Radiation exposure happens when ionizing radiation from a source, spill or event reaches the body, either from outside or from radioactive material on the skin or inside the body. Life-threatening injuries come first, and contamination is rarely dangerous to rescuers who use standard protection.
Key symptoms
- Nausea and vomiting, earlier and worse with higher doses
- Headache, fatigue and weakness
- Skin redness, burning or blisters where the source touched
- Diarrhea and fever after a large dose
- Often no symptoms right after a small exposure
What you find on exam
- Scene safety: time, distance and shielding; follow hazmat command
- Primary survey and treat trauma first
- Radiation survey meter to find contamination on skin and clothes
- Skin for burns, redness and open wounds
- Time from exposure to first vomiting, which hints at the dose
Tests
- Hospital: blood count with lymphocyte count repeated over 48 hours
- Swabs of the nose and wounds for contamination
- Urine and stool testing if internal contamination is suspected
- Dose estimate with the radiation safety officer
Treatment basics
- Treat life threats first; do not delay care for decontamination
- Remove clothing, which takes away most external contamination
- Wash skin and wounds gently with soap and water; do not scrub
- Notify the receiving hospital early so it can prepare
- Specific drugs for internal contamination in hospital, such as potassium iodide or Prussian blue
Red flags
- Vomiting within 1 to 2 hours of exposure
- Contaminated open wounds or burns
- Trauma with unstable vital signs
Practice it in Making Synapses
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Related guides
Sources: NASEMSO National Model EMS Clinical Guidelines; NREMT psychomotor skill sheets (EMT and Paramedic); National EMS Education Standards (2021). Written by Making Synapses. Making Synapses is not affiliated with these organizations.