At-Risk / Special Needs Populations


Definitions

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Managing At-Risk / Special Needs Populations - General


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Elderly


  • Bone marrow reserve diminishes with age
    • Predisposition to anemia
    • Predisposition to infection
    • Predisposition to bleeding
  • May have increased risk of bleeding due to medications, poor diet, or other factors
  • Increasing number of co-existing diseases and conditions may be associated with
    • Inability to tolerate certain drugs
    • Lesser ability to tolerate aggressive salvage treatments, such as stem cell transplant for treatment of Acute Radiation Syndrome
    • Cognitive issues may need to be addressed

Resources

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Immune-suppressed


  • Whole body radiation exposure will exacerbate pre-existing diminished immune functions.
  • Countermeasures (e.g., myeloid cytokines) used to enhance blood cell production may be less effective.
  • Affected individuals are more susceptible to infection.
  • These individuals usually require leuko-reduced, irradiated blood.
  • May not be able to tolerate radiation-induced prolonged pancytopenia or stem cell transplant due to underlying condition (e.g., cancer, congenital or acquired immune deficiency).

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Infants and Children

 

At-Risk / Special Needs Populations - Infants and Children

 

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Pregnant Woman and Fetus


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Persons with Disabilities and Other Special Needs


  • Patients with diminished mobility may not be able to
    • Evacuate the radiation scene as directed
    • Tolerate the austere environments required during the emergency
    • Mobilize without assistance for transportation or decontamination
  • Transportation issues may need to be arranged to accommodate special needs.
  • Patients with diminished mental capacity may not be able to follow directions.
  • Patients with limited language proficiency or non-English speakers may not be able to follow directions.
  • Patients with medical disabilities may not be able to tolerate standard radiation rescue treatments and may be disconnected from chronic treatments such as dialysis, oxygen, insulin, and other chronic medications.

Resources

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