Radiation Injury
Basics
Description
Description
- 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
- Units and conversions:
ALERT
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
Etiology
Etiology
- 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
- Muscle 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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Citation
Schaider, Jeffrey J., et al., editors. "Radiation Injury." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307101/all/Radiation_Injury.
Radiation Injury. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307101/all/Radiation_Injury. Accessed December 10, 2024.
Radiation Injury. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307101/all/Radiation_Injury
Radiation Injury [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 December 10]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307101/all/Radiation_Injury.
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