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Manage Subsyndromes of ARS > Response Category of ARS - Overview


 
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Response Category of Acute Radiation Syndrome - Overview

Adapted from Fliedner, TM, Friesecke, I, Beyrer K. Medical Management of Radiation Accidents: Manual on the Acute Radiation Syndrome. Oxford: British Institute of Radiology; 2001.


What are the Response Categories and how are they used?
  • Response Categories were developed by Fliedner1 and have been modified by others.
  • Global RC for a specific patient suggests where victim should be transported for care 2-4:
    (See Figure 1)
    • Ambulatory monitoring
    • Hospital routine care on a medical/surgical floor
    • Hospital critical care unit


    Figure 1. Response Category-based Triage
    response category-based triageD


  • How do you calculate a Response Category for an individual patient?
    1. Assess manifestations of each of the 4 ARS Subsyndromes
      • hematopoietic subsyndrome
      • cutaneous subsyndrome
      • gastrointestinal subsyndrome
      • neurovascular subsyndrome
        (a.k.a. Cerebrovascular)
    2. Record Subsyndrome Severity Score for each Subsyndrome: Interactive Tool
    3. Use individual Subsyndrome Severity Score to calculate Global Response Category (RC): Interactive Tool
    4. Example of Response Category assignment (see Figure 2 below)

      Figure 2. Example of Responce Category Assignment
      Example of response category assignmentD

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References

  1. Fliedner, TM, Friesecke, I, Beyrer K. Medical Management of Radiation Accidents: Manual on the Acute Radiation Syndrome. Oxford: British Institute of Radiology; 2001.
  2. Waselenko JK, Armitage JO, Dainiak N; Treatment of radiation injury in the adult. www.UpToDate.com (Subscription required)
  3. Waselenko JK, Dainiak N; Biology and clinical features of radiation injury in adults. www.UpToDate.com (Subscription required)
  4. Waselenko JK, MacVittie TJ, Blakely WF, Pesik N, Wiley AL, Dickerson WE, Tsu H, Confer DL, Coleman CN, Seed T, Lowry P, Armitage JO, Dainiak N; Strategic National Stockpile Radiation Working Group. Medical management of the acute radiation syndrome: recommendations of the Strategic National Stockpile Radiation Working Group. Annals of Internal Medicine 2004; Vol. 140:1037-51. [PubMed Citation]
  5. Fliedner TM, Graessle D, Meineke V, Dorr H. Pathophysiological principles underlying the blood cell concentration responses used to assess the severity of effect after accidental whole-body radiation exposure: an essential basis for an evidence-based clinical triage. Exp Hematol. 2007 Apr;35(4 Suppl 1):8-16. [PubMed Citation]
 

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