c. Decontamination. Removing all outer clothing and a brief washing or brushing of exposed skin will reduce 95 percent of contamination; vigorous bathing or showering is unnecessary. See [Appendix G] for patient decontamination procedures.
d. Internal Contamination. Internalization of radioactive isotopes will primarily occur via inhalation, ingestion, and contaminated wounds. Extensive internal decontamination should only be undertaken when individual dose estimates indicate that the individual will benefit from the procedures. Soldiers who wear their protective mask will be adequately protected from inhalation and ingestion of radioactive particulate matter. Internal contamination is considered a delayed problem and does not influence triage categories, as does irradiation injury.
e. Treatment. Treatment procedures for radiation injuries are described in FM 4-02.283, FM 8-9, and the NATO Handbook, Emergency War Surgery. Appropriate medical intervention and bone marrow resuscitation will prevent most deaths secondary to irradiation and infection.
Table A-9. Acute Clinical Effects of Single High Dose Rate Exposures of Whole-body Irradiation of Healthy Adults
[Part 1]
| DOSE (RANGE) | 0-100 cGy (SUBCLINICAL RANGE) | 100-1000 cGy (SUBLETHAL RANGE) | ||||
| 100-200 cGy | 200-600 cGy | 600-1000 cGy | ||||
| INITIAL PHASE | INCIDENCE OF NAUSEA & VOMITING | NONE | 5-50% | 50-100% | 75-100% | |
| TIME OF ONSET | —— | APPROX 3-6 HRS | APPROX 2-4 HRS | APPROX 1-2 HRS | ||
| DURATION | —— | LESS THAN 24 HRS | LESS THAN 24 HRS | LESS THAN 48 HRS | ||
| COMBAT EFFECTIVENESS | 100% | 100% | CAN PERFORM ROUTINE TASKS. SUSTAINED COMBAT OR COMPARABLE ACTIVITIES HAMPERED FOR 6-20 HRS. | CAN PERFORM ONLY SIMPLE ROUTINE TASKS. SIGNIFICANT INCAPACITATION IN UPPER PART OF RANGE. LASTS MORE THAN 24 HRS. | ||
| LATENT PHASE | DURATION | —— | MORE THAN 2 WEEKS | APPROX 7-15 DAYS | NONE TO APPROX 7 DAYS | |
| SECONDARY PHASE | SIGNS & SYMPTOMS | NONE | MODERATE LEUKOPENIA | SEVERE LEUKOPENIA; PURPURA, HEMORRHAGE; INFECTION; EPILATION ABOUT 300 cGy. | ||
| TIME OF ONSET POST EXPOSURE | —— | 2 WEEKS OR MORE | SEVERAL DAYS TO 2 WEEKS | |||
| CRITICAL PERIOD POST EXPOSURE | —— | NONE | 4-6 WEEKS | |||
| ORGAN SYSTEM RESPONSIBLE | NONE | HEMATOPOIETIC TISSUE | ||||
| HOSPITAL-IZATION | PERCENTAGE | NONE | LESS THAN 5% | 90% | 100% | |
| DURATION | —— | 45-60 DAYS | 60-90 DAYS | 90-120 DAYS | ||
| INCIDENCE OF DEATH | NONE | NONE | 0-80% | 90-100% | ||
| AVERAGE TIME OF DEATH | —— | —— | 3 WEEKS TO 2 MONTHS | |||
| THERAPY | NONE | REASSURANCE HEMATOLOGIC SURVEILLANCE | BLOOD TRANSFUSION, ANTIBIOTICS | |||
[Part 2]
| DOSE (RANGE) | OVER 1000 cGy (LETHAL RANGE) | |||
| 1000-3000 cGy | OVER 3000 cGy | |||
| INITIAL PHASE | INCIDENCE OF NAUSEA & VOMITING | 100% | ||
| TIME OF ONSET | LESS THAN 1 HR | |||
| DURATION | LESS THAN 48 HRS | APPROX 48 HRS | ||
| COMBAT EFFECTIVENESS | PROGRESSIVE INCAPACITATION FOLLOWING AN EARLY CAPABILITY FOR INTERMITTENT HEROIC RESPONSE. | PROGRESSIVE INCAPACITATION FOLLOWING AN EARLY CAPABILITY FOR INTERMITTENT HEROIC RESPONSE. | ||
| LATENT PHASE | DURATION | NONE TO APPROX 2 DAYS | NONE | |
| SECONDARY PHASE | SIGNS & SYMPTOMS | DIARRHEA; FEVER; DISTURBANCE OF ELECTROLYTE BALANCE. | CONVULSIONS; TREMOR ATAXIA; LETHARGY. | |
| TIME OF ONSET POST EXPOSURE | 2-3 DAYS | |||
| CRITICAL PERIOD POST EXPOSURE | 5-14 DAYS | 1-48 HRS | ||
| ORGAN SYSTEM RESPONSIBLE | GASTROINTESTINAL TRACT | CENTRAL NERVOUS SYSTEM | ||
| HOSPITAL-IZATION | PERCENTAGE | 100% | 100% | |
| DURATION | 2 WEEKS | 2 DAYS | ||
| INCIDENCE OF DEATH | 90-100% | |||
| AVERAGE TIME OF DEATH | 1-2 WEEKS | 2 DAYS | ||
| THERAPY | MAINTENANCE OF ELECTROLYTE BALANCE | SEDATIVES | ||