Acute Radiation Syndrome (ARS)
- What is ARS?
- What is exposure?
- What are the time phases of classical ARS?
- Estimate dose from exposure
- Perform targeted physical exam
- Consider these tools for clinical diagnosis and treatment
- Special clinical issues
- Multimedia resources
- References
What is ARS?
- Dictionary definition including 4 subsyndromes: hematologic, gastrointestinal, cutaneous, neurovascular
- More on Hematopoietic subsyndrome
- More on Cutaneous radiation subsyndrome
- Managing Subsyndromes of ARS: hematologic, gastrointestinal, cutaneous, neurovascular
What is exposure?
What are the time phases of classical ARS?
- Phases
- Prodromal
- Latent
- Manifest Illness (Critical Phase)
- Recovery or Death
- The higher the dose, the faster the time of onset, the shorter the time between phases, the more severe the illness
- Interactive illustrations of phases and time dose effects
Estimate dose from exposure
- Dose Estimator (Biodosimetry Tools)
- Explaining Biodosimetry - Frequently asked questions
- Dose Reconstruction - Location, duration, shielding (geographic dosimetry)
Perform targeted physical exam
Consider these tools for clinical diagnosis and treatment
- REMM clinical algorithm for exposure
- Template for adult/pediatric orders after a radiation incident
- Other radiation injury management algorithms
- Tool for managing ARS
- The hematopoietic subsyndrome of ARS
- The cutaneous subsyndrome of ARS
- Expert consultation from the Radiation Injury Treatment Network (RITN)
- Dose magnitude estimation information to help inform medical management of radiation incidents (ORAU)
- Manage ARS with scarce resources after an IND detonation
- Multi-organ dysfunction syndrome: a new hypothesis about radiation injury
Special clinical issues
- Use of Blood Products - guidelines and warnings
- Burns and radiation exposure: combined injury
- Trauma and radiation exposure: combined injury
- Timing of surgery
- Caution about prescribing aspirin and NSAIDs in irradiated patients
- Multi-organ dysfunction syndrome
- Clinical course after high dose whole body radiation
- Management of febrile neutropenia
- Myeloid cytokines
- Hematopoietic stem cell transplant
- Antiemetics
Multimedia resources
- Time/dose effects in ARS
- Time phases of ARS
- Radiation effects on blood counts
- Lymphocyte depletion kinetics graph (Andrews)
- Radiation effects on blood counts (Verobiev)
- Radiation effects on blood counts (Fliedner)
- Radiation effects on blood counts (TMT Handbook)
- Radiation Injury Treatment Network (RITN) Videos
- Just in time Training Module: ARS Primer for Healthcare Providers (YouTube - 16:10 min)
- What you Need to Know about What is RITN and How it Works? (YouTube - 4:17 min)
- Just in time Training Module: ARS Primer for Healthcare Providers (YouTube - 16:10 min)
- Lethality as a Function of Dose and LD50/60
References
- Medical Management of Radiation Injury - REMM Bibliography
- Hematopoietic Subsyndrome
- Cutaneous Radiation Subsyndrome
- Myeloid Cytokines
- Radiation Injury Treatment Network (See Reference Materials on tab at top.)