Nuclear medicine

[Craig]

Ive been reading with interest the increasing nuclear concern, on various boards. While personally I dont have nuclear overly high in my risk assessment, medical aspects of nuclear attack are somewhat neglected in my thoughts. I feel a cold chill at the thought of austere management of a patient with radiation exposure.

So, my thoughts : - most people with a decent exposure will die.

Otherwise the problems as I see it fall into 4 groups

1) Blast damage

2) Thermal damage

3) Early radiation damage

4) Late radiation damage

For 1 and 2 the standard trauma management applies, as best as your able within your circumstances

For 4) the only thing you can do anything about is block the uptake of radioactive iodine by the thyroid with some form of iodine preperation and try and avoid ingestion or breathing contaminated particulate matter

For 3) as I say you die or you get better by yourself, however as I understand it most of the deaths in the low dose range are not due to bone marrow failure or CNS problems, but due to GI problems and dehydration - so appropriate fluid management might save a few.

Sounds pretty bleak.
Anyone else got any thoughts or plans on this

cheers

Craig

[Reasonable Rascal]

I have been trying to find references to whether increased calcium intake will aid in blocking uptake of Strontium 90, which of course settles in the bones. It has been a problem in past decades during the era of wide-spread above-ground testing, usually ending up in milk products of grazed animals.

So far I have only found passing reference/conjecture made following the Chernobyl incident indicating further research might prove anti-oxident saturation as well as increased calcium may be beneficial. Iodine saturation is already an accepted means of protection. Increased calcium of course may have its own side effects (renal calculi formation) in some instances but like Iodine saturation may prevent long-term cancer development.

Is there any way to produce low-tech chelation solutions in the basic pharmaceutical lab environment? That is another thought that has crossed my mind for low-borderline cases.

RR

[tangent]

RR,

try typing in "strontium 90 calcium" into PubMed - returned 142 refs for me. This on on the second page (of 8) looks like a match - I'm sure there are more.

Ivannikov AT, Altukhova GA, Zhorova ES, Parfenova IM. Related Articles

[The protective action of calcium alginate in chronic 90Sr uptake into the body]
Radiobiologiia. 1993 Mar-Apr;33(2):297-301. Russian.
PMID: 8502751 [PubMed - indexed for MEDLINE]

Craig - check out:

http://www.oism.org/nwss/

chapters 12 and 13.

Bruce Clayton also wrote a book that addresses these topics - "life after doomsday?" - I believe it's OOP, though. good technical coverage, though. Written at the level of a paramedic or above.

-t