Radiation Injury

Acute Radiation Toxicity primarily affects rapidly dividing cells based on dosage

Hematopoiteic - Pancytopenia, Infection

 • Dose > 2 Gy

 • Onset <2 days 

GI - N/V, Dehydration, GI Bleed

 • Dose > 6 Gy

 • Onset Hours

Cardio/CNS - Circuatory collapse, CNS damage

 • Dose > 10 Gy

 • Onset Minutes

LD50 (lethal dose to kill 50% of people) = 4.5 Gy. 1 Gy = ~10,000 CXRs

Primary ED goal is containment and decontamination

If exposed to radioactive Iodine (power plants and nuclear weapons), consider potassium iodide to prevent thyroid cancer

Start broad spectrum Abx, consider antivirals/antifungals, and admit to heme/onc facility capable of bone marrow transplant

Lymphopenia is first lab abnormality to develop (absolute lymphocyte count = ALC) and should be checked at 48 hours

 • ALC > 1000 = good prognosis

 • ALC < 300 = lethal



- MH/CCF/CWRU EM Res @MetroHealth_EM



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