Supportive and Comfort Care

On the other hand, patients developing multiorgan failure several days to weeks after exposure should receive routine critical care because they have likely received a moderate exposure and have a reasonable chance of survival. Significant bums, hypovolemia and hypotension require early resuscitation with fluids. Additional critical care may include endotracheal intubation, anticonvulsant agents, anxiolytic agents and sedatives as necessary (2). 

Radiation victims exposed to doses greater than 10-12 Gy have virtually no chance for survival, and are therefore not candidates for definitive care. These patients should receive comfort measures rather than aggressive definitive treatment. Comfort measures should include analgesia, antiemetic agents and antidi-arrheal agents. In addition, these patients, their families and their friends would benefit from psychological support and spiritual care. 

Leikin, JB, McFee, RB, Walter, FG, Edsall, K. A Primer for Nuclear Terrorism. Disease-a-Month, 49(8) 485-516, 2003 

Waselenko, JK, MacVittie, TJ, Blakely, WF, et al. Medical Management of the ARS Recommendations of the Strategic National Stockpile Radiation Working Group. Annals of Internal Medicine, 140(12) 1037-1051, 2004 

Federation of American Scientists. Special Weapons Primer. Weapons of Mass Destruction. http //www.fas.org/nuke/intro/nuke/intro.htm, last accessed 9-04-05 

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