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	You are here: Home > Exposure: Diagnose/Manage Acute Radiation Syndrome > Text Version		Population Monitoring and Radionuclide Decorporation Following a Radiological or Nuclear Incident (NCRP Report No. 166, 2011) NEW! Nuclear Detonation Scarce Resources Working Group Publications, 3/2011 (HHS/ASPR) NEW! Response to a Nuclear Detonation: State and Local Medical Planners Playbook, 3/2011 (HHS/ASPR) NEW! Responding to a Radiological or Nuclear Terrorism Incident: A Guide for Decision Makers (NCRP Report No. 165, 2010) Management of Persons Contaminated With Radionuclides: Handbook (NCRP Report No. 161, Vol. I, 2008)    New Users: Where Do I Start? What's New on REMM? Emergency Contacts Patient Management Algorithms Dose Estimator for Exposure Dictionary Isotopes of Interest Countermeasures: Internal Contamination Countermeasures: Exposure Decontamination Procedures Acute Radiation Syndrome (ARS) Hematopoietic Subsyndrome Cutaneous Radiation Syndrome Manage ARS Subsyndromes Time/Dose Effects in ARS Time Phases of ARS Strategic National Stockpile Scarce Resources Triage Tool Multimedia Library Print Algorithms & Tables Download REMM (1/2012) Download Mobile REMM (1/2012)    AFRRI AHRQ CDC CRCPD DHS DOE EPA FDA HHS HPS   IAEA ICRP NCRP NRC OSHA REAC/TS RERF RITN UNSCEAR WHO
	Exposure: Diagnose/Manage Acute Radiation Syndrome (Text Version) Management Modifiers Burns Trauma Mass casualty Timing of surgery Blood products use At-risk/special needs populations Evaluate for Acute Radiation Syndrome (ARS) (What Is ARS?) Look for Signs of ARS Perform targeted physical examination Estimate Dose from Exposure Use any clinical data available (Interactive Tools) Lymphocyte depletion kinetics Time to onset of vomiting Prodromal symptoms Chromosome analysis (dicentrics) Dose reconstruction by patient location Match patient location to exposure map Begin Assessment & Management Assess/manage 4 sub-syndromes of ARS: hematopoietic, gastrointestinal, cutaneous, neurovascular Does patient need outpatient or inpatient management? (Response category tool) Plan for evolution of ARS over time Expect heterogeneity of signs/symptoms Consider using template for hospital orders Special Issues Manage ARS with scarce resources (e.g., after nuclear detonation) Consider white cell cytokines to mitigate neutropenia if dose > 2 gray Consider multi-organ dysfunction and multi-organ failure syndromes of ARS Consider hematopoietic stem cell transplant for severe ARS For Deceased Decedents with exposure only and no contamination require no special radiation precautions Register decedent in incident database For Survivors Discharge with appropriate follow-up instructions Register patient in incident database Radiation follow-up considerations Whole-body dose Immune status Risk of cancer Risk of specific organ dysfunction

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