Home Forums General Medicine RADIATION EFFECTS TREATMENT & PREVENTION FINAL MBBS REVISION

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      OVERVIEW
      Radiation is energy and travels either as high-speed particles or waves. It can occur naturally or be man-made.
      The two types of radiation include
      ?Non-ionizing radiation, which includes waves such as radio waves, microwaves, infrared radiation, radiation from mobile phones and visible light
      ?Ionizing radiation, which includes ultraviolet radiation, x-rays, and gamma rays and radon

      SOURCES OF RADIATION
      Natural radiation from minerals present in the ground, soil, water, and even our bodies.
      Background radiation exposure occurs from sun and outer space
      Man-made radiation in the form of x-ray imaging, radiation therapy to treat cancer

      HEALTH HAZARDS OF RADIATION EXPOSURE
      Humans can deal with the low levels exposed to in our everyday lives. However, excess radiation can damage tissues by causing cell injury and damaging DNA. This can result in health problems, including cancer.
      The amount of damage caused by radiation exposure depends on several factors such as
      ?The type of radiation
      ?The dose (amount) of radiation
      ?Route of exposure such as skin contact, inhaling radiation, swallowing or when rays pass through the body
      ?Site of localization in the body and how long it stays there
      ?Individual sensitivity to radiation. eg fetus is most vulnerable to the effects of radiation. Infants, young children, pregnant women, elderly persons and people with compromised immune systems are more vulnerable to harmful effects of radiation compared to healthy adults

      It has been estimated that the average radiation exposure of a person in the US is 6.2 mSv/yr which includes natural background radiation and imaging studies

      WHAT ARE X-RAYS?
      X-rays are a type of radiation used for diagnostic medical imaging to look for presence of abnormalities within the body. X-rays pass through the body and and the image obtained depends on the amount of radiation that are absorbed and the amount that pass through the body. The image produced which is in the form of a films is referred to an as “x-ray,” but x-rays actually refers to the type of radiation that is used to produce the image.

      Imaging tests that use x-rays include plain films, computed tomography (CT scan) and fluoroscopy.

      There is no evidence that the low doses of radiation used to obtain common x-rays or CT scan imaging may cause cancer, but it is imperative to get these tests done only if absolutely needed.

      ACUTE RADIATION SICKNESS
      Being exposed to a large amount of radiation period of time, such as from a radiation leak, can cause skin burns. It may cause symptoms of acute radiation syndrome (ARS, or “radiation sickness”). These include

      ?Headache and diarrhea that start within hours
      ?Vomiting
      ?They may go away for a while and the person seems to be getting better, but may develop symptoms again
      ?How soon they recur, or how severe the symptoms are depends on the dose of exposed radiation
      ?Death in severe acute radiation sickness

      CHRONIC LOW LEVEL EXPOSURE
      Mild to moderate levels of exposure over a prolonged period may not produce visible effects but
      increases risk of cancer

      DIAGNOSIS OF ACUTE RADIATION SICKNESS
      The treating doctors first need to know the level and amount of radiation absorbed into the body. This
      information can be obtained by taking a detailed history to know the type of radiation, duration of
      exposure and distance from the radiation site, and a thorough examination.

      BLOOD TESTS
      Frequent blood tests over many days allows doctors to look for decreasing count of white blood cells in
      the blood and abnormal changes in the DNA of blood cells. These results indicate the severity of bone
      marrow damage, which depends on how much radiation the body has absorbed.

      GEIGER COUNTER
      A device such as a Geiger counter can be used to survey patients exposed to radiation to find the
      location of radioactive particles in the body.

      DOSIMETER
      A device called a dosimeter measures absorbed dose of radiation. However, it can be used only if the
      instrument was also exposed to the same radiation event suffered by the patient.

      TREATMENT OF ACUTE RADIATION SICKNESS
      ?The aim of treatment in radiation sickness is
      ?To prevent further radioactive contamination
      ?Preventing dehydration
      ?Treat life-threatening injuries, such as from burns and trauma
      ?Reduce symptoms
      ?Pain management.
      ?Reducing and treating infections

      EXTERNAL DECONTAMINATION
      Decontamination includes removing external radioactive particles on clothing and shoes and this itself
      could eliminates about 90 percent of external contamination. Gently washing with water and soap
      removes additional radiation particles on the skin
      Decontamination reduces risk of further spread, absorption into the body by inhalation, ingestion or
      Wounds

      INTERNAL DECONTAMINATION
      These treatments are given only if a person has been exposed to a specific type of radiation in order to reduce injury to internal organs. These treatments include the following

      Potassium Iodide (Thyroshield)
      This is a non radioactive form of Iodine.  It prevents the absorption of radio iodine. Potassium iodide
      is most effective if taken within a day of exposure. The excess radio iodine is eliminated in the urine

      Prussian Blue
      It binds to particles of radioactive elements such as cesium and thallium, which are are then excreted in feces. This treatment hastens elimination of radioactive particles and reduces absorption

      Diethylenetriamine pentaacetic acid (DTPA). 
      This substance binds to metal, plutonium, americium and curium particles. The radioactive particles pass out of the body in urine, thus limiting the amount of absorbed radiation

      SUPPORTIVE TREATMENT

      ?Bacterial infections
      ?Fever
      ?Headache
      ?Nausea, vomiting and diarrhea
      ?Dehydration
      ?Burns
      ?Sores or ulcers

      PREVENTION OF RADIATION EFFECTS
      ?Discuss with your doctor before getting an x-ray or CT scan tests
      ?Reduce use of cell phones to avoid electromagnetic radiation exposure
      ?Measure indoor radon levels within your home
      ?In case of an acute radiation event, take shelter indoors and shut the doors and windows. If possible, stay tuned to the news and follow the instructions provided

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