The more rapid the prodromal symptoms occur, the more likely a significant exposure has taken place.
Partial exposure tends to be less severe, as some stem cells should be unaffected and able to proliferate.
Nausea, vomiting, diarrhea are common.
Other symptoms include fever, eye burning, and abdominal pain.
Mediated by inflammatory response and parasympathetic stimulation.
The rapidity of onset of the prodrome phase is predictive of the severity of the Manifest Phase.
Inflammatory response quietens, and patients are relatively asymptomatic.
Cellular deficits become manifest.
Epithelial and endothelial cells slough.
Deficits in hematopoetic cells
Fibrosis
Stem cells recover and may mount a proliferative response.
If proliferation is insufficient to prevent critical organ failure, then death will occur.
|
Parameter |
Fourth Degree |
Third Degree |
Second Degree |
First Degree |
|---|---|---|---|---|
|
Prodrome onset/h |
< 0.5 Vomiting, headache ,fever |
0.5-1 Vomiting, headache, hyperemia |
1.0-3 Vomiting |
>3 |
|
Latent Period/d |
6 to 8 |
8 to 17 |
15 to 25 |
>30 |
|
Skin Burns |
40% - 90% |
Mod to severe |
Slight |
Slight |
|
Enteritis |
7 to 9 days |
Xx |
Xx |
Xx |
|
Lymphocyte Count |
< 100 |
100 to 200 |
300 to 500 |
600 to 1000 |
|
Radiation Dose/gy |
6 to 16 |
4 to 6 |
2 to 4 |
1 to 2 |
|
Symptoms |
Intoxication, fever, oral and salivary lesions, severe burns, severe enteritis |
Fever, infection, hemorrhage, skin injury |
Infections, minor hemmorhage, |
No severe skin changes, |
|
Survival |
Unlikely |
Probable with Tx |
Possible without Tx |
Probable without Tx |
One of the earliest systems to be affected.
Depression appears at .25Gy and is maximal at 6Gy.
Neutrapenia occurs maximally at 15 days.
Lymphocytes are suddenly depressed after 48 hours. They are the most sensitive cell to radiation.
Platelets are maximally depressed at 15-30 days.
Patients should be treated as usual for Neutrapenia
Symptoms begin at 6Gy
Begins as inflammation and leads to desquamation.
Interstitial Pneumonitis leads to later radiation fibrosis in months to years time.
Changes to hair follicles at 0.75Gy. Depilation at 3Gy.
Skin erythema occurs at 6Gy.
Desuamation is maximal at 2 weeks.
Occurs only at extremely high doses.
May include Early Transient Incapacitation (Loss of Consciousness) at supralethal doses.
Increased intracranial pressure may occur due to edema at 2 days.