A reflection on medical treatment of radionuclide-contaminated wounds during medical response to nuclear emergencies / 中国辐射卫生

Radionuclide-contaminated wounds are common in medical response to nuclear emergencies, which have different manifestations in different types of accidents. Medical treatment is the key part of the response. Based on the drill experience gained from medical response to nuclear emergencies, the authors summarize the research advances in radionuclide-contaminated wounds in recent years, mainly involving the biokinetic characteristics, medical response, surgical debridement, and prevention and treatment of internal contamination of radionuclide-contaminated wounds; the authors summarize the key points of technical operations and provide suggestions on improvements in the drills. The authors believe that medical treatment of radionuclide-contaminated wounds requires highly compatible integration of the practical skills from clinical medicine and radiological knowledge; emergency response, surgical debridement, and prevention and treatment of internal contamination all together constitute an integrated rescue and treatment strategy with internal logic correlations. However, targeted improvements are needed to achieve desired effects in the drills.

A preliminary investigation on internal exposure dose of artificial radionuclides in nuclear medicine staff / 上海预防医学

ObjectiveTo tentatively understand the status of radioactive contamination in nuclear medicine personnel. MethodsA total of 34 radiation staff engaged in nuclear medicine diagnosis and treatment were selected from two hospitals in Shanghai as the survey subjects.Among the 34 medical staff， 8 were nuclear medicine doctors， 14 were nuclear medicine technicians and 12 were nuclear medicine nurses. After surface contamination monitoring was first carried out to confirm that they had no surface radioactivity contamination， whole body scanning was performed with a whole body counter to determine whether they were internally contaminated with artificial radionuclides. ResultsThe α surface contamination was not detected in the nuclear medical staff. The β surface contamination of the nuclear medicine doctors， technicians and nurses was （13.8±0.8）， （14.1±0.8） and （14.0±0.7） times per second， respectively. There were 2， 2， and 4 nuclear medicine doctors who were contaminated with 18F， 99mTc and 131I， 3， 5， and 2 nuclear medicine technicians who were contaminated with 18F， 99mTc and 131I， and 6， 8， and 5 nuclear medicine nurses who were contaminated with 18F， 99mTc and 131I， respectively. The 18F activity of nuclear medicine technicians was 1 997‒9 401 Bq， and the 99mTc activity of nuclear medicine technicians and nurses was 3 699‒18 692 and 652‒388 22 Bq， respectively. One nuclear medicine nurse had a 99mTc activity of 35 389 Bq. According to the preliminary estimation of 131I internal irradiation dose， the maximum committed effective dose of nuclear medicine doctors， technicians and nurses could reach 0.370， 0.018 and 0.584 mSv， respectively. ConclusionThe nuclear medicine staff are exposed to radioactive contamination， and it is important to monitor and evaluate their internal radiation doses.

Development of radionuclide parameter database on internal contamination in nuclear emergencies / 中华放射医学与防护杂志

Objective To develop a radionuclide parameter database on internal contamination in nuclear emergencies. Methods By researching the radionuclides composition discharged from different nuclear emergencies, the radionuclide parameters were achieved on physical decay, absorption and metabolism in the body from ICRP publications and some other publications. The database on internal contamination for nuclear incidents was developed by using MS Visual Studio 2005 C# and MS Access programming language. Results The radionuclide parameter database on internal contamination in nuclear emergency was established. Conclusions The database may be very convenient for searching radionuclides and radionuclide parameter data discharged from different nuclear emergencies, which wonld be helpful to the monitoring and assessment of internal contamination in nuclear emergencies.

Diagnostic and Therapeutic Management of Acute Radiation Syndrome and Internal Contamination

The ARS(Acute Radiation Syndrome) develops, within 60 days after exposure to ionising radiation with typical clinical signs and symptoms as a function of time. The interactions and combined effects of radiation-induced damage to different organ systems are diverse and not yet fully understood. Therefore, when accidental exposure to ionising radiation is documented or suspected, guidance for immediate diagnostic procedures and specialised care are required to handle the complexity of the ARS. The following four organ systems, Neurovascular system (N), Hematopoietic system (H), Cutaneous system (C) and Gastrointestinal system (G) are considered to be of critical significance for the development of ARS and should therefore receive special attention in the medical management of radiation accident cases. The Assessment of the severity of damage, Decision on the kind of hospitalisation, Provision of appropriate therapeutic interventions and Evaluation of the patient's prognosis must be considered in the management of a patient after a radiation accident. When significant levels of radioactive materials are incorporated, pathological consequences may ensue, making emergent treatment particularly important. However, this should not take priority over treatment of life threatening conditions and of acute injuries. Following medical stabilization, careful radiological assessment can be performed to determine the presence of both external and internal contamination. It is important to note that 1) contaminated patients do not represent a direct hazard to health care providers and 2) lifesaving procedures should not be delayed regardless of the level of contamination.