Radiation Sickness – Diagnosis and Treatment
Diagnosis
When evaluating a person after a possible radiation emergency, healthcare teams use several methods to figure out how much radiation the person received. This helps them understand the likely effects of acute radiation syndromes and guides their next steps.
First, doctors collect details about the person’s contact with radiation, including distance from the source and how long the exposure lasted. People who were closer or exposed for longer periods tend to receive more severe doses.
Early symptoms are also key. The time between exposure and the start of vomiting often serves as an important clue—a shorter interval usually signals a higher radiation dose.
Other symptoms, like diarrhea, fever, fatigue, confusion, or skin problems such as erythema (redness) and desquamation (skin peeling), can help show the stage or severity of radiation sickness.
Blood tests play a major role in diagnosing damage. They check for:
| Test | What It Shows |
|---|---|
| White blood cell drops | Bone marrow injury (seen in hematopoietic syndrome) |
| Unusual DNA changes | Radiation damage to blood cells |
Devices also aid the process. A dosimeter measures how much radiation someone received, but it must have been exposed at the same time and place.
A Geiger counter or similar survey device can detect radioactive particles on or inside the body, which helps check for external or internal contamination.
Doctors also determine the type of radiation involved, as this affects treatment. In serious cases, medical teams watch for specific problems like cutaneous radiation injury or budding signs of genetic defects from radiation’s impact.
Initial triage helps decide who needs urgent care, who may recover after the latency stage, and who needs treatments for complications like acute radiation sickness, radiation dermatitis, or other organ injuries.
Treatment
Removing Radioactive Substances from the Body
Removing radioactive dust or particles on the skin and clothes is an important first step. Taking off contaminated clothing and shoes eliminates most of the outside radioactive matter.
Washing the body well with water and soap removes the rest. This process lowers the chance for radioactive material to get inside the body by breathing, swallowing, or through cuts.
Below is a table showing removal methods and what they help with:
| Step | What It Removes |
|---|---|
| Take off clothes and shoes. | ~90% of surface dust |
| Wash skin and hair with soap and water. | Remaining particles |
Decontamination keeps the spread of radioactive particles low and protects both the patient and healthcare workers.
Helping Bone Marrow Recover
Radiation can harm bone marrow, which makes blood cells. Medicines called growth factors (such as filgrastim, pegfilgrastim, and sargramostim) help the body make more white blood cells.
These medicines lower the risk of infections. If bone marrow is badly hurt, patients might need blood transfusions.
Red blood cells and platelets are sometimes replaced to help with anemia or bleeding. Platelet transfusions may be especially important if bleeding becomes hard to control.
Tools for Damaged Bone Marrow:
- Colony-stimulating factors (filgrastim, pegfilgrastim, sargramostim)
- Platelet and red blood cell transfusions
Treating Radioactive Particles Inside the Body
When radioactive substances get inside someone, certain medicines help remove them or keep the body from absorbing them:
- Potassium iodide prevents the thyroid from taking up radioactive iodine. It is most useful if taken soon after exposure.
- A binding agent for radioactive cesium or thallium can help the body eliminate these materials through bowel movements.
- A chelating agent may be used to bind metals like plutonium, americium, and curium, helping to remove them through urine.
- Some other substances, such as a radioprotective agent, may help protect healthy tissue during certain types of radiation exposure, though they are not always used.
Treatments that Provide Comfort and Support
Many people with acute radiation sickness need care to manage symptoms and prevent problems. This can include:
- Drinking plenty of fluids to stop dehydration
- Medicine for nausea, diarrhea, or pain
- Antibiotics for bacterial infections
- Care for burns or skin ulcers
- Ways to lower fever and control headaches
Supportive treatments help those with symptoms of bone marrow syndrome, gastrointestinal (GI) syndrome, and tissue reactions.
Care When Recovery is Not Possible
Some people receive a very high dose of radiation and are not expected to survive. In these cases, the main goal is to make the person comfortable.
Doctors give strong pain medicines, manage nausea and vomiting, and offer emotional support. Families and patients may also receive counseling or spiritual care when needed. This type of care helps with symptoms until the end of life.
