Targeted Physical Examination Following a Nuclear Detonation

Physical findings suggestive of ARS

Vital signsSkinNervous systemGastrointestinal tractHematologic
  • Fever
  • Hypotension
  • Tachycardia
  • Tachypnea
  • Erythema
  • Edema
  • Blistering*
  • Desquamation*
  • Impaired level of consciousness
  • Ataxia
  • Papilledema
  • Motor/sensory deficits
  • Presence/absence of reflexes
  • Abdominal tenderness
  • GI bleeding
  • Bruising*
  • Ecchymoses*
  • Petechiae of skin/ mucous membranes*

*If caused by ARS may not be evident in the first 96 hours; these evolve over time. See also:

Traumatic injuries suggestive of exposure

External physical injuryBlast injury to
tympanic membrane
Eye injuriesBlunt traumaThermal burns
  • Penetrating truncal injuries
  • Eardrum rupture (hearing loss)
  • Permanent visual loss (retinal scarring)
  • Temporary flash blindness*
  • Minor trauma
  • Foreign bodies (including glass projectiles)*
  • Rupture or contusion of major air-containing organs or solid-organ injury from crush or poly-trauma
  • Flash burns to the skin

*Typically expected at distances farther from ground zero