Learning Objectives
Differentiate RDD (dirty bomb) from nuclear detonation
Recognize phases of Acute Radiation Syndrome (ARS)
Implement radiological decontamination procedures
Administer appropriate radiation countermeasures
Radiological Dispersal Device (RDD) - "Dirty Bomb"
Video: Understanding Radiation Emergencies
Conventional explosive + radioactive material
PANIC and economic disruption
From the BLAST, not radiation
Typically low-level
CRITICAL PRIORITIES
- 1. TREAT LIFE-THREATENING TRAUMA FIRST - radiation injuries are NOT immediately life-threatening
- 2. DECONTAMINATE - remove all clothing (eliminates most contamination)
- 3. COUNTERMEASURES if internal contamination confirmed
Acute Radiation Syndrome (ARS)
ARS occurs after large whole-body doses of penetrating radiation (typically from nuclear detonation, NOT dirty bombs).
| Phase | Timeline | Manifestations |
|---|---|---|
| Prodromal | Hours to days | Nausea, vomiting, diarrhea - onset/severity predict dose |
| Latent | Days to weeks | Symptom-free period ("walking ghost" phase) |
| Manifest Illness | Weeks | Bone marrow suppression, GI failure, CV collapse |
| Recovery or Death | Weeks to months | Outcome depends on dose and treatment |
KEY POINT
Patient is NOT radioactive and NOT contagious once externally decontaminated!
Radiation Countermeasures
| Agent | Countermeasure | Mechanism |
|---|---|---|
| Radioactive Iodine (I-131) | Potassium Iodide (KI) | Blocks thyroid uptake |
| Cesium-137 | Prussian Blue | Binds cesium in GI tract |
| Plutonium, Americium | Ca-DTPA or Zn-DTPA | Chelating agent - enhances excretion |
KI Limitations
- • Protects THYROID only from radioactive iodine
- • Must be given BEFORE or shortly after exposure
- • Does NOT protect against other radionuclides
- • Does NOT treat radiation sickness
Key Takeaways
Dirty bombs cause blast injuries primarily; radiation exposure is usually low
TREAT TRAUMA FIRST - radiation injuries are not immediately life-threatening
ARS phases: Prodromal → Latent → Manifest → Recovery/Death
Externally decontaminated patients are NOT radioactive