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Radiation Injury

Radiation Injury is a topic covered in the 5-Minute Emergency Consult.

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  • Radiation in this chapter refers to ionizing radiation.
  • Alpha (α)—helium nucleus; does not penetrate skin
  • Beta (β)—electron; penetrates tissue a few cm
  • Gamma (γ)—photon; penetrates body
  • Neutron—very penetrating; not detected by Geiger counter, but neutron emitters also emit γ radiation
  • Radioisotope/radionuclide—chemical element that emits radiation from its nucleus:
    • Radioactivity cannot be destroyed, only relocated or shielded.
    • Being radioactive does not change element's other chemical and physical properties, such as heavy metal toxicity.
  • Exposure/irradiation—patient has been in presence of ionizing radiation:
    • Whole body or only certain areas may be exposed.
  • Contamination—radioactive material where it is not desired:
    • Internal—within body (e.g., lung)
    • External—outside body (skin, hair, clothing)
  • Dose—amount of radiation energy absorbed by tissue:
    • Units and conversions:
      • 1 gray (Gy) = 100 rad
      • 1 sievert (Sv) = 100 rem
    • For β and γ radiation:
      • 1 Gy = 1 Sv = 100 rad = 100 rem

Contact regional or federal authorities for guidance if radiation incident is suspected.

Pediatric Considerations
  • Children are more sensitive to radiation injury.
  • Potassium iodide is most protective for children and should be given promptly if contamination with radioactive iodine (I-131) is suspected.

Pregnancy Considerations
  • Developing fetus is very sensitive to radiation.
  • Pregnant staff should not care for radioactively contaminated patients.


  • Ionizing radiation leads to cellular injury.
  • Damage to blood vessels leads to endarteritis and loss of tissue blood supply.
  • Higher rates of cell division within an organ make it more sensitive to radiation:
    • Bone marrow and GI tract are very sensitive.
    • Skin and nerve are less sensitive.
  • Acute radiation syndrome (ARS) occurs in stages following whole-body exposure:
    • Prodromal: Acute radiation injury leads to acute inflammation (0–48 hr).
    • Latent: If the acute phase of injury is survived, inflammation and symptoms subside (0–2 wk).
    • Manifest illness: At higher radiation doses, organ failure then develops.
    • Recovery or death (usually from infection) follows.
  • Sources of radiation include medical devices, therapeutics, nuclear weapons, and industry.

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Rosen, Peter, et al., editors. "Radiation Injury." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307101/all/Radiation_Injury.
Radiation Injury. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307101/all/Radiation_Injury. Accessed April 25, 2019.
Radiation Injury. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307101/all/Radiation_Injury
Radiation Injury [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 25]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307101/all/Radiation_Injury.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Radiation Injury ID - 307101 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307101/all/Radiation_Injury PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -