Information on the effect of radiation, signs and symptoms characteristic of it allow a correct diagnosis to be made. In the refinement, radiation counters are sometimes used to determine the type of radionuclides and to find their localization.
Impact Features
In a nuclear explosion, the direct effect of radiation causes a primary burn radiation damage. The skin that is on the side of the accident, subject to profile and superficial burns. Contact damage is characteristic for areas with a snug fit. Secondary burns are caused by the flames of the accompanying fires.
The appearance of damage does not change from the external influence of neurons or gamma rays. At the same time, the epidermis adsorbs beta rays, due to which, in addition to changing external manifestations, poor wound healing is noted. The occurrence of such pathologies during the destruction of energy enterprises and nuclear attacks is characteristic.
Acute radiation damage occurs due to the shock wave of the explosion. With their direct influence, the appearance of barotrauma is noted. An indirect shock wave causes the appearance of so-called secondary shells from damaged trees and structures. Among mechanical injuries, closed and open fractures of limbs, bruises and ruptures of internal organs in combination with other injuries are most common.
Internal changes
Exposure to radionuclides leads to systemic changes in hemostasis, a decrease in the protective nonspecific systems of the body, poisoning, and a change in regenerative processes. Large doses of radiation are characterized by the loss of electrolytes and fluid through the intestinal wall.
Radiation damage due to photonic and neural flows does not pose a risk to the life and health of the treating staff. The injured upon admission to the medical facility are sanitization and radiation level monitoring with a dosimeter. The degree of pollution is significantly reduced after removing clothes. Adequate decontamination is possible after treatment of exposed skin. If damage threatens the patient's life, disinfection is carried out after emergency care.
Treatment
Medical care for radiation injuries is to reduce the external influence of radiation, the use of supporting drugs, and the treatment of existing injuries. Isolation of patients with acute radiation sickness is required, followed by measures to support bone marrow. A preliminary forecast is made based on the level of lymphocytes in the first day, concomitant symptoms, the time interval between radiation and the first manifestations of the disease. Based on the data compiled, first aid is provided for radiation injuries.
Radiation can be irradiating and polluting. The latter refers to contact with radioactive materials and their preservation. Pollution is divided into internal and external.
Material can enter the body through damage to the skin, during breathing or swallowing. With internal pollution, there is a chance of transferring elements to various organs, followed by radiation of radiation. Any radionuclides pose a risk of internal contamination, even a small number of them also have a great risk to the patient.
Initial symptoms appear as general and local reactions within a few days. There is an increase in temperature, chills, headaches, nausea, redness of the skin. For high radiation doses, a disorder of consciousness is characteristic.
During the latent period, patients note an improvement in health for several weeks, while pathological changes continue in the tissues and organs.
Signs of high exposure
Clinically expressed symptoms of radiation damage include the addition of infectious complications, repeated bleeding, a decrease in general immunity, severe damage to the gastrointestinal tract and blood formation system. In the case of a favorable course, the condition of the patients improves after a few weeks, the affected organs restore their functions.
High doses of radiation contribute to large lesions, characterized by a complex course with a probability of death in the first day.
Skin lesions
Radiation damage to the skin is damage to the skin and tissues adjacent to it, from the effects of acute radiation. It often accompanies radiation focal damage and can reach necrosis. Delayed effects include increased fibrosis and changes in pigmentation. Atrophic thin integuments can be easily damaged by any mechanical force or injury. The presence of a non-healing skin area with increased soreness and lack of data on thermal damage may indicate the possibility of radiation exposure.
The occurrence of focal lesions is possible due to the use of radiation therapy. Also dangerous are units for the disinfecting treatment of products, medical and industrial radioactive sources with high radiation, among which are devices for radiation therapy and x-rays. Radiation damage to the skin can also be caused by fluoroscopy. The development of radiation ulcers is possible both within a few weeks, and after 2-3 years. Such injuries are characterized by the presence of severe pain.
Diagnostics
For the implementation of the diagnosis requires the collection of medical history data, the conclusion of laboratory tests, the identification of concomitant signs and symptoms. In determining the degree of exposure, the severity of symptoms and the duration of the course are of greatest importance, and the victims are also divided according to the predicted consequences. Symptoms characteristic of the prodromal period, such as tremors, vomiting, or nausea, are nonspecific and cannot be used to make a diagnosis. Many patients with insufficient exposure to radiation sickness complain of similar symptoms, which is especially characteristic after accidents at reactors and mass terrorist attacks that cause a strong sense of anxiety and adrenaline rush.
Urgent action
First aid for radiation damage is based on the removal of victims to a safe area and the implementation of a range of measures to eliminate pollution. A cleansing enema and gastric lavage are used in order to remove radionuclides from the body. There are specific antidotes that are substances that can form strong compounds with isotopes. Potassium iodide is effective in prophylactic use with respect to radioactive iodine; compounds with barium sulfate are used for internal infection with strontium and radium nuclides.
What is needed for emergency care
To stop vomiting and nausea in acute radiation injury, drugs containing chlorpromazine and atropine are administered.The use of blood substitutes and adrenaline is required when concomitant cardiovascular failure occurs. Infectious complications can prevent antibacterial agents, and it is important to constantly monitor the level of white blood cells in the blood. With its decrease, blood transfusion is necessary. Some complicated cases require a bone marrow transplant.
Protection
There are standard safety rules for people involved in transporting and treating victims. For used clothing, special marked containers are used. A constant change of medical staff is required, as well as the use of individual devices to determine the level of exposure in order to prevent radiation damage. Their prevention is possible due to screening of the source, maximum distance from it and prevention of contamination by elements with radiation activity.
When using the ionizing effect of radiation for medical diagnostic procedures, the most susceptible areas of the body that do not require treatment or diagnosis should be covered with a lead screen or apron.
Despite the effective reduction of the effect of X-rays with a low energy charge during research and diagnostics, such protective equipment is ineffective in shielding the high-energy radiation rays that characterize accidents at nuclear power plants. In order to reduce chemical radiation damage in the event of radionuclide exposure, standard safety measures must be followed. Isolation of injured people after first aid is needed, as well as decontamination measures.
Prevention Tools
There is a decrease in the number of deaths when taking special medications, such as thiol with radical-binding characteristics, when taken before or during irradiation. Amifostine is an effective radioprotective for injection in this category. It avoids some of the side effects of radiation therapy. Despite the high effectiveness of preparations with thiol, allergic manifestations, vomiting, and a decrease in pressure are noted during their use. There are experimental chemical compositions and agents that reduce mortality among animals with prior administration before irradiation. But doses that provide the required level of protection are too toxic, so they have not gained distribution.
The consequences of radiation damage
Large doses of radiation are characterized by an early onset of obvious consequences - from several minutes from the moment of injury to several days. The emergence of distant manifestations is possible after two to three years. After exposure to radiation, mutations at the gene level appear in offspring that may have congenital malformations.
Particular attention should be paid to the proper organization of care for victims of radiation injuries. Patients are in boxed separate wards with regular air disinfection with special bactericidal devices. Such measures are necessary to reduce the likelihood of infectious complications.
