Radiation injury diagnosis

Radiation Injury Diagnosis, Triage and Exposure Assessment... 

The differential diagnosis of OCP varies depending on the stage of the disease. It includes conditions that produce cicatricial changes of the ocular surface, such as chemical trauma, radiation injury, and other mucous membrane disorders. Conjunctival biopsy can aid in the diagnosis. Immunofluorescence study of the tissue demonstrates deposition of immunoreactants at the epithelial basement membrane zone in OCP. 

Diagnosis. The diagnosis of radiation sickness is based primarily upon the clinical picture presented by the patient. A precise history of exposure may be very difficult to obtain. Dosimetry will not give adequate information to determine either the extent of radiation injury or the prognosis. Dosimeters cannot tell whether a radiation exposure is whole body or partial body. They do not tell what the dose rate of the exposure was. Finally, they cannot differentiate between single exposures and multiple exposures unless read at regular intervals. However, in the... 

B. Radiation Injury Probable. Anorexia, nausea, and vomiting are the primary prodromal symptoms associated with radiation injury. Priority for further evaluation will be assigned after all life-threatening injuries have been stabilized. Casualties in this category will not require any medical treatment within the first few days for their radiation injuries. Evidence to support the diagnosis of significant radiation injury in the absence of bums and trauma may be obtained from lymphocyte assays taken over the next 2 days. If the evidence indicates that a significant radiation injury was received, these casualties need to be monitored for pancytopenic complications. 

Andrews, G.A., Sitterson, RW., Kretchng, AL, and Brucer, M, Criticality accident at the Y- 12 Plant, Proc. Scientific Meeting on the Diagnosis md Treatment of Acute Radiation Injury, World Health Organization, Geneva, 17 October, 1960. 

II-7] INTERNATIONAL ATOMIC ENERGY AGENCY, Diagnosis and Treatment of Radiation Injuries, Safety Reports Series No. 2, IAEA, Vienna (1998). 

The early recognition and a quick initial response to an accidental radiation injury are important in diagnosis, in treatment planning, and assessing the prognosis (O Table 47.11). 

Fatal Dose of Radiation. Casualties who have received a potentially fatal dose of radiation will most likely experience a pattern of prodromal symptoms that is associated with the radiation exposure itself. Unfortunately, these symptoms are nonspecific and may be seen with other forms of illness or injury, which may complicate the process of diagnosis. 

Diagnosis and Treatment of Patient with Combined Injuries. Conventional injuries should be treated first, since no immediate life-threatening hazard exists for radiation casualties who can ultimately survive. All surgery should be completed within 36-48 hours of irradiation. 

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