Purpose:The effects of ionising radiation on the human body has been discussed. The authors believe that the understanding of the radiation incidents from the perspective of its effects is crucial for better preparation, and therefore safer and more effective responses to incidents involving such threats. Introduction: The increasing use of radioactive materials and radiation producing devices in many areas of our lives carries the risk of exposure to high doses of radiation being hazardous to our health due to possible damage to radiation sources or improper handling. Exposure resulting from the intentional use of radioactive materials for criminal or terrorist purposes cannot be excluded, either. Exposure to ionising radiation may cause adverse health effects both to victims of a radiation incident and for rescuers providing emergency care. Such threats require the proper preparation of emergency medical services (EMS). Part of these preparations is to examine the specifics of radiation hazards, including radiation sources, the mechanism of injury of ionising radiation and the type of radiation damage. Methodology: The publication presents the properties of ionising, corpuscular and electromagnetic types of radiation, which are the most important from EMS's perspective. The dangers of contact with a radiation source, the problem of external and internal contamination, the estimation of the amount of absorbed radiation were discussed, and the interrelationships between them were presented. The mechanism of direct and indirect action of ionising radiation on cell structures (DNA, mRNA, cytoplasmic membranes) and intracellular enzymes was thoroughly discussed. The authors presented health consequences of radiation for the body in the form of acute (deterministic) lesions and late (stochastic) lesions. Conclusions: Particular attention was paid to acute radiation syndrome (ARS). The dependence of ARS on the amount of absorbed radiation was discussed in detail. Four stages of ARS were presented: initial, latent, manifest illness and recovery (or death) as well as the time of their onset, duration and end. The mechanism of damage to individual organs and systems was also analysed. The most common symptoms, their severity, and causes of life-threatening conditions, resulting from radiation damage in particular syndromes of ARS, were indicated. In addition to systemic effects, local changes in the form of Cutaneous Radiation Syndrome (CSR) were discussed.

Introduction: Medical personnel of the state Emergency Medical Services (EMS) will be the first element involved in providing assistance to victims of radiation incidents. Triage, initial diagnosis and further patient medical management will depend on their actions. In many radiation incidents, initial radiation triage and early diagnostics will be carried out in the emergency department (ED) or trauma center (TC). Extended triage, diagnosis of ARS and proper treatment will be continued in specialist centers. The aim: To present a model of patient medical management including initial triage and early diagnosis of ARS that can be carried out at the ED and TC. Material and methods: The initial medical procedures prepared by expert groups were presented. The choice of procedures was made in terms of the possibility of their application by the EMS teams in Poland. Particular attention was paid to the method of initial triage, based on the clinical condition and laboratory diagnostics. Results: Based on the material collected, the path of the initial medical procedure was presented. Variants of the radiation triage, interpretation of clinical parameters and results of laboratory tests are presented. The methods of initial treatment and the method of qualification for specialist treatment, and new methods of treating patients were also described. Conclusions: An adequate evaluation of radiation incidents, determining the absorbed dose of ionising radiation and ARS, as well as initial triage seem to be crucial skills of the EMS workers.

Introduction: The use of radiation sources in various areas of life generates the risk of accidents and radiation disasters. The increase in terrorist threats as well as the risk of an outbreak of new armed conflicts carries the risk of using radioactive materials by terrorist groups and the military. Exposure to high doses of radiation and absorbing above-threshold doses by victims may cause acute radiation syndrome (ARS), as well as some distant effects. Personnel of the State Emergency Medical System (EMS) will be the first professional medical team in the process of providing assistance to such victims. The effects of further medical treatment in the hospital will depend on EMS’s first response, radiological triage and initial interventions taken. The aim: To present pathophysiology and clinical symptoms of acute radiation syndrome in the context of the medical practice of the EMS. Material and methods: For the purpose of this publication, an analysis of literature on the subject of the mechanism of ionizing radiation and its effects on the human body was performed. The work is focused on the interpretation of research results and their presentation from the EMS’s perspective. Results: The publication presents the impact of ionizing radiation on the body, the mechanism of damage to cellular structures and its consequences for individual organs and systems. ARS’s clinical (hematopoietic, intestinal, cerebrovascular) syndromes were discussed in detail, paying attention to radiation doses, the sensitivity of individual systems and organs, the dynamics of individual phases, as well as the ability to recognize and assess the severity of their progression by EMS personnel. Conclusions: The knowledge of pathophysiology, and ARS’s symptoms and dynamics is important to respond correctly to radiation incidents. This knowledge allows for efficient organization and emergency management during rescue operations. The increase in the risk of radiation incidents and radiation disasters generates the need for appropriate preparation of emergency rescuers, in particular, of the medical personnel of the State Emergency Medical Services.