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Key limitations in treating mass casualty
- 1. bed capacity/availability
- 2. burn and trauma care
- 3. decontamination
- 4. antidotes
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Ionizing Radiation types
- alpha: doesnt go through uniforms
- beta: internal contamination (GI, airways)
- gamma/neutron: goes right through you
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Properties of Fallout
- -reaches ground after first 24hrs
- 7/10 rule: for every 7 hours, 10-fold increase in radiation risk
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Acute Radiation Syndrome
- prodromal: nausea, vomiting, diarrhea, hypotension
- -transient
- -lethal dose if seen 30 min - hr
- latent phase: symptom free
- -shorter this phase, higher the likelyhood of death
- **manifest illness phase: three dose-dependent subsyndromes - hematopeitic, GI, CV/CNS
- recovery/death phase: -
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Hematopoeitic syndrome
- -1.5-2.0Gy
- -immunosupression
- -pneumonia a major issue
- -earliest test, best predictor of outcome
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GI Syndrome
- -3-7 Gy
- -intestinal mucosal barrier destruction
- -fluid loss, electrolyte imbalance
- -enteric flora enter blood
- -faster reproducing cells, more affected by radiation; all result in fatalities
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Cardiovascular/CNS syndrome
- -20-30Gy
- -already dead, body just hasnt figured it out yet
- -death in 1-3 days due to circulatory collapse
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Management
- Step 1: limit exposure (shielding, distance, time)
- Step 2: decon
- Step 3: treat - life threatening trauma first (w/in first four hours = expectant )
- then treat radiation effects - burns, drugs
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