Trauma and the Radiation Exposure Algorithm
- Trauma + radiation exposure = combined injury
- Prognosis is worse than the same traumatic injury or exposure alone.
- When prioritizing delivery of scarce resources in radiation mass casualty emergencies, it is appropriate to consider prognosis related to
- Extent of trauma
- Extent of external whole body radiation exposure and significant exposure from any
internal contamination, e.g., Polonium-210
- Percent body surface area and depth (i.e., degree) of burns
- Pre-existing medical conditions
- Implementation of "Crisis Standards of Care" may be needed in disaster situations.
- The Institute of Medicine has provided extensive guidance.
- Resource limitations may be severe initially, but will improve over time.
- Suggested treatment sequence for victims of trauma with exposure
- Treat life- or limb-threatening injuries first.
- Assess for exposure and the Acute Radiation Syndrome (ARS) and consider early (pre-operative) use of white cell cytokines
- Consider Timing of Surgery
- This algorithm and supporting material provide guidelines, not mandates.
- See REMM Radioactive Shrapnel for guidance on management.
- See REMM Radiation + Trauma page for details.
- See REMM Mass Casualty page for details.