Page 97 - 2022 Ranger Medic Handbook

RADIATION POISONING
MARCH PPE AND DECON CONSIDERATIONS
M – Massive hemorrhage/Mask check: ensure the • Airway protection as needed based on isotope.
patient has good mask seal • Wearing one (1) pair of nitrile gloves will provide
A – Airway/Antidote: As needed needed protection IOT put hands on patient.
R – Respirations/Rapid DECON: Rapid DECON • Ensure patient is masked or has protected airway to
with physical removal of clothing and any particulates prevent inhalation injuries (goggles and mask would
on skin suffice). SECTION 2
C – Circulation/Countermeasures: Prussian Blue, zinc/ • DECON with tape or baby wipes and removal of
calcium DTPA for internal contamination clothing.
H – Hypothermia/Head injury • Wounds should be irrigated to less than 2 ×
background.
• Time, distance, and shielding are the three major
factors in the amount of radiation the patient will
receive. Doubling patient’s distance from the source
with quarter amount of radiation received.
IMMEDIATE CONSIDERATIONS PFC CONSIDERATIONS
• Time to emesis is key to dosage and patient outcome • Supportive care
(< 1 hour is expectant, 1–4 hours is immediate/
delayed, > 4 hours minimal).
• Dosage should be kept as low as reasonably
possible.
• BPT suction airway post vomiting.
• Removal of any foreign objects should be done
so with instruments only and placed as far from
personnel as reasonably possible.
λ Gamma Emitters Radiation Pearls
Industry Use, of Terrorist Interest. RDD or RED • Radiation Exposure
Cobalt 60 ➣ From existing sources or small-scale criticality
Chelating agent: DTPA calcium or zinc, 1g in 5mL incident
in 250mL of NS over 30 minutes ➣ Detection, dosimetry, conduct bioassay post
Cesium 137 mission with medical evaluation
Chelating agent: Prussian Blue (Radiogardase), ➣ Radioactive gasses may be present in reprocessing
3g tid facility or at a damaged nuclear reactor
➣ Reverse isolation for severely irradiated casualties
β Beta Emitters • Corrosive liquids and gasses
Uranium hexafluoride can off gas hydrogen
➣
Strontium 90 fluoride gas
Aluminum hydroxide ➣ Nitric acid used in reprocessing
10% Calcium chloride suspension IV: 200mg to 1g • Heavy metal toxicity
every 1–3 days, slow 1mL/min
Calcium gluconate PO: 10g powder in 30mL water Acute Radiation Syndrome (ARS)
Iridium 192 Whole body dose of greater than 100cGy or 100 rad
DTPA calcium or zinc, 1g in 5mL in 250mL of NS over Hematopoietic syndrome > 200–300cGy
30 minutes for internal contamination Gastrointestinal syndrome > 600cGy
Tritium H3 Neurovascular syndrome > 1200cGy
Beer. Increase diuresis
ARS symptoms do not manifest immediately, our role
α Alpha Emitters involves treating immediate life threats and administra-
Uranium 235, 238 tion of chelating agents and decontamination. Dose
Sodium bicarbonate oral or IV estimation determines prognosis. We have the ability
Americium 241/Plutonium 239 to perform blood collection for later biodosimetry. We
DTPA calcium or zinc, 1g in 5mL in 250mL of NS over do not have cytokines. Initiate stem cell banking recall
30 minutes for sick personnel. Prolonged evacuation times may
necessitate the treatment of ARS.

2022 RANGER MEDIC HANDBOOK 83