Targeted Physical Examination
If ARS is suspected, check for these things:
- Vital signs
- Temperature
- Blood pressure
- Pulse
- Respiratory rate
- Skin
- Erythema
- Edema
- Blistering*
- Desquamation*
- Nervous system
- Level of consciousness
- Ataxia
- Papilledema
- Motor/sensory deficits
- Presence or absence of reflexes
- Gastrointestinal tract
- Abdominal tenderness
- Gastrointestinal bleeding
- Hematologic examination
- Bruising*
- Ecchymoses*
- Petechiae of skin/mucous membranes*
*May not be evident initially if caused by ARS; these evolve over time.
After a nuclear detonation, these things may correlate with exposure and risk of ARS:
- Blast injuries
- Lung damage
- Crush injuries
- Blunt/penetrating trauma
- Eardrum rupture (hearing loss)
- Thermal burns
- Flash burns to the skin
- Eye injury
- Permanent loss of vision (retinal scarring)
- Temporary flash blindness*
- Minor trauma
- Foreign bodies (including glass projectiles)*
*Typically expected at distances farther from ground zero
Note:
- After a nuclear detonation, certain injuries are characteristic of a victim's distance from ground zero.
- These findings may correlate with dose from exposure and could be used as approximate estimates of dose until more definitive clinical biodosimetry or dose reconstruction information becomes available. In some circumstances, this information may be used to consider early administration of white cell cytokines.