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You are here: Home > Exposure: Diagnose/Manage Acute Radiation Syndrome > Manage 4 Subsyndromes of ARS - Interactive Tool video icon
Video Tutorial (6:40)

Managing Acute Radiation Syndrome (ARS)

Overview - How to Use This Tool

  • Click through each ARS Subsyndrome tab on the left.
  • For each clinical parameter, check "degree of severity": 1 (least) to 4 (most).
  • Click "View Treatments to Consider", based on severity inputs. [Print result.]
  • Click "View Response Category (RC)" to assist with venue referral based on your inputs.
  • Click "Start Over" to clear all previous inputs.

Disclaimers | References for Tool

Hematopoietic (H)








View Treatments to Consider View Response Category (RC) Start Over

Gastrointestinal (G)












View Treatments to Consider View Response Category (RC) Start Over

Cutaneous (C)













View Treatments to Consider View Response Category (RC) Start Over

Neurovascular (N)















View Treatments to Consider View Response Category (RC) Start Over

Response Category

The calculated Response Category (RC):

H G C N = RC (Read-only fields)

  • RC is auto-calculated using the highest degree of severity checked for any parameter in each of the 4 subsyndromes of ARS.
    • Example: H4, C2, G3, N1 = RC4
  • In a vary large mass casualty incident with austere conditions, referral decisions may need to change. RC recommendations in this tool do not reflect austere conditions.
  • See Scarce Resources Project publications and interactive tool.

The actions are described in table below, where the response categories (RC1 to RC4) are correlated with:

  • Severity of damage (mild, moderate, severe or serious)
  • Likelihood of autologous recovery.

Therapeutic strategy according to the METREPOL response categories
Response Category (RC) Severity of damage Strategy
RC 1
  • Mild damage
  • Autologous recovery certain
  • Outpatient care or general medical wards.
  • General support of recovery processes.
  • Usually no specific therapy.
RC 2
  • Moderate damage
  • Autologous recovery likely
  • Medical wards with hematological, neurological and dermatological consultation services.
  • Supportive care.
  • Substitutive therapy with blood components.
RC 3
  • Severe damage
  • Autologous recovery possible
  • Hematological-oncological institution/service with reverse isolation; intensive care unit; consultations of all medical specialities.
  • Supportive care.
  • Substitutive therapy with blood components.
  • Stimulation therapy (cytokines/growth factors).
RC 4
  • Serious damage
  • Autologous recovery most unlikely
  • Specialised hospital with experience in all areas of intensive care medicine, particularly allogeneic stem cell transplantation.
  • Supportive care.
  • Substitutive therapy with blood components.
  • Stimulation therapy (cytokines/growth factors).
  • Stem cell transplantation

"Each RC represents a level of damage, which in turn can be associated with a probability of autologous recovery. The requirements for the institution where the patients should be hospitalised are highly dependent on patients' RCs, which in turn require specific therapeutic interventions. The complexity of clinical care required for the patients increases at higher RC."

Source: Adapted from Triage, Monitoring and Treatment of people exposed to ionising radiation following a malevolent act, (PDF - 11 MB) Chapter J, page 266, Table J8 (TMT Handbook Partners, March 2009)




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