negative perceptions of radiation risk adversely impacted care for patients requiring radiation isolation since there were some reservations and unwillingness to provide such care. […] The lack of information was a significant barrier as it led to fears and misconceptions around radiation exposure. […] These challenges should be understood to offer support to nurses in order to fully address their concerns when caring for radiation isolation patients and enhance their preparedness to handle emergencies. […] Standardization of treatment protocols and patient care would help create a consistent infrastructure for care provision, eliminating some of the concerns and misconceptions identified. […] Nurses need adequate training on safely handling emergencies due to the increased risk they undertake.

• #1 Radiation Isolation and the Impact of Care: Nursing Knowledge and Perception of Radiation Risks

  https://academicworks.cuny.edu/sph_etds/82/

  Standardization of radiopharmaceutical protocols should be implemented to improve nurses safety, reduce variations in care provision, and enhance their understanding of their roles. […] When administering high doses of I-131 radiopharmaceutical therapy, rolling lead shields are recommended for use in non-dedicated lead-lined rooms since they allow nursing staff to be in the same room as the patients and maintain exposure levels below regulatory limits. […] The findings from this study captured the perspective of nurses regarding the care of patients requiring radiation isolation.

• #2 Radiation sickness

  https://www.mymlc.com/health-information/diseases-and-conditions/r/radiation-sickness2/?section=Symptoms

  Radiation sickness is damage to your body caused by a large dose of radiation often received over a short period of time (acute). The amount of radiation absorbed by the body — the absorbed dose — determines how sick you’ll be. […] Radiation sickness is also called acute radiation syndrome or radiation poisoning. Radiation sickness is not caused by common imaging tests that use low-dose radiation, such as X-rays or CT scans. […] The initial signs and symptoms of treatable radiation sickness are usually nausea and vomiting. The amount of time between exposure and when these symptoms develop is a clue to how much radiation a person has absorbed. […] If you’ve had a mild exposure, it may take hours to weeks before any signs and symptoms begin. But with severe exposure, signs and symptoms can begin minutes to days after exposure.

• #2 Radiation sickness – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/radiation-sickness/diagnosis-treatment/drc-20377061

  If you have radiation sickness, you may receive additional medicines or interventions to treat: bacterial infections, headache, fever, diarrhea, nausea and vomiting, dehydration, burns, sores or ulcers. […] A person who has absorbed very large doses of radiation has little chance of recovery. Depending on the severity of illness, death can occur within two days or two weeks. People with a lethal radiation dose receive medicine to control pain, nausea, vomiting and diarrhea. They also may benefit from psychological or pastoral care.

• #2 Health Impacts of Radiation Exposure | Union of Concerned Scientists

  https://www.ucsusa.org/resources/health-impacts-radiation-exposure

  Acute radiation syndrome (ARS) can also occur after a high-dose, sudden exposure, when the radiation can penetrate to internal organs and all or most of the body is exposed. This is also commonly referred to as radiation sickness. Symptoms include nausea, vomiting, headache, and diarrhea within hours after exposure, and may cause death in the following days or weeks. The dose range for radiation sickness is 70 rads or 0.7 Gy, and mild symptoms may be observed at doses as low as 0.3 Gy or 30 rads. There are known acute effects to the brain, thyroid, blood, heart, gastrointestinal tract, reproductive system, and even hair at doses of 200 rem and higher. […] Acute exposure to radiation (as in direct contact with radioactive material or being near a nuclear detonation) can result in cutaneous radiation injury (CRI), a skin burn that can occur at radiation doses as low as 2 grays (Gy) or 200 rads2, increasing in severity as the dose increases.

• #2 Radiation sickness

  https://www.mymlc.com/health-information/diseases-and-conditions/r/radiation-sickness2/?section=Symptoms

  The treatment goals for radiation sickness are to prevent further radioactive contamination; treat life-threatening injuries, such as from burns and trauma; reduce symptoms; and manage pain. […] Decontamination involves removing external radioactive particles. Removing clothing and shoes eliminates about 90 percent of external contamination. Gently washing with water and soap removes additional radiation particles from the skin. […] If you have radiation sickness, you may receive additional medications or interventions to treat bacterial infections, headache, fever, diarrhea, nausea and vomiting, dehydration, burns, and sores or ulcers. […] A person who has absorbed very large doses of radiation has little chance of recovery. Depending on the severity of illness, death can occur within two days or two weeks. People with a lethal radiation dose will receive medications to control pain, nausea, vomiting, and diarrhea. They may also benefit from psychological or pastoral care.

• #2 Radiation sickness – UF Health

  https://ufhealth.org/conditions-and-treatments/radiation-sickness

  Giving first aid to radiation victims may expose rescue personnel to radiation unless they are properly protected. Victims must be decontaminated so that they do not cause radiation injury to others. […] If symptoms occur during or after medical radiation treatments: Tell the provider or seek medical treatment right away. […] Preventive measures include: Avoid unnecessary exposure to radiation, including unnecessary CT scans and x-rays.

• #2 Radiation sickness: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000026.htm

  Your health care provider will advise you how best to treat these symptoms. Medicines may be prescribed to help reduce nausea, vomiting, and pain. Blood transfusions may be given for anemia (low counts of healthy red blood cells). Antibiotics are used to prevent or fight infections. […] Giving first aid to radiation victims may expose rescue personnel to radiation unless they are properly protected. Victims must be decontaminated so that they do not cause radiation injury to others. […] If symptoms occur during or after medical radiation treatments: Tell the provider or seek medical treatment right away. Handle affected areas gently. Treat symptoms or illnesses as recommended by the provider. […] Preventive measures include: Avoid unnecessary exposure to radiation, including unnecessary CT scans and x-rays. People working in radiation hazard areas should wear badges to measure their exposure level. Protective shields should always be placed over the parts of the body not being treated or studied during x-ray imaging tests or radiation therapy.

• #2

  https://flutrackers.com/forum/forum/health-humanitarian-issues/105241-recognizing-and-treating-radiation-sickness

  A protein called granulocyte colony-stimulating factor, which promotes the growth of white blood cells, may counter the effect of radiation sickness on bone marrow. Treatment with this protein-based medication, which includes filgrastim (Neupogen) and pegfilgrastim (Neulasta), may increase white blood cell production and help prevent subsequent infections. If you have severe damage to bone marrow, you may also receive transfusions of red blood cells or blood platelets. […] If you have radiation sickness, you may receive additional medications or interventions to treat bacterial infections, headache, fever, diarrhea, nausea and vomiting, and dehydration. […] A person who has absorbed large doses of radiation (6 Gy or greater) has little chance of recovery. Depending on the severity of illness, death can occur within two days or two weeks. People with a lethal radiation dose will receive medications to control pain, nausea, vomiting and diarrhea. They may also benefit from psychological or pastoral care.

• #2 Radiation symptom management – Oncology Nursing

  https://allnurses.com/radiation-symptom-management-t672200/

  If there is any signs of erythema, desquamation or pain the patient will then be seen at least weekly by the nurses for regular skin follow ups from then on. If we have to start dressings then they see nurses daily. […] For skin reactions in the perineal/ lady parts area we use a combination of – sitz baths with saline – saline compresses – 5% xylocaine gel mixed 50/50 with solosite wound gel (an aqueous wound gel) – padded dressings and non adherent pads to prevent skin from sticking to clothing. […] We DO NOT use any form of barrier cream as the majority contain zinc which is contraindicated with radiotherapy. […] To manage mucositis we recommend – using a saliva substitute (eg biotene, oral balance) – regular saline mouthwashes -regular bicarbonate soda mouth washes -cephasol – use of mouth swabs rather than tooth brushes.

• #2 Radiation symptom management – Oncology Nursing

  https://allnurses.com/radiation-symptom-management-t672200/

  In terms of pain relief our initial tx is soluble paracetamol 1g QID gargled and then swallowed. […] When this is no longer enough then we use a combination of: Fentanyl patches Oxycodone elixir Xylocaine viscous prior to meals. […] Patients are seen by their RO on a fortnightly basis throughout treatment, and know that they can see nurses as needed. […] Once they complete treatment every patient is given a 1 week follow up phone assessment by the nurses to check in and make sure they are ok. If they are having concerns they can then attend the clinic to see nursing or their ROs.

• #2 Guidelines for medical management of nuclear/radiation emergencies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5771710/

  Management of victim of radiation injury poses a wide spectrum of challenges to the health care provider starting with the evaluation of the damage, the kind of hospitalization and treatment and the regular monitoring of the patient. […] Health care institutions must develop protocols to respond to radiation exposure related emergencies in tandem with the local response teams. Multidisciplinary approach between clinical specialists, nursing staff and psychological experts is of critical significance. […] Reverse isolation, antacids, H2 blockers, use of reverse barrier nursing and prophylactic antimicrobials are part of the treatment plan. […] A well-structured and coordinated care by various specialties supported by good nursing care for inpatients, especially those admitted in ICU will be the bedrock for successful outcomes. […] If severe Granulocytopenia is observed, reverse barrier nursing, prophylactic antimicrobials should be given.

• #2 Management of radiation injury – UpToDateRx_guide_radiation_exposure.htm

  https://www.uptodate.com/contents/management-of-radiation-injury/print

  Management of radiation exposure, for an individual or a community, requires knowledge of the principles of radiation safety, advance preparation, and planning at both the regional and health care facility levels. […] Important considerations for facility preparation for a radiation emergency are provided below but are not sufficient to serve as a detailed facility plan. […] While caring for patients with radiologic contamination, health care providers should always wear personal protective equipment to prevent radioactive substances from contacting or entering the body. […] Recommended personal protective equipment depends upon the type of hazard that is likely to be encountered. […] The plan should explicitly direct that patients with immediately life-threatening conditions be brought directly to the emergency department resuscitation area prior to radiologic survey and decontamination.

• #2 Management of radiation injury – UpToDateRx_guide_radiation_exposure.htm

  https://www.uptodate.com/contents/management-of-radiation-injury/print

  For stable patients with serious illness or injury, radiologic decontamination consists of removal of all clothing and thorough washing of the skin and hair with tepid water and soap in the emergency decontamination area before the patient is brought into the clean area of the emergency department or other parts of the hospital. […] Patients who are known to have received a lethal dose of gamma radiation (eg, ≥10 gray [Gy]) or with multiorgan failure should receive pain control, antiemetics, antiepileptics, and other aspects of palliative care in a proper inpatient or outpatient setting. […] All patients, including those who have insignificant or no exposure, may have significant psychosocial needs, and reassurance and counseling should be offered to all individuals. […] The approach to initial and ongoing management of children with radiation injury is similar to adults, with a few notable exceptions.

• #2 Radiation Injury Treatment Network | Blood Stem Cell

  https://bloodstemcell.hrsa.gov/about/radiation-injury-treatment-network

  As part of the C.W. Bill Young Cell Transplantation Program (CWBYCTP), contractors must have an emergency response process in place. Additionally, the CWBYCTP has created a specialized group, the Radiation Injury Treatment NetworkSM (RITNSM). The RITN is a national network of medical centers with expertise in the management of bone marrow failure and works with partners from other medical specialties to assist with managing acute radiation syndrome (ARS) and its health-related consequences. […] Many of the casualties with radiation injury from such an incident will be salvageable but will require intensive supportive care in an outpatient and/or inpatient setting. […] RITN hospitals develop treatment guidelines for managing hematologic toxicity among victims of radiation exposure and educate health care professionals about pertinent aspects of radiation exposure management through training and disaster exercises.

• #2 Management of radiation injury – UpToDateRx_guide_radiation_exposure.htm

  https://www.uptodate.com/contents/management-of-radiation-injury/print

  Radiation injury can affect multiple organ systems, most notably the skin, hematopoietic system, gastrointestinal tract, and cerebrovascular system. Toxicity is influenced by the type and amount of radiation exposure and the nature of the exposure event. […] This topic will address the management of radiation injury in adults and children. Clinical manifestations of acute radiation exposure and long-term consequences of radiation exposure and the management of victims of chemical terrorism are discussed separately. […] Protection from radiation exposure is primarily accomplished through: Maximizing the distance from the source, Minimizing the time of exposure, Shielding from exposure. […] For all patients with radiation exposure and/or contamination, evacuation from the source or incident site and reducing further exposure (eg, radiation fallout, contaminated soil or food, or radiation from medical imaging) are of prime importance.

• #2 Disease risk rises for health care workers exposed to radiation on the job | STAT

  https://www.statnews.com/2016/04/12/radiation-health-care-workers/

  Health care professionals who have been exposed to radiation over the long term face a higher risk of disease, according to a study published Tuesday in the journal Circulation. […] This study suggests health care professionals who work in labs that use radiation for procedures such as coronary angiography and angioplasty face an elevated risk of a number of health problems beyond cancer. […] Researchers also reported higher rates of thyroid disease, anxiety, depression, high blood pressure, and high cholesterol. […] Protective measures like leaded aprons, thyroid collars, leaded glasses, and overhead radiation shields can be used to reduce workers radiation exposure, but unfortunately, in many catheterization laboratories, these measures do not exist or are not employed routinely, said lead investigator Maria Grazia Andreassi of the Italian National Research Council. […] Education and awareness are key, said Andreassi. Health care workers should understand the risks theyre exposed to in catheterization labs and other settings, and take protective measures.

• #2 Radiation Isolation and the Impact of Care: Nursing Knowledge and Perception of Radiation Risks

  https://academicworks.cuny.edu/sph_etds/82/

  The findings revealed that nurses negative perceptions of radiation risk adversely impacted care for patients requiring radiation isolation since there were some reservations and unwillingness to provide such care. […] The lack of information was a significant barrier as it led to fears and misconceptions around radiation exposure. […] These challenges should be understood to offer support to nurses in order to fully address their concerns when caring for radiation isolation patients and enhance their preparedness to handle emergencies. […] Standardization of treatment protocols and patient care would help create a consistent infrastructure for care provision, eliminating some of the concerns and misconceptions identified. […] Nurses need adequate training on safely handling emergencies due to the increased risk they undertake.

• #3 Radiation sickness

  https://www.mymlc.com/health-information/diseases-and-conditions/r/radiation-sickness2/?section=Symptoms

  Radiation sickness is damage to your body caused by a large dose of radiation often received over a short period of time (acute). The amount of radiation absorbed by the body — the absorbed dose — determines how sick you’ll be. […] Radiation sickness is also called acute radiation syndrome or radiation poisoning. Radiation sickness is not caused by common imaging tests that use low-dose radiation, such as X-rays or CT scans. […] The initial signs and symptoms of treatable radiation sickness are usually nausea and vomiting. The amount of time between exposure and when these symptoms develop is a clue to how much radiation a person has absorbed. […] If you’ve had a mild exposure, it may take hours to weeks before any signs and symptoms begin. But with severe exposure, signs and symptoms can begin minutes to days after exposure.

• #3 Radiation symptom management – Oncology Nursing

  https://allnurses.com/radiation-symptom-management-t672200/

  If there is any signs of erythema, desquamation or pain the patient will then be seen at least weekly by the nurses for regular skin follow ups from then on. If we have to start dressings then they see nurses daily. […] For skin reactions in the perineal/ lady parts area we use a combination of – sitz baths with saline – saline compresses – 5% xylocaine gel mixed 50/50 with solosite wound gel (an aqueous wound gel) – padded dressings and non adherent pads to prevent skin from sticking to clothing. […] We DO NOT use any form of barrier cream as the majority contain zinc which is contraindicated with radiotherapy. […] To manage mucositis we recommend – using a saliva substitute (eg biotene, oral balance) – regular saline mouthwashes -regular bicarbonate soda mouth washes -cephasol – use of mouth swabs rather than tooth brushes.

• #3 Guidelines for medical management of nuclear/radiation emergencies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5771710/

  Management of victim of radiation injury poses a wide spectrum of challenges to the health care provider starting with the evaluation of the damage, the kind of hospitalization and treatment and the regular monitoring of the patient. […] Health care institutions must develop protocols to respond to radiation exposure related emergencies in tandem with the local response teams. Multidisciplinary approach between clinical specialists, nursing staff and psychological experts is of critical significance. […] Reverse isolation, antacids, H2 blockers, use of reverse barrier nursing and prophylactic antimicrobials are part of the treatment plan. […] A well-structured and coordinated care by various specialties supported by good nursing care for inpatients, especially those admitted in ICU will be the bedrock for successful outcomes. […] If severe Granulocytopenia is observed, reverse barrier nursing, prophylactic antimicrobials should be given.

• #3 Radiation sickness

  https://www.mymlc.com/health-information/diseases-and-conditions/r/radiation-sickness2/?section=Symptoms

  The treatment goals for radiation sickness are to prevent further radioactive contamination; treat life-threatening injuries, such as from burns and trauma; reduce symptoms; and manage pain. […] Decontamination involves removing external radioactive particles. Removing clothing and shoes eliminates about 90 percent of external contamination. Gently washing with water and soap removes additional radiation particles from the skin. […] If you have radiation sickness, you may receive additional medications or interventions to treat bacterial infections, headache, fever, diarrhea, nausea and vomiting, dehydration, burns, and sores or ulcers. […] A person who has absorbed very large doses of radiation has little chance of recovery. Depending on the severity of illness, death can occur within two days or two weeks. People with a lethal radiation dose will receive medications to control pain, nausea, vomiting, and diarrhea. They may also benefit from psychological or pastoral care.

• #3 Radiation Injury Treatment Network | Blood Stem Cell

  https://bloodstemcell.hrsa.gov/about/radiation-injury-treatment-network

  As part of the C.W. Bill Young Cell Transplantation Program (CWBYCTP), contractors must have an emergency response process in place. Additionally, the CWBYCTP has created a specialized group, the Radiation Injury Treatment NetworkSM (RITNSM). The RITN is a national network of medical centers with expertise in the management of bone marrow failure and works with partners from other medical specialties to assist with managing acute radiation syndrome (ARS) and its health-related consequences. […] Many of the casualties with radiation injury from such an incident will be salvageable but will require intensive supportive care in an outpatient and/or inpatient setting. […] RITN hospitals develop treatment guidelines for managing hematologic toxicity among victims of radiation exposure and educate health care professionals about pertinent aspects of radiation exposure management through training and disaster exercises.

• #3 Management of radiation injury – UpToDateRx_guide_radiation_exposure.htm

  https://www.uptodate.com/contents/management-of-radiation-injury/print

  Management of radiation exposure, for an individual or a community, requires knowledge of the principles of radiation safety, advance preparation, and planning at both the regional and health care facility levels. […] Important considerations for facility preparation for a radiation emergency are provided below but are not sufficient to serve as a detailed facility plan. […] While caring for patients with radiologic contamination, health care providers should always wear personal protective equipment to prevent radioactive substances from contacting or entering the body. […] Recommended personal protective equipment depends upon the type of hazard that is likely to be encountered. […] The plan should explicitly direct that patients with immediately life-threatening conditions be brought directly to the emergency department resuscitation area prior to radiologic survey and decontamination.

• #3 Management of radiation injury – UpToDateRx_guide_radiation_exposure.htm

  https://www.uptodate.com/contents/management-of-radiation-injury/print

  For stable patients with serious illness or injury, radiologic decontamination consists of removal of all clothing and thorough washing of the skin and hair with tepid water and soap in the emergency decontamination area before the patient is brought into the clean area of the emergency department or other parts of the hospital. […] Patients who are known to have received a lethal dose of gamma radiation (eg, ≥10 gray [Gy]) or with multiorgan failure should receive pain control, antiemetics, antiepileptics, and other aspects of palliative care in a proper inpatient or outpatient setting. […] All patients, including those who have insignificant or no exposure, may have significant psychosocial needs, and reassurance and counseling should be offered to all individuals. […] The approach to initial and ongoing management of children with radiation injury is similar to adults, with a few notable exceptions.

• #3 Radiation sickness: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000026.htm

  Your health care provider will advise you how best to treat these symptoms. Medicines may be prescribed to help reduce nausea, vomiting, and pain. Blood transfusions may be given for anemia (low counts of healthy red blood cells). Antibiotics are used to prevent or fight infections. […] Giving first aid to radiation victims may expose rescue personnel to radiation unless they are properly protected. Victims must be decontaminated so that they do not cause radiation injury to others. […] If symptoms occur during or after medical radiation treatments: Tell the provider or seek medical treatment right away. Handle affected areas gently. Treat symptoms or illnesses as recommended by the provider. […] Preventive measures include: Avoid unnecessary exposure to radiation, including unnecessary CT scans and x-rays. People working in radiation hazard areas should wear badges to measure their exposure level. Protective shields should always be placed over the parts of the body not being treated or studied during x-ray imaging tests or radiation therapy.

• #3 Radiation sickness – UF Health

  https://ufhealth.org/conditions-and-treatments/radiation-sickness

  Giving first aid to radiation victims may expose rescue personnel to radiation unless they are properly protected. Victims must be decontaminated so that they do not cause radiation injury to others. […] If symptoms occur during or after medical radiation treatments: Tell the provider or seek medical treatment right away. […] Preventive measures include: Avoid unnecessary exposure to radiation, including unnecessary CT scans and x-rays.

• #4 Radiation symptom management – Oncology Nursing

  https://allnurses.com/radiation-symptom-management-t672200/

  If there is any signs of erythema, desquamation or pain the patient will then be seen at least weekly by the nurses for regular skin follow ups from then on. If we have to start dressings then they see nurses daily. […] For skin reactions in the perineal/ lady parts area we use a combination of – sitz baths with saline – saline compresses – 5% xylocaine gel mixed 50/50 with solosite wound gel (an aqueous wound gel) – padded dressings and non adherent pads to prevent skin from sticking to clothing. […] We DO NOT use any form of barrier cream as the majority contain zinc which is contraindicated with radiotherapy. […] To manage mucositis we recommend – using a saliva substitute (eg biotene, oral balance) – regular saline mouthwashes -regular bicarbonate soda mouth washes -cephasol – use of mouth swabs rather than tooth brushes.

• #4 Guidelines for medical management of nuclear/radiation emergencies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5771710/

  Management of victim of radiation injury poses a wide spectrum of challenges to the health care provider starting with the evaluation of the damage, the kind of hospitalization and treatment and the regular monitoring of the patient. […] Health care institutions must develop protocols to respond to radiation exposure related emergencies in tandem with the local response teams. Multidisciplinary approach between clinical specialists, nursing staff and psychological experts is of critical significance. […] Reverse isolation, antacids, H2 blockers, use of reverse barrier nursing and prophylactic antimicrobials are part of the treatment plan. […] A well-structured and coordinated care by various specialties supported by good nursing care for inpatients, especially those admitted in ICU will be the bedrock for successful outcomes. […] If severe Granulocytopenia is observed, reverse barrier nursing, prophylactic antimicrobials should be given.

• #4 Management of radiation injury – UpToDateRx_guide_radiation_exposure.htm

  https://www.uptodate.com/contents/management-of-radiation-injury/print

  Management of radiation exposure, for an individual or a community, requires knowledge of the principles of radiation safety, advance preparation, and planning at both the regional and health care facility levels. […] Important considerations for facility preparation for a radiation emergency are provided below but are not sufficient to serve as a detailed facility plan. […] While caring for patients with radiologic contamination, health care providers should always wear personal protective equipment to prevent radioactive substances from contacting or entering the body. […] Recommended personal protective equipment depends upon the type of hazard that is likely to be encountered. […] The plan should explicitly direct that patients with immediately life-threatening conditions be brought directly to the emergency department resuscitation area prior to radiologic survey and decontamination.

• #5 Guidelines for medical management of nuclear/radiation emergencies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5771710/

  Management of victim of radiation injury poses a wide spectrum of challenges to the health care provider starting with the evaluation of the damage, the kind of hospitalization and treatment and the regular monitoring of the patient. […] Health care institutions must develop protocols to respond to radiation exposure related emergencies in tandem with the local response teams. Multidisciplinary approach between clinical specialists, nursing staff and psychological experts is of critical significance. […] Reverse isolation, antacids, H2 blockers, use of reverse barrier nursing and prophylactic antimicrobials are part of the treatment plan. […] A well-structured and coordinated care by various specialties supported by good nursing care for inpatients, especially those admitted in ICU will be the bedrock for successful outcomes. […] If severe Granulocytopenia is observed, reverse barrier nursing, prophylactic antimicrobials should be given.

• #5 Management of radiation injury – UpToDateRx_guide_radiation_exposure.htm

  https://www.uptodate.com/contents/management-of-radiation-injury/print

  Management of radiation exposure, for an individual or a community, requires knowledge of the principles of radiation safety, advance preparation, and planning at both the regional and health care facility levels. […] Important considerations for facility preparation for a radiation emergency are provided below but are not sufficient to serve as a detailed facility plan. […] While caring for patients with radiologic contamination, health care providers should always wear personal protective equipment to prevent radioactive substances from contacting or entering the body. […] Recommended personal protective equipment depends upon the type of hazard that is likely to be encountered. […] The plan should explicitly direct that patients with immediately life-threatening conditions be brought directly to the emergency department resuscitation area prior to radiologic survey and decontamination.

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