Dirty bomb - Revision history

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-26T20:42:23Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 20:42, 26 July 2016
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	{{MCI types}}		{{MCI types}}

	==~~Diagnosis~~==		==Evaluation==
	*Determined by injuries		*Determined by injuries
	*If [[Acute radiation syndrome]] suspected, establishing baseline with CBC and CMP is appropriate.		*If [[Acute radiation syndrome]] suspected, establishing baseline with CBC and CMP is appropriate.

Ostermayer: Text replacement - "Category:Environ" to "Category:Environmental"

2016-03-22T14:47:06Z

Text replacement - "Category:Environ" to "Category:Environmental"

← Older revision		Revision as of 14:47, 22 March 2016
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	<references/>		<references/>

	[[Category:~~Environ~~]]		[[Category:Environmental]]
	[[Category:EMS]]		[[Category:EMS]]

Mholtz at 04:48, 25 February 2016

2016-02-25T04:48:52Z

← Older revision		Revision as of 04:48, 25 February 2016
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	==Clinical Features==		==Clinical Features==
			*See [[Blast injury]] and [[Acute radiation syndrome]]

	==Differential Diagnosis==		==Differential Diagnosis==
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	*If [[Acute radiation syndrome]] suspected, establishing baseline with CBC and CMP is appropriate.		*If [[Acute radiation syndrome]] suspected, establishing baseline with CBC and CMP is appropriate.

	==~~Treatment~~==		==Management==
	*Priority is treatment of blast injuries and burns		*Priority is treatment of blast injuries and burns
	*ED treatment of [[Acute radiation syndrome]] is primarily supportive		*ED treatment of [[Acute radiation syndrome]] is primarily supportive

Rossdonaldson1: /* Differential Diagnosis */

2015-07-14T21:32:57Z

Differential Diagnosis

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	==Differential Diagnosis==		==Differential Diagnosis==
			{{MCI types}}

	==Diagnosis==		==Diagnosis==

Rossdonaldson1 at 21:26, 14 July 2015

2015-07-14T21:26:55Z

← Older revision		Revision as of 21:26, 14 July 2015
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	*Most injuries and deaths will be caused by blast injuries, not radiation injury<ref name="Chin">Chin FK. Scenario of a dirty bomb in an urban environment and acute management of radiation poisoning and injuries. Singapore Med J. 2007 Oct;48(10):950-7.</ref>		*Most injuries and deaths will be caused by blast injuries, not radiation injury<ref name="Chin">Chin FK. Scenario of a dirty bomb in an urban environment and acute management of radiation poisoning and injuries. Singapore Med J. 2007 Oct;48(10):950-7.</ref>
	*Triage of patients by radiation dose received is important and should be coordinated with disaster response officials.		*Triage of patients by radiation dose received is important and should be coordinated with disaster response officials.

			==Clinical Features==

			==Differential Diagnosis==

	==Diagnosis==		==Diagnosis==
	*Clinical diagnosis

	~~==Work-Up==~~
	*Determined by injuries		*Determined by injuries
	*If [[Acute radiation syndrome]] suspected, establishing baseline with CBC and CMP is appropriate.		*If [[Acute radiation syndrome]] suspected, establishing baseline with CBC and CMP is appropriate.

	~~==DDx==~~


	==Treatment==		==Treatment==

Mholtz at 09:31, 13 July 2015

2015-07-13T09:31:09Z

← Older revision		Revision as of 09:31, 13 July 2015
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	**Radioactive material spread locally via blast, and carried more distantly via aerosolized or particulate "plumes"		**Radioactive material spread locally via blast, and carried more distantly via aerosolized or particulate "plumes"
	**Multiple radioisotopes from various sources (e.g. nuclear fuel waste, medical radiography, etc) could be employed		**Multiple radioisotopes from various sources (e.g. nuclear fuel waste, medical radiography, etc) could be employed
			*Most injuries and deaths will be caused by blast injuries, not radiation injury<ref name="Chin">Chin FK. Scenario of a dirty bomb in an urban environment and acute management of radiation poisoning and injuries. Singapore Med J. 2007 Oct;48(10):950-7.</ref>
			*Triage of patients by radiation dose received is important and should be coordinated with disaster response officials.

	==Diagnosis==		==Diagnosis==
			*Clinical diagnosis

	==Work-Up==		==Work-Up==
			*Determined by injuries
			*If [[Acute radiation syndrome]] suspected, establishing baseline with CBC and CMP is appropriate.

	==DDx==		==DDx==
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	==Treatment==		==Treatment==
			*Priority is treatment of blast injuries and burns
			*ED treatment of [[Acute radiation syndrome]] is primarily supportive

	==Disposition==		==Disposition==
			*Most patients require admission.

	==See Also==		==See Also==
	*[[Disaster medicine]]		*[[Disaster medicine]]
			*[[Acute radiation syndrome]]
	*[[Radiation exposure (disaster)]]		*[[Radiation exposure (disaster)]]

Mholtz at 10:22, 11 July 2015

2015-07-11T10:22:40Z

← Older revision		Revision as of 10:22, 11 July 2015
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	==Diagnosis==		==Diagnosis==
	~~Insert~~

	==Work-Up==		==Work-Up==
	~~Insert~~

	==DDx==		==DDx==
	~~Insert~~

	==Treatment==		==Treatment==
	~~Treatment with stable iodine when the committed dose equivalent to the adult thyroid is expected to exceed 250 milliSieverts (mSv), the equivalent of 25 rem (FDA 2001).~~

	~~#Under 40 years old~~
	~~##potassium iodide (KI)~~
	~~##immediate and Qday x 7-14 days~~
	~~#Over 40 years old~~
	~~##no KI treatment~~

	*contraindication = ~~iodine allergy~~		==Disposition==
	*potassium iodate (KIO3) can also be used (more GI irritation)

	~~==Disposition==~~
	~~Insert~~

	==See Also==		==See Also==
			*[[Disaster medicine]]
	*[[Radiation exposure (disaster)]]		*[[Radiation exposure (disaster)]]

Mholtz at 10:14, 11 July 2015

2015-07-11T10:14:35Z

← Older revision		Revision as of 10:14, 11 July 2015
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	==Background==		==Background==
	*~~Non-nuclear (conventional) bomb cased in radioactive material~~		*Also known as "Radiological Dispersal Device"<ref name="Rosoff">Rosoff H, von Winterfeldt D. A risk and economic analysis of dirty bomb attacks on the ports of Los Angeles and Long Beach. Risk Anal. 2007 Jun;27(3):533-46.</ref>
	*can cause exposure to I-131		*Consists of radioactive material packaged into non-nuclear (conventional) bomb<ref name="Rosoff" />
	*administration of potassium iodide (KI) can significantly reduce thyroid I-131 uptake, which can later causes thyroid cancer		**No nuclear fusion/fission occurs
	*for persons older than 40 years of age, the risk for radiation-induced thyroid cancer is extremely low, while the potential side effects of prophylaxis due to preexisting thyroid disease tend to increase		**Detonation causes injuries from conventional explosion and also spreads radioactive material, causing radiation injuries and cancer
			**Radioactive material spread locally via blast, and carried more distantly via aerosolized or particulate "plumes"
	~~{\| width=~~"~~339~~" ~~border~~="1"		**Multiple radioisotopes from various sources (e.g. nuclear fuel waste, medical radiography, etc) could be employed
	~~\| '''Time to KI Dose'''<br /~~>
	~~\| '''Reduction in Radioactive Uptake'''<br />~~
	\|-
	~~\| <2hrs~~<br />
	~~\| 90%<br />~~
	\|-
	~~\| 3hrs~~<br />
	~~\| 50%<br~~ />
	\|-
	~~\| 4hrs<br />~~
	~~\| 10%<br />~~
	\|-
	~~\| >4hrs<br />~~
	~~\| little protection~~*~~<br />~~
	\|}

	~~<nowiki>~~*~~unless the exposure to I-131 continues</nowiki>~~

	==Diagnosis==		==Diagnosis==

Mholtz at 10:02, 11 July 2015

2015-07-11T10:02:58Z

← Older revision		Revision as of 10:02, 11 July 2015
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	*potassium iodate (KIO3) can also be used (more GI irritation)		*potassium iodate (KIO3) can also be used (more GI irritation)

	==Disposition>==		==Disposition==
	Insert		Insert

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	==References==		==References==
	<references/>		<references/>
	~~Adapted from KajiQuestions~~


	[[Category:Environ]]		[[Category:Environ]]
	[[Category:EMS]]		[[Category:EMS]]

Mholtz at 10:00, 11 July 2015

2015-07-11T10:00:57Z

← Older revision		Revision as of 10:00, 11 July 2015
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	==Background==		==Background==
			*Non-nuclear (conventional) bomb cased in radioactive material
	*~~is a non~~-nuclear ~~normal~~ bomb cased in radioactive material
	*can cause exposure to I-131		*can cause exposure to I-131
	*administration of potassium iodide (KI) can significantly reduce thyroid I-131 uptake, which can later causes thyroid cancer		*administration of potassium iodide (KI) can significantly reduce thyroid I-131 uptake, which can later causes thyroid cancer
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	==Diagnosis==		==Diagnosis==

	Insert		Insert

	==Work-Up==		==Work-Up==

	Insert		Insert

	==DDx==		==DDx==
			Insert
	Insert~~</div>~~

	==Treatment==		==Treatment==

	Treatment with stable iodine when the committed dose equivalent to the adult thyroid is expected to exceed 250 milliSieverts (mSv), the equivalent of 25 rem (FDA 2001).		Treatment with stable iodine when the committed dose equivalent to the adult thyroid is expected to exceed 250 milliSieverts (mSv), the equivalent of 25 rem (FDA 2001).

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	*[[Radiation exposure (disaster)]]		*[[Radiation exposure (disaster)]]

	==~~Source~~==		==References==
			<references/>
	Adapted from KajiQuestions		Adapted from KajiQuestions


	[[Category:Environ]]		[[Category:Environ]]
			[[Category:EMS]]