Symptoms of Acute Radiation Sickness

Nuclear/Radiological Medical Management Medical Management of Nuclear & Radiological Patients

The following information contains adaptations and excerpts from the US Army Center for Health Promotion and Preventive Medicine (USACHPPM) Tech Guide 244, The Medical NBC Battlebook.

These symptoms frequently occur in whole-body irradiated casualties within the first few hours of post exposure.

Nausea and Vomiting. Nausea and vomiting occur with increasing frequency as the radiation exceeds 100-200 cGy. Their onset may be as long 6-12 hours post exposure, but usually subside within the first day. The occurrence of vomiting within the first 2 hours is usually associated with a severe radiation dose. Vomiting within the first hour, especially if accompanied by explosive diarrhea, is associated with fatal doses. Due to the transient nature of these symptoms, it is possible that the patient will have already passed through the initial phase of gastrointestinal distress before being seen.

Hyperthermia. Casualties who have received a potentially lethal radiation injury show a significant rise in body temperature within the first few hours post exposure. The occurrence of a fever and chills within the first day post exposure is associated with a severe and life-threatening radiation dose. Hyperthermia may occur in patients who receive lower but still serious radiation doses (200 cGy or more).

Erythemia. A person who received a whole-body dose of more than 1000-2000 cGy will develop erythema within the first day post exposure. This is also true for those who received comparable doses to local body regions. In this case, the erythema is restricted to the affected area. With doses lower but still in the potentially fatal range (200 cGy or more), erythema is less frequently seen.

Hypotension. A noticeable decline in systemic blood pressure has been recorded in victims who received a lethal whole-body radiation dose. In persons who received several hundred cGy, a drop in systemic blood pressure of more than 10% has been noted. Sever hypotension after irradiation is associated with a poor prognosis.

Neurologic Dysfunction. Experience indicated that almost all persons who demonstrate obvious signs of damage to the central nervous system within the first hour post exposure have received a lethal dose. Symptoms include mental confusion, convulsion, and coma. Intractable hypotension will probably accompany these symptoms. Despite vascular support, these partients succumb within 48 hours.