2015
DOI: 10.1016/j.emc.2014.09.008
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Emergency Department Management of Patients Internally Contaminated with Radioactive Material

Abstract: SUMMARY Internal contamination with radioactive material can expose patients to radiation leading to short- and long-term clinical consequences. After the patient’s emergency conditions are addressed and the skin is decontaminated, the treating physicians assess the amount of radioactive material that has been internalized. This evaluation allows the estimation of the radiation dose that is delivered the specific radionuclide inside the body and supports the need for additional therapies and monitoring. These … Show more

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Cited by 21 publications
(16 citation statements)
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“…Conventional biomarkers of experimental radiation-induced damage including dicentric chromosomes, micronucleus formation, γ-H2AX phosphorylation and changes in gene expression, such as xeroderma pigmentosum ( Xpc ), cyclin-dependent kinase inhibitor 1A ( Cdknla ), growth arrest and DNA-damage-inducible 45 alpha ( Gadd45a ) and mouse 3T3 cell double minute 3 ( Mdm3 ) (2, 3), have been proposed as biomarkers for radiation exposure but these are largely low-throughput technologies that require large sample volumes, inaccessible tissues and significant sample processing time (4). Currently, human exposure to radiation is evaluated based upon the onset and duration of nausea, vomiting, whole blood cell counts and neurological symptoms (5, 6). Hence, novel high-throughput biodosimetry devices should be of great value for the medical management of radiation exposure incidents for the purpose of triage applications.…”
Section: Introductionmentioning
confidence: 99%
“…Conventional biomarkers of experimental radiation-induced damage including dicentric chromosomes, micronucleus formation, γ-H2AX phosphorylation and changes in gene expression, such as xeroderma pigmentosum ( Xpc ), cyclin-dependent kinase inhibitor 1A ( Cdknla ), growth arrest and DNA-damage-inducible 45 alpha ( Gadd45a ) and mouse 3T3 cell double minute 3 ( Mdm3 ) (2, 3), have been proposed as biomarkers for radiation exposure but these are largely low-throughput technologies that require large sample volumes, inaccessible tissues and significant sample processing time (4). Currently, human exposure to radiation is evaluated based upon the onset and duration of nausea, vomiting, whole blood cell counts and neurological symptoms (5, 6). Hence, novel high-throughput biodosimetry devices should be of great value for the medical management of radiation exposure incidents for the purpose of triage applications.…”
Section: Introductionmentioning
confidence: 99%
“…This expert should be an integral part of the team receiving exposed patients in a dedicated area of the emergency department. The trained staff in CBRN medicine, which includes medical handling of patients after Chemical, Biological, Radiological and Nuclear accidents, in case of nuclear accidents should work in close cooperation with the expert in nuclear medicine, who should take part in the important administrative steps, which can be summarized as follows [5]: In an emergency situation, a limit for the radiation dose to the emergency staff is not set when they perform the initial life-saving activities. However, a cumulative dose limit (0.5 Gy) has been suggested as a decision point for the team leader when considering how to proceed after an initial time period of about 60 min [5].…”
Section: General Principles In Therapy Of Contaminated Casesmentioning
confidence: 99%
“…Human uptake of radionuclides may occur via contaminated food or dust. A primary purpose of emergency therapy mobilization is to minimize the radiation dose of contaminated individuals [3][4][5]. Nuclear incidents occur infrequently and some occur very rarely.…”
Section: Introductionmentioning
confidence: 99%
“…If the amount of radionuclide measured inside the body is greater than or equal to the corresponding Clinical Decision Guide, further medical management is warranted. 49 For radionuclides other than the isotopes of iodine, the Clinical Decision Guide values for children are 20% of those for adults because of their increased radiosensitivity. 50 The medical management of patients with internal contamination consists primarily of supportive care and long-term monitoring for cancer and other health outcomes.…”
Section: Internal Contaminationmentioning
confidence: 99%