Radiation Exposure: Diagnose and Manage
Acute Radiation Syndrome (ARS)

Look for Signs of ARS

• Perform targeted physical examination

Estimate Dose from Exposure

Use any clinical data available (Interactive Tools)

• Lymphocyte depletion kinetics
• Time to onset of vomiting
• Prodromal symptoms
• Chromosome analysis (dicentrics)

Dose reconstruction by patient location

• Match patient location to exposure map

Begin Assessment & Management

• Assess/manage 4 sub-syndromes of ARS:
  hematopoietic, gastrointestinal, cutaneous, neurovascular
• Does patient need outpatient or inpatient management? (Response category tool)
• Plan for evolution of ARS over time
• Expect heterogeneity of signs/symptoms
• Consider using template for hospital orders

Special Issues

• Manage ARS with scarce resources (e.g., after nuclear detonation)
• Consider cytokine treatment for those acutely exposed to myelosuppressive doses of radiation (H-ARS), especially if dose > 2 gray
• Consider multi-organ dysfunction and multi-organ failure syndromes of ARS
• Consider hematopoietic stem cell transplant for severe ARS