Targeted Physical Examination Following a Nuclear Detonation

Vital signs	Skin	Nervous system	Gastrointestinal tract	Hematologic
Fever Hypotension Tachycardia Tachypnea	Erythema Edema Blistering* Desquamation*	Impaired level of consciousness Ataxia Papilledema Motor/sensory deficits Presence/absence of reflexes	Abdominal tenderness GI bleeding	Bruising* Ecchymoses* Petechiae of skin/ mucous membranes*

See also:

External physical injury	Blast injury to tympanic membrane	Eye injuries	Blunt trauma	Thermal burns
Penetrating truncal injuries	Eardrum rupture (hearing loss)	Permanent visual loss (retinal scarring) Temporary flash blindness* Minor trauma Foreign bodies (including glass projectiles)*	Rupture or contusion of major air-containing organs or solid-organ injury from crush or poly-trauma	Flash burns to the skin

After a nuclear detonation, certain injuries (one or more) may
- Correlate with a victim's distance from ground zero
- Suggest that radiation exposure may have been received
- Serve as approximate estimates of dose until more definitive clinical biodosimetry or dose reconstruction information becomes available
- Serve as clinical markers when considering early administration of white cell cytokines.
For more details on physical exam, see Table 4 in
Coleman CN, Casagrande R, Hick JL, Weinstock DM, Bader JL, Chang F, Nemhauser JB, Knebel AR. Triage and Treatment Tools for Use in a Scarce Resources - Crisis Standards of Care Setting following a Nuclear Detonation. Disaster Med Pub Health Prep. 2011 Mar; 5 Suppl 1:S111-21. [PubMed Citation]