Materiały źródłowe

• #1 Protecting Yourself from Radiation | US EPA

  https://www.epa.gov/radiation/protecting-yourself-radiation

  One of the best ways to be prepared is to understand the radiation protection principles of time, distance and shielding. […] Time, distance, and shielding actions minimize your exposure to radiation in much the same way as they would to protect you against overexposure to the sun: […] For people who are exposed to radiation in addition to natural background radiation, limiting or minimizing the exposure time reduces the dose from the radiation source. […] Just as the heat from a fire reduces as you move further away, the dose of radiation decreases dramatically as you increase your distance from the source. […] Barriers of lead, concrete, or water provide protection from penetrating gamma rays and x-rays. […] Therefore, inserting the proper shield between you and a radiation source will greatly reduce or eliminate the dose you receive.

• #1 Preparing for a Radiation Emergency | Radiation Emergencies | CDC

  https://www.cdc.gov/radiation-emergencies/safety/index.html

  If a radiation emergency occurs, you can take actions to protect yourself, your loved ones, and your pets. […] The best way to protect yourself in a radiation emergency is to get inside, stay inside, and stay tuned. […] It is important to stay inside until officials provide instructions or say it is safe to go outside. […] Getting inside of a building and staying there is called „sheltering in place.” […] As soon as you get inside, decontaminate yourself (remove and wash radioactive material from your body). […] While inside, decontaminate yourself to lower your exposure to harmful radioactive material. […] Because radioactive materials become weaker over time, staying inside for at least 24 hours can protect you and your family until it is safe to leave the area. […] Remember: Get Inside, Stay Inside, and Stay Tuned. […] People can protect themselves from radiation exposure if they are in or around an affected area.

• #1 Radiation sickness – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/radiation-sickness/symptoms-causes/syc-20377058

  In the event of a radiation emergency, listen to the radio or watch television to hear what protective actions local, state and federal authorities recommend. Those actions depend on the situation, but you will be told to either stay in place or evacuate your area. […] If you’re advised to stay where you are, whether you’re at home or work or elsewhere, do the following: Close and lock all doors and windows. Turn off fans, air conditioners and heating units that bring air in from outside. Close fireplace dampers. Bring pets indoors. Move to an inner room or basement. Stay tuned to your emergency response network or local news. Stay put for at least 24 hours. […] If you’re advised to evacuate, follow the instructions provided by your local authorities. Try to stay calm and move quickly and in an orderly manner. Travel lightly, but take supplies, including: Flashlight. Portable radio. Batteries. First-aid kit. Necessary medicines. Sealed food, such as canned foods, and bottled water. Manual can opener. Cash and credit cards. Extra clothes.

• #1 Radiation Injury – Injuries and Poisoning – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/injuries-and-poisoning/radiation-injury/radiation-injury

  Following widespread high-level environmental contamination from a nuclear power plant accident or the intentional release of radioactive material, people should follow the advice of public health officials. Such information is usually broadcast on TV and radio. […] If sheltering is recommended, sheltering in a concrete or metal structure, particularly one below grade (such as in a basement), is best. Halfway between the top and bottom of a tall building, near the center away from windows, is best when no below-grade shelter is available. […] Changing clothes and showering are recommended if people suspect they may have been contaminated with radioactive material. People can obtain potassium iodide (KI) tablets from local pharmacies and some public health agencies. However, potassium iodide is only useful if radioactive iodine is released. It does not provide protection from other radioactive materials.

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

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

  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 prevents radioactive materials from spreading more. It also lowers the risk of internal contamination from inhalation, ingestion or open wounds. […] If you’re exposed to significant radiation, your thyroid will absorb radioactive iodine (radioiodine) just as it would other forms of iodine. The radioiodine is eventually cleared from the body in urine. […] If you take potassium iodide, it may fill „vacancies” in the thyroid and prevent the absorption of radioiodine. Potassium iodide isn’t a cure-all and is most effective if taken within a day of exposure. […] This treatment speeds up the elimination of the radioactive particles and reduces the amount of radiation cells may absorb. […] That lowers the amount of radiation absorbed.

• #1 Radiation Poisoning: Causes, Symptoms, and Prevention

  https://www.healthline.com/health/radiation-poisoning

  Decontaminating as soon as possible after a nuclear event can help you reduce your radiation exposure. […] Taking off your clothing and washing your body with soapy water can remove most radioactive contamination. […] In the event of a terrorist attack, the Centers for Disease Control and Prevention (CDC) recommends: undressing at your doorway or garage if possible before entering your home, avoiding unnecessary hand-to-face contact and avoiding chewing gum or smoking until after decontamination, showering with warm water and soap, gently blowing your nose, wiping your eyelids, and cleaning out your ears, changing into clean clothing, rinsing out your tub or shower, tuning into media for instructions from public health officials in your area. […] If you’re in a radiation emergency, you can reduce your risks by taking the following steps: Get inside a building and close and lock the windows and doors.

• #1 Potassium Iodide (KI) and Radiation Emergencies: Fact Sheet

  https://www.health.ny.gov/environmental/radiological/potassium_iodide/fact_sheet.htm

  When you take the KI pill, it fills your thyroid with a kind of iodine that prevents your thyroid gland from taking in any of the radioactive kind of iodine. […] You need to take KI before or just after you are exposed to radioiodine. You can also take it 3 or 4 hours later, but it will not be as helpful. […] If there is an emergency, you will hear an announcement from your local or state health officials. Your local health department will tell you when you should start taking KI and they will also tell you when you can stop taking it. […] KI will only protect you from radioactive iodine. It does not protect you from other kinds of radioactive material. KI works very well to protect your thyroid gland. However, it protects only your thyroid, not other parts of your body. […] You will be told what, if any, actions you should take to protect yourself. This might include leaving the area, staying inside with your windows closed and/or taking KI.

• #1 Potassium Iodide (KI) and Radiation Emergencies: Fact Sheet

  https://www.health.ny.gov/environmental/radiological/potassium_iodide/fact_sheet.htm

  The manufacturers say KI stays „fresh” for 5-7 years. If you keep it in a dry, dark and cool place, it should last for many years. […] No. You are allowed to get it over-the-counter. […] Yes, though it may not widely available in drug stores near you. Since it is not a prescription drug, you can buy it over the Internet. As with other drugs, make sure the KI you buy has been approved by the FDA. A supply of KI has been made available to people who live within 10 miles of a nuclear power plant in New York State. If you live within 10 miles of a nuclear power plant and did not receive KI, contact your local Office of Emergency Management.

• #1 Radiation sickness: Sources, effects, and protection

  https://www.medicalnewstoday.com/articles/219615

  Radiation sickness describes damage to the body that occurs after a large dose of radiation. […] There is no cure, but barriers can prevent exposure and some medications may remove some radiation from the body. […] Possible treatments include: Removing all clothing, Rinsing with water and soap. Use of potassium iodide (KI) to block thyroid uptake if a person inhales or swallows too much radioiodine. Prussian blue, given in capsules, can trap cesium and thallium in the intestines and prevent them from being absorbed. This allows them to move through the digestive system and leave the body in bowel movements. Filgrastim, or Neupogen, stimulates the growth of white blood cells. This can help if radiation has affected the bone marrow. […] Tips for reducing unnecessary exposure to radiation include: keeping out of the sun around midday and using a sunscreen or wearing clothes that cover the skin, making sure any CT scans and x-rays are necessary, especially for children, letting the doctor know if you are or may be pregnant before having an x-ray, PET, or CT scan.

• #1

  https://www.who.int/news/item/27-01-2023-who-updates-critical-medicines-list-for-radiation-and-nuclear-emergencies

  The World Health Organization (WHO) today updated its list of medicines that should be stockpiled for radiological and nuclear emergencies, along with policy advice for their appropriate management. These stockpiles include medicines that either prevent or reduce exposure to radiation, or treat injuries once exposure has occurred. […] It provides policy advice for acquisition of drugs which can prevent or reduce radionuclides uptake or increase elimination of radionuclides from the human body. […] This publication includes only specific drugs which are known and licensed today to prevent or treat human over-exposure to radiation. […] A typical radiation emergency stockpile will include the following medicines: Stable iodine, administered to prevent or reduce the exposure of the thyroid to radioactive iodine; Chelating sand decorporating agents (Prussian blue, applied to remove radioactive caesium from the body and calcium- / zinc-DTPA used to treat internal contamination with transuranium radionuclides); Cytokines used for mitigation of damage to the bone marrow, in case of acute radiation syndrome (ARS); and Other medicines used to treat vomiting, diarrhoea and infections. […] Emerging treatments and countermeasures also discussed in the report give insight to the future medical countermeasures that could be used for managing patients overexposed to radiation.

• #1 Radiation Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441931/

  Early use of antibiotics should be the rule. The use of bone marrow transplant has been used for large dose exposures but remains controversial. […] Check your local institutions for radiation exposure protocols. Many hospitals have disaster committees with protocols in place for radiation exposure. […] Management of acute radiation syndrome is best done by a team of healthcare professionals.

• #1 Medical management of acute radiation syndrome and associated infections in a high-casualty incident

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5941165/

  An important caveat when comparing infections occurring after chemotherapy with those occurring after accidental exposure to IR is that infectious organisms are actually identified in only 20-30% of febrile episodes after chemotherapy, compared with documentation in nearly all febrile episodes after accidental irradiation. […] The overall approach to treatment of infections in the irradiated patient may be thought of in terms of time after exposure. […] Candidates for prophylactic antimicrobial therapy include those with (i) fever plus neutropenia, (ii) afebrile neutropenia with clinical signs and symptoms of infection, and (iii) clinical signs and symptoms of infection without neutropenia. […] The selection of prophylaxis for low-risk patients is determined by local community susceptibility patterns of the most likely infectious organisms.

• #1 Acute Radiation Exposure – Core EM

  https://coreem.net/core/acute-radiation-exposure/

  Protection from ionizing radiation rests upon the principles of maximizing shielding and distance while minimizing the time of exposure. […] Once a radioactive threat is identified, prior to caring for patients, all staff should don appropriate personal protective equipment: disposable scrubs with taped seams, waterproof shoe covers, bouffant, masks, goggles, and a dosimeter. […] Decontamination considerations should be made in climates with cold temperatures and for EMS personnel entering the hospital with patients without on-scene decontamination. […] It is recommended that all surgical procedures be performed within 36 hours of exposure due to the possibility of developing anemia, thrombocytopenia, immunosuppression, and GI bleeding. […] Colony-stimulating factors can be used to produce more white blood cells (e.g., filgrastim, sargramostim) and platelets (e.g., romiplostim) to prevent infection from neutropenia and are given early if required.

• #1 Prevention of pelvic radiation disease

  https://www.wjgnet.com/2150-5349/full/v6/i1/1.htm

  Pelvic cancers are among the most frequently diagnosed cancers worldwide. Treatment of patients requires a multidisciplinary approach that frequently includes radiotherapy. Gastrointestinal (GI) radiation-induced toxicity is a major complication and the transient or long-term problems, ranging from mild to very severe, arising in non-cancerous tissues resulting from radiation treatment to a tumor of pelvic origin, are actually called as pelvic radiation disease. […] Therefore, the prevention of radiation-induced toxicity represents a reasonable way to avoid a dramatic drop of the quality of life of these patients. In the current manuscript we provide an updated and practical review on the best available evidences in the field of the prevention of pelvic radiation disease. […] Aim of the current manuscript is to provide an updated and practical review on the best available evidences in the field of the prevention of pelvic radiation disease.

• #1 Radiation therapy induced nausea and vomiting

  https://www.eviq.org.au/clinical-resources/side-effect-and-toxicity-management/gastrointestinal/426-radiation-therapy-induced-nausea-and-vomiting

  Radiation-induced nausea and vomiting (RINV) is dependent on a number of treatment and patient related risk factors. […] Ensure high and moderate risk patients receive appropriate prophylaxis before each radiation treatment fraction. […] The purpose of this document is to provide guidance to minimise and where possible, prevent radiation therapy induced nausea and vomiting (RINV). […] The likelihood of experiencing RINV can be divided into the following 4 groups. […] Patients having concurrent chemoradiation therapy should receive antiemetic prophylaxis according to the emetogenicity of anti-cancer therapy, unless the emetic risk with the planned radiation therapy is higher. […] It is important to assess the patients risk of RINV prior to the start of radiation therapy to ascertain whether antiemetic therapy should be given routinely as a preventative measure (prior to treatment each day) or rescue once symptoms have presented.

• #1 Prophylaxis of radiation-induced nausea and vomiting: a systematic review and meta-analysis of randomized controlled trials – Li – Annals of Palliative Medicine

  https://apm.amegroups.org/article/view/13184/html

  The aim of this article was to systematically review the efficacy and safety of various antiemetics in prophylaxis of radiation-induced nausea and vomiting (RINV). […] For patients at high emetogenic risk (i.e., receiving TBI or total nodal irradiation), current guidelines recommend prophylaxis with a 5HT3 RA and a short course of dexamethasone. […] Our systematic review demonstrated that 5HT3 RA was significantly more efficacious than all other therapy groups (placebo, dopamine receptor antagonist, rescue therapy and dopamine receptor antagonist plus dexamethasone) in the prevention of acute RINV among patients receiving single or multiple fraction radiotherapy to the abdomen/pelvis. […] The addition of dexamethasone to 5HT3 RA gives a slight benefit in the prophylaxis of RINV when compared with 5HT3 RA plus placebo.

• #1 Prevention of pelvic radiation disease

  https://www.wjgnet.com/2150-5349/full/v6/i1/1.htm

  Therefore, it has been suggested that probiotics supplementation during radiation treatment might reduce the development of radiation-induced side effects, in particular of diarrhea. […] These encouraging results, however, have not yet been confirmed and further well-performed, high-quality studies should be performed on this highly interesting issue.

• #1 Radiation Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441931/

  Prolonged or significant exposure to ionizing radiation can result in acute radiation syndrome. The proper care of acute radiation syndrome requires planning at the governmental, local, and clinical levels to ensure that exposure to radiation is limited and that individuals with acute radiation syndrome are identified and treated appropriately. […] The proper care of acute radiation syndrome requires planning at the governmental, local, and medical levels to ensure the proper treatment and use of limited resources. […] Prevention of thyroid cancer must be a priority. All children and pregnant women must be offered potassium iodide to protect the thyroid from the uptake of radioactive iodine. […] The staff must be protected from contamination, and all patients with a history of contamination should be disrobed and bathed. You can decrease exposure by 80% just by removing any contaminated clothing.

• #1 Medical management of acute radiation syndrome and associated infections in a high-casualty incident

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5941165/

  A successful medical response requires health care facilities to not only communicate and integrate medical services, meet surge capacity, protect health care workers and implement triage and treatment protocols, but also to provide the venue for clinical management of acute radiation injuries and their associated infections. […] Here, (i) recommendations made in Geneva are summarized; (ii) the analysis of countermeasures for HS is updated by review of two additional cases and extended to published reports not meeting inclusion criteria; and (iii) guidelines are provided for management of microbial infections based upon patient risk for prolonged immunosuppression. […] Recommendations were made for the use of cytokines to manage hematopoietic subsyndrome (HS) based on the then-current published reports of cases that met specific inclusion criteria.

• #1 Study identifies possible therapy for radiation sickness

  https://www.dana-farber.org/newsroom/news-releases/2011/study-identifies-possible-therapy-for-radiation-sickness

  A combination of two drugs may alleviate radiation sickness in people who have been exposed to high levels of radiation, even when the therapy is given a day after the exposure occurred, according to a study led by scientists from Dana-Farber Cancer Institute and Children’s Hospital Boston. […] The larger time window for administering the two-drug regimen raises the prospect that it could become a mainstay of the response to public health threats such as a nuclear power plant accident or nuclear terror attack. […] The investigators also found that the ability to generate new blood cells which can shut down in the aftermath of radiation exposure rebounded much more quickly and vigorously in the mice treated with fluoroquinolone and rBPI21 (the synthetic version of BPI), potentially contributing to their return to health.

• #1 Lesson learnt from nuclear disasters – health hazards & its prevention – MedCrave online

  https://medcraveonline.com/MOJPH/lesson-learnt-from-nuclear-disasters—health-hazards-amp-its-prevention.html

  Acute Radiation Syndrome also is known as radiation sickness caused by a high dose of penetrating radiation. […] The best prevention of radiation sickness is to minimize the exposure dose. This can be achieved by increasing the distance from the radiation source and early evacuation. […] Sustained Information, Education and Communication (IEC) activities should be carried out vigorously to sensitize the people of health hazards of radiation exposure that can occur in the health sector or due to nuclear fallout that may be accidental or intentional. […] The best prevention for radiation syndrome is to scale back the exposure dose or to chop the rate through increasing the space from the area and time reduction. […] Increasing distance from the radiation source will reduce exposure. […] The longer humans are subjected to radiation, the larger the dose absorbed. The exposed person should be taken out of the place of disaster as early as possible.

• #1 Radiation Sickness | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/1688608/all/Radiation_Sickness?q=Acute+leukemia

  Radiation sickness, or acute radiation syndrome (ARS), is defined as an acute illness caused by radiation of most or all of the body with a relatively high dose of radiation over a short period of time. […] Potassium iodide can reduce thyroid cancer risk; give promptly if contamination with radioactive iodine (iodine-131) is suspected. […] Avoidance of exposure: exposure reduced by decreasing time, increasing distance, and shielding. […] Pretreatment: In certain situations, damage to the thyroid may be reduced by preexposure consumption of radiostable iodine.

• #1 Radiation sickness – UF Health

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

  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 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

  Protection from radiation exposure is accomplished by avoiding contamination with radioactive material, minimizing the duration of exposure, maximizing the distance from the source of radiation, and shielding the source. […] During radiation therapy, parts of the body that are near, but are not the target of the therapy procedure, should be shielded to the extent possible with lead. […] Medical personnel with routine exposure to radiation sources should follow procedures to minimize duration of exposure, maximize distance from the source of radiation, and wear appropriate shielding. […] People living within 16 km (10 miles) of a nuclear power plant should have ready access to potassium iodide tablets in case radioactive iodine, which is a fission byproduct, is released from the plant. Potassium iodide helps prevent radioactive iodine uptake by the thyroid. […] Radioprotective medications, such as thiol compounds with radical scavenging properties, have been shown to reduce mortality when given before or at the time of irradiation in patients undergoing chemotherapy and/or radiation therapy.

• #2 Ionizing Radiation – Control and Prevention | Occupational Safety and Health Administration

  http://www.osha.gov/ionizing-radiation/control-prevention

  This section provides information on controlling ionizing radiation hazards and preventing dose. […] Developing and implementing a radiation protection program is a best practice for protecting workers from ionizing radiation. […] A key concept underlying radiation protection programs is keeping each worker’s occupational radiation dose As Low As Reasonably Achievable (ALARA). […] Employers should use engineering controls to maintain occupational radiation doses (and doses to the public) ALARA is applied after determining that radiation dose will not exceed applicable regulatory dose limits. […] Administrative controls generally supplement engineering controls. […] Personal Protective Equipment (PPE) is used to prevent workers from becoming contaminated with radioactive material. […] One of the most important functions of a radiation protection program is training radiation workers on safe work practices.

• #2 Acute radiation syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Acute_radiation_syndrome

  A guiding principle of radiation safety is as low as reasonably achievable (ALARA). This means try to avoid exposure as much as possible and includes the three components of time, distance, and shielding. […] The longer that humans are subjected to radiation the larger the dose will be. The advice in the nuclear war manual entitled Nuclear War Survival Skills published by Cresson Kearny in the U.S. was that if one needed to leave the shelter then this should be done as rapidly as possible to minimize exposure. […] Usually, matter attenuates radiation, so placing any mass (e.g., lead, dirt, sandbags, vehicles, water, even air) between humans and the source will reduce the radiation dose. […] There are many types of shielding strategies that can be used to reduce the effects of radiation exposure. Internal contamination protective equipment such as respirators are used to prevent internal deposition as a result of inhalation and ingestion of radioactive material.

• #2 About Preventing and Treating Radiation Injuries and Illness | Radiation Emergencies | CDC

  https://www.cdc.gov/radiation-emergencies/prevention/index.html

  The best way to prevent radiation injuries and illness is to […] Get inside as soon as possible […] Stay away from the radioactive material outside […] Shower or wash once inside (self-decontamination) […] Emergency officials will set up community reception centers to check people for radiation exposure and contamination. […] If you have symptoms after a radiation emergency, seek medical attention as soon as emergency officials determine it is safe to do so.

• #2 Mayo Clinic Health Library – Radiation sickness | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20377044

  In the event of a radiation emergency, listen to the radio or watch television to hear what protective actions local, state and federal authorities recommend. Those actions depend on the situation, but you will be told to either stay in place or evacuate your area. […] If you’re advised to stay where you are, whether you’re at home or work or elsewhere, do the following: Close and lock all doors and windows. Turn off fans, air conditioners and heating units that bring air in from outside. Close fireplace dampers. Bring pets indoors. Move to an inner room or basement. Stay tuned to your emergency response network or local news. Stay put for at least 24 hours. […] If you’re advised to evacuate, follow the instructions provided by your local authorities. Try to stay calm and move quickly and in an orderly manner. Travel lightly, but take supplies, including: Flashlight. Portable radio. Batteries. First-aid kit. Necessary medicines. Sealed food, such as canned foods, and bottled water. Manual can opener. Cash and credit cards. Extra clothes.

• #2 Radiation Emergencies – Housatonic Valley Health District

  https://hvhdct.gov/emergency-preparedness/radiation-emergencies/

  Housatonic Valley Health District encourages individuals to take immediate action to protect themselves and loved ones in the event a radiation emergency occurs in an area where they live or work. […] Why should I stay inside during a radiation emergency? Because radioactive materials become weaker over time, staying inside for at least 24 hours can protect you and your family until it is safe to leave the area. […] What does it mean to shelter-in-place during a radiation emergency? “Sheltering-in-place” means to get inside a building and stay there. In a radiation emergency, such as a nuclear power plant accident, a nuclear detonation, or the explosion of a dirty bomb you may be asked to get inside a building and take shelter for a period of time instead of leaving. The walls of a building can block much of the harmful radiation. Because radioactive materials become weaker over time, staying inside for at least 24 hours can protect you and your family until it is safe to leave the area. […] Essential Info: HVHD encourages individuals to take immediate action to protect themselves and loved ones in the event a radiation emergency. […] Do not leave your shelter until you are told that it is safe by local officials.

• #2 Mayo Clinic Health Library – Radiation sickness | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20377044

  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. Decontamination prevents radioactive materials from spreading more. It also lowers the risk of internal contamination from inhalation, ingestion or open wounds. […] 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. […] If you take potassium iodide, it may fill „vacancies” in the thyroid and prevent the absorption of radioiodine. Potassium iodide isn’t a cure-all and is most effective if taken within a day of exposure.

• #2 Radiation Sickness (Acute Radiation Syndrome)

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

  Radiation sickness can cause a range of symptoms at first, which include feeling weak, confused, feverish and sick to your stomach. […] 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. […] Providers typically recommend that all children and pregnant women who were exposed take potassium iodide to protect their thyroid from the uptake of radioactive iodine. […] There are steps you can take to protect yourself if a nuclear emergency happens. You can: Avoid the exposure area. Leave (or dont enter) the area where the exposure occurred. […] Seek emergency medical treatment as soon as possible.

• #2 Potassium Iodide (KI) and Radiation Emergencies: Fact Sheet

  https://www.health.ny.gov/environmental/radiological/potassium_iodide/fact_sheet.htm

  In general, most people who have taken KI have not had any reactions (side effects). If people did have a reaction, it did not last very long. In a few cases, babies had a reaction in their thyroids. Adults who had reactions had stomach problems or a rash. The federal government thinks the benefits of taking KI are much greater than the risks. […] Most people can take KI, but you should talk to your doctor before taking it. Talk to your doctor before an emergency occurs. It is not a good idea to take KI if you have certain medical conditions or problems. Babies need to be watched carefully if they take KI. […] KI is helpful for about 24 hours. You should keep taking it once a day until the health department says to stop, or you are out of the emergency area. […] KI can come as a pill or a liquid. Pills are available in 65-mg or 130-mg doses. KI is also available as a liquid.

• #2 Medical management of acute radiation syndrome and associated infections in a high-casualty incident

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5941165/

  An important caveat when comparing infections occurring after chemotherapy with those occurring after accidental exposure to IR is that infectious organisms are actually identified in only 20-30% of febrile episodes after chemotherapy, compared with documentation in nearly all febrile episodes after accidental irradiation. […] The overall approach to treatment of infections in the irradiated patient may be thought of in terms of time after exposure. […] Candidates for prophylactic antimicrobial therapy include those with (i) fever plus neutropenia, (ii) afebrile neutropenia with clinical signs and symptoms of infection, and (iii) clinical signs and symptoms of infection without neutropenia. […] The selection of prophylaxis for low-risk patients is determined by local community susceptibility patterns of the most likely infectious organisms.

• #2 Medical management of acute radiation syndrome and associated infections in a high-casualty incident

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5941165/

  Fluconazole prophylaxis should be administered to immunosuppressed patients whenever a fungal infection is suspected by the presence of characteristic clinical signs and symptoms. […] Empirical acyclovir or valacyclovir should be considered in all patients with a past medical history of a herpes simplex virus (HSV) infection and in those who are found to be seropositive for HSV to prevent virus reactivation from its latent state in nerve cell bodies. […] The management of health consequences from a high-casualty radiological incident requires that hospitals and the hospital networks apply their resources to integrative activities within the emergency response.

• #2 Radiation therapy induced nausea and vomiting

  https://www.eviq.org.au/clinical-resources/side-effect-and-toxicity-management/gastrointestinal/426-radiation-therapy-induced-nausea-and-vomiting

  Radiation-induced nausea and vomiting (RINV) is dependent on a number of treatment and patient related risk factors. […] Ensure high and moderate risk patients receive appropriate prophylaxis before each radiation treatment fraction. […] The purpose of this document is to provide guidance to minimise and where possible, prevent radiation therapy induced nausea and vomiting (RINV). […] The likelihood of experiencing RINV can be divided into the following 4 groups. […] Patients having concurrent chemoradiation therapy should receive antiemetic prophylaxis according to the emetogenicity of anti-cancer therapy, unless the emetic risk with the planned radiation therapy is higher. […] It is important to assess the patients risk of RINV prior to the start of radiation therapy to ascertain whether antiemetic therapy should be given routinely as a preventative measure (prior to treatment each day) or rescue once symptoms have presented.

• #2 Prophylaxis of radiation-induced nausea and vomiting: a systematic review and meta-analysis of randomized controlled trials – Li – Annals of Palliative Medicine

  https://apm.amegroups.org/article/view/13184/html

  The aim of this article was to systematically review the efficacy and safety of various antiemetics in prophylaxis of radiation-induced nausea and vomiting (RINV). […] For patients at high emetogenic risk (i.e., receiving TBI or total nodal irradiation), current guidelines recommend prophylaxis with a 5HT3 RA and a short course of dexamethasone. […] Our systematic review demonstrated that 5HT3 RA was significantly more efficacious than all other therapy groups (placebo, dopamine receptor antagonist, rescue therapy and dopamine receptor antagonist plus dexamethasone) in the prevention of acute RINV among patients receiving single or multiple fraction radiotherapy to the abdomen/pelvis. […] The addition of dexamethasone to 5HT3 RA gives a slight benefit in the prophylaxis of RINV when compared with 5HT3 RA plus placebo.

• #2 Prophylaxis of radiation-induced nausea and vomiting: a systematic review and meta-analysis of randomized controlled trials – Li – Annals of Palliative Medicine

  https://apm.amegroups.org/article/view/13184/html

  Our systematic review supports the recommendation of current guidelines. 5HT3 RA is the antiemetic of choice in the prophylaxis of RINV in patients receiving radiotherapy at high and moderate emetogenic risk. […] Therefore, radiation oncologists are encouraged to be aware of current guidelines on RINV and follow the recommendations in daily practice, in order to maximize the control of RINV and preserve the QoL of patients. […] Future RCTs should investigate the efficacy and safety of substance P neurokinin 1 receptor antagonist in addition to 5HT3 RA for the prophylaxis of RINV during both acute and delayed phases.

• #2 Medical management of acute radiation syndrome and associated infections in a high-casualty incident

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5941165/

  A successful medical response requires health care facilities to not only communicate and integrate medical services, meet surge capacity, protect health care workers and implement triage and treatment protocols, but also to provide the venue for clinical management of acute radiation injuries and their associated infections. […] Here, (i) recommendations made in Geneva are summarized; (ii) the analysis of countermeasures for HS is updated by review of two additional cases and extended to published reports not meeting inclusion criteria; and (iii) guidelines are provided for management of microbial infections based upon patient risk for prolonged immunosuppression. […] Recommendations were made for the use of cytokines to manage hematopoietic subsyndrome (HS) based on the then-current published reports of cases that met specific inclusion criteria.

• #2 Radiation Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441931/

  Early use of antibiotics should be the rule. The use of bone marrow transplant has been used for large dose exposures but remains controversial. […] Check your local institutions for radiation exposure protocols. Many hospitals have disaster committees with protocols in place for radiation exposure. […] Management of acute radiation syndrome is best done by a team of healthcare professionals.

• #2 Study identifies possible therapy for radiation sickness

  https://www.dana-farber.org/newsroom/news-releases/2011/study-identifies-possible-therapy-for-radiation-sickness

  A combination of two drugs may alleviate radiation sickness in people who have been exposed to high levels of radiation, even when the therapy is given a day after the exposure occurred, according to a study led by scientists from Dana-Farber Cancer Institute and Children’s Hospital Boston. […] The larger time window for administering the two-drug regimen raises the prospect that it could become a mainstay of the response to public health threats such as a nuclear power plant accident or nuclear terror attack. […] The investigators also found that the ability to generate new blood cells which can shut down in the aftermath of radiation exposure rebounded much more quickly and vigorously in the mice treated with fluoroquinolone and rBPI21 (the synthetic version of BPI), potentially contributing to their return to health.

• #2 Study identifies possible therapy for radiation sickness

  https://www.dana-farber.org/newsroom/news-releases/2011/study-identifies-possible-therapy-for-radiation-sickness

  „Both fluoroquinolone antibiotics and rBPI21 have been shown to be quite safe in humans,” says Levy. „Their combined effectiveness in our study involving mice is an indication that they may be equally beneficial in people.” […] The research potentially represents a major step in the United States government’s efforts to build a stockpile of therapies to counter radiological dangers. […] „Developing useful agents has proven difficult. Most existing drugs aren’t effective enough and must be given within a very short time frame to provide any benefit.” […] The treatment approach developed by Guinan, Levy and their colleagues takes direct aim at two potential contributors to radiation sickness: bacteria and the endotoxins on their surface. „We theorized that a two-drug therapy would be most effective,” Levy states.

• #2 Radiation Sickness | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/1688608/all/Radiation_Sickness?q=Acute+leukemia

  Radiation sickness, or acute radiation syndrome (ARS), is defined as an acute illness caused by radiation of most or all of the body with a relatively high dose of radiation over a short period of time. […] Potassium iodide can reduce thyroid cancer risk; give promptly if contamination with radioactive iodine (iodine-131) is suspected. […] Avoidance of exposure: exposure reduced by decreasing time, increasing distance, and shielding. […] Pretreatment: In certain situations, damage to the thyroid may be reduced by preexposure consumption of radiostable iodine.

• #2 Lesson learnt from nuclear disasters – health hazards & its prevention – MedCrave online

  https://medcraveonline.com/MOJPH/lesson-learnt-from-nuclear-disasters—health-hazards-amp-its-prevention.html

  Acute Radiation Syndrome also is known as radiation sickness caused by a high dose of penetrating radiation. […] The best prevention of radiation sickness is to minimize the exposure dose. This can be achieved by increasing the distance from the radiation source and early evacuation. […] Sustained Information, Education and Communication (IEC) activities should be carried out vigorously to sensitize the people of health hazards of radiation exposure that can occur in the health sector or due to nuclear fallout that may be accidental or intentional. […] The best prevention for radiation syndrome is to scale back the exposure dose or to chop the rate through increasing the space from the area and time reduction. […] Increasing distance from the radiation source will reduce exposure. […] The longer humans are subjected to radiation, the larger the dose absorbed. The exposed person should be taken out of the place of disaster as early as possible.

• #3 Acute radiation syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Acute_radiation_syndrome

  A guiding principle of radiation safety is as low as reasonably achievable (ALARA). This means try to avoid exposure as much as possible and includes the three components of time, distance, and shielding. […] The longer that humans are subjected to radiation the larger the dose will be. The advice in the nuclear war manual entitled Nuclear War Survival Skills published by Cresson Kearny in the U.S. was that if one needed to leave the shelter then this should be done as rapidly as possible to minimize exposure. […] Usually, matter attenuates radiation, so placing any mass (e.g., lead, dirt, sandbags, vehicles, water, even air) between humans and the source will reduce the radiation dose. […] There are many types of shielding strategies that can be used to reduce the effects of radiation exposure. Internal contamination protective equipment such as respirators are used to prevent internal deposition as a result of inhalation and ingestion of radioactive material.

• #3 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

  Protection from radiation exposure is accomplished by avoiding contamination with radioactive material, minimizing the duration of exposure, maximizing the distance from the source of radiation, and shielding the source. […] During radiation therapy, parts of the body that are near, but are not the target of the therapy procedure, should be shielded to the extent possible with lead. […] Medical personnel with routine exposure to radiation sources should follow procedures to minimize duration of exposure, maximize distance from the source of radiation, and wear appropriate shielding. […] People living within 16 km (10 miles) of a nuclear power plant should have ready access to potassium iodide tablets in case radioactive iodine, which is a fission byproduct, is released from the plant. Potassium iodide helps prevent radioactive iodine uptake by the thyroid. […] Radioprotective medications, such as thiol compounds with radical scavenging properties, have been shown to reduce mortality when given before or at the time of irradiation in patients undergoing chemotherapy and/or radiation therapy.

• #3 Protecting Yourself from Radiation | US EPA

  https://www.epa.gov/radiation/protecting-yourself-radiation

  If a radiation emergency occurs, you can take actions to protect yourself, your loved ones and your pets: Get Inside, Stay Inside and Stay Tuned. […] Staying inside will reduce your exposure to radiation. […] Emergency officials are trained to respond to disaster situations and will provide specific actions to help keep people safe.

• #3 Radiation Poisoning: Causes, Symptoms, and Prevention

  https://www.healthline.com/health/radiation-poisoning

  Decontaminating as soon as possible after a nuclear event can help you reduce your radiation exposure. […] Taking off your clothing and washing your body with soapy water can remove most radioactive contamination. […] In the event of a terrorist attack, the Centers for Disease Control and Prevention (CDC) recommends: undressing at your doorway or garage if possible before entering your home, avoiding unnecessary hand-to-face contact and avoiding chewing gum or smoking until after decontamination, showering with warm water and soap, gently blowing your nose, wiping your eyelids, and cleaning out your ears, changing into clean clothing, rinsing out your tub or shower, tuning into media for instructions from public health officials in your area. […] If you’re in a radiation emergency, you can reduce your risks by taking the following steps: Get inside a building and close and lock the windows and doors.

• #3 Preparing for a Radiation Emergency | Radiation Emergencies | CDC

  https://www.cdc.gov/radiation-emergencies/safety/index.html

  If a radiation emergency occurs, you can take actions to protect yourself, your loved ones, and your pets. […] The best way to protect yourself in a radiation emergency is to get inside, stay inside, and stay tuned. […] It is important to stay inside until officials provide instructions or say it is safe to go outside. […] Getting inside of a building and staying there is called „sheltering in place.” […] As soon as you get inside, decontaminate yourself (remove and wash radioactive material from your body). […] While inside, decontaminate yourself to lower your exposure to harmful radioactive material. […] Because radioactive materials become weaker over time, staying inside for at least 24 hours can protect you and your family until it is safe to leave the area. […] Remember: Get Inside, Stay Inside, and Stay Tuned. […] People can protect themselves from radiation exposure if they are in or around an affected area.

• #3 Potassium Iodide (KI) and Radiation Emergencies: Fact Sheet

  https://www.health.ny.gov/environmental/radiological/potassium_iodide/fact_sheet.htm

  Potassium Iodide (KI) and Radiation Emergencies: Fact Sheet is available in Portable Document Format (PDF, 26KB, 2pg.) […] This fact sheet is about the NYS policy for people, especially those who live within ten miles of a nuclear power plant, who may be exposed to radiation from a nuclear plant emergency. In December 2001, the federal Food and Drug Administration (FDA) said if there was a radiation emergency, people should take a drug that would help protect them from thyroid cancer. This drug is called potassium iodide (KI). The New York State Health Department agrees. The questions and answers below will give you more information. […] If there is a radiation emergency at a nuclear plant, large amounts of something called radioiodine could be put into the air. This could hurt your thyroid gland, or even cause thyroid cancer later on. You could breathe in the radioiodine or eat food that has some radioiodine in it. When you take the KI pill, it protects your thyroid gland from being harmed.

• #3 Accidents at Nuclear Power Plants and Cancer Risk – NCI

  https://www.cancer.gov/about-cancer/causes-prevention/risk/radiation/nuclear-accidents-fact-sheet

  What can people do to protect themselves from health risks associated with exposure to contamination from a nuclear power plant accident? […] Local or national authorities may also advise certain people (newborns, infants, children, adolescents, and women who are pregnant) in areas with high I-131 contamination to take potassium iodide (KI) to prevent the accumulation of I-131 in their thyroid. KI should not pose a danger to someone who previously received radiation therapy or chemotherapy. Patients who are actively being treated for cancer and who are advised to take KI should consult with their doctor before taking the medication, so their doctor can evaluate their treatment plan and their health status, including their nutritional status, to determine the safety of KI treatment for them.

• #3 Radiation sickness: Sources, effects, and protection

  https://www.medicalnewstoday.com/articles/219615

  Radiation sickness describes damage to the body that occurs after a large dose of radiation. […] There is no cure, but barriers can prevent exposure and some medications may remove some radiation from the body. […] Possible treatments include: Removing all clothing, Rinsing with water and soap. Use of potassium iodide (KI) to block thyroid uptake if a person inhales or swallows too much radioiodine. Prussian blue, given in capsules, can trap cesium and thallium in the intestines and prevent them from being absorbed. This allows them to move through the digestive system and leave the body in bowel movements. Filgrastim, or Neupogen, stimulates the growth of white blood cells. This can help if radiation has affected the bone marrow. […] Tips for reducing unnecessary exposure to radiation include: keeping out of the sun around midday and using a sunscreen or wearing clothes that cover the skin, making sure any CT scans and x-rays are necessary, especially for children, letting the doctor know if you are or may be pregnant before having an x-ray, PET, or CT scan.

• #3 Division of Public Health – – Health Alert – Delaware Health and Social Services – State of Delaware

  https://dhss.delaware.gov/dph/php/alerts/dhan65.html

  During an orange (high) alert, clinicians should be prepared to respond to a terrorist event involving radiation or nuclear weapons. […] CDC has developed new interim guidelines for hospital response to casualties from a radiological or nuclear emergency. […] Clinicians should be informed that removing clothing from potentially contaminated patients eliminates most external contamination and that universal precautions are generally sufficient to protect clinicians from harm of radiation exposure. […] In case of a radiation or nuclear emergency, clinicians should be aware of the immediate symptoms of acute radiation syndrome (ARS), sometimes called radiation sickness. […] Focus should be placed on prevention and treatment of infections. […] Information on conditions, stages and treatment of ARS can be found at: http://www.bt.cdc.gov/radiation/arsphysicianfactsheet.asp. […] Additional medical guidance can be found at the Department of Homeland Securitys Report on Medical Treatment of Radiological Casualties: http://www1.va.gov/emshg/docs/radiologic_medical_countermeasures_051403.pdf.

• #3 Radiation therapy induced nausea and vomiting

  https://www.eviq.org.au/clinical-resources/side-effect-and-toxicity-management/gastrointestinal/426-radiation-therapy-induced-nausea-and-vomiting

  The aims of RINV management are to: prevent an initial emetic episode from occurring, or manage symptoms once they present as a result of radiation therapy. […] Anticipatory RINV can occur any time after the first course of radiation therapy and is a conditioned response, typically occurring after a previous negative experience with radiation therapy. Prevention of RINV will also prevent anticipatory phase RINV. […] Educate your patient: to take antiemetics as prescribed (e.g. prior to radiation therapy).

• #3 Psychological First Aid in Radiation Disasters

  https://www.orau.gov/rsb/pfaird/01-introduction.html

  Psychological Mental health consequences of radiation disasters are unique, serious, and can be more severe and longer lasting than physical and economic consequences. […] Disaster mental health training is important for all: Public health professionals, Clinicians, First responders, Volunteers who may respond to a radiation disaster. […] Disaster preparedness training can reduce the risk of post-traumatic stress disorder for workers and volunteers who respond to disasters. […] The Centers for Disease Control and Prevention have developed this program to help clinical and public health professionals better prepare to respond to radiation emergencies.

• #3 Study identifies possible therapy for radiation sickness

  https://www.dana-farber.org/newsroom/news-releases/2011/study-identifies-possible-therapy-for-radiation-sickness

  The promise of this approach is underscored by the nature of the two agents, the study authors say. Both have a proven safety record in humans and can be stored for long periods of time, making them suitable for stockpiling. […] „These observations led to the hypothesis that replenishing BPI could decrease the toxicity of radiation,” Levy adds. […] „This result is a promising new strategy for response to a nuclear event.”

• #3 Lesson learnt from nuclear disasters – health hazards & its prevention – MedCrave online

  https://medcraveonline.com/MOJPH/lesson-learnt-from-nuclear-disasters—health-hazards-amp-its-prevention.html

  Prevention of adverse effects can be done through the following measures: […] Find out and respect the regulations regarding production, transport, handling and storage of radioactive substances. […] If an atomic explosion occurs- take shelter behind a solid wall if you’re outside. […] The entire city or neighborhood could become endangered by radiological hazards. […] Plan a haven at your residence. […] The water-soaked cloth should be wont to seal gaps under doors. […] Protective equipment mask, waterproof clothing, long-sleeved shirts, long trousers, raincoats, boots, gloves, etc. […] We should always use radiation in medical sciences judiciously taking all the precautions and medicine.

• #4 American College of Emergency Physicians | ACEP

  https://www.acep.org/imports/clinical-and-practice-management/resources/ems-and-disaster-preparedness/disaster-preparedness-grant-projects/cdc—blast-injury/cdc-blast-injury-fact-sheets/radiological-dispersal-devices-and-radiation-injury

  Radiological Dispersal Devices (RDDs) or „dirty bombs” consist of radioactive material combined with conventional explosives. […] Guidelines for protection and treatment are provided below. […] Establish an ad hoc triage area in a location based on the hospitals disaster plan and the anticipated number of casualties. Stock a sufficient quantity of hospital-supplied gowns to replace contaminated clothing. […] Survey the patient with a radiation meter using a consistent technique and trained personnel. […] For mass casualties, consider establishing separate shower areas for ambulatory and non-ambulatory patients. […] Monitor for fluid and electrolyte balance and for evidence of hemodynamic instability. […] Consider cytokines, e.g., Neupogen and hematopoietic growth factors. […] Radiation experts may recommend early administration of radionuclide-specific decorporation agents such as Prussian Blue, DTPA, or Bicarbonate.

• #4 Division of Public Health – – Health Alert – Delaware Health and Social Services – State of Delaware

  https://dhss.delaware.gov/dph/php/alerts/dhan65.html

  During an orange (high) alert, clinicians should be prepared to respond to a terrorist event involving radiation or nuclear weapons. […] CDC has developed new interim guidelines for hospital response to casualties from a radiological or nuclear emergency. […] Clinicians should be informed that removing clothing from potentially contaminated patients eliminates most external contamination and that universal precautions are generally sufficient to protect clinicians from harm of radiation exposure. […] In case of a radiation or nuclear emergency, clinicians should be aware of the immediate symptoms of acute radiation syndrome (ARS), sometimes called radiation sickness. […] Focus should be placed on prevention and treatment of infections. […] Information on conditions, stages and treatment of ARS can be found at: http://www.bt.cdc.gov/radiation/arsphysicianfactsheet.asp. […] Additional medical guidance can be found at the Department of Homeland Securitys Report on Medical Treatment of Radiological Casualties: http://www1.va.gov/emshg/docs/radiologic_medical_countermeasures_051403.pdf.

• #4 Radiation protection with anti-radiation vaccine and anti-radiation antidote in reducing the biological impact of high dose and dose-rate, low-linear energy transfer radiation exposure. – ADS

  http://ui.adsabs.harvard.edu/abs/2021cosp…43E1873P/abstract

  Radiation protection with anti-radiation vaccine and anti-radiation antidote in reducing the biological impact of high dose and dose-rate, low-linear energy transfer radiation exposure. […] The prior development of radiation protection strategies included an anti-radiation vaccine and an anti-radiation hyperimmune serum, which demonstrated novel methods for both immunoprophylaxis and immunotherapy of acute radiation syndromes. […] Active immunization with MAC molecules, isolated from membranes of irradiated cells, administered to mammals before irradiation, increase survival rate among animals that were irradiated by lethal doses of gamma-radiation. […] Therefore, active immunization can be induced by MAC molecules as a prophylaxis. […] Our results suggest that a humanized anti-radiation vaccine can be developed for prophylactic use against radiation damage induced by acute exposure to significant doses of low Linear Energy Transfer (LET) radiation for humans, including nuclear power workers, commercial and military pilots, cosmonauts/astronauts, nuclear-powered engine vessel operators and possibly even the civilian population in the case of a nuclear terrorism event.

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