This publication focuses on the medical management of individuals involved in radiation emergencies, especially those who have been exposed to high doses of ionizing radiation. Its primary objective is to provide practical information, to be used for treatment decisions by medical personnel during a radiation emergency. It also addresses general and specific measures for the medical management of individuals who have been internally contaminated with radionuclides. This publication is complementary to other publications developed by the IAEA in the medical area of radiation emergencies.

• 1. INTRODUCTION
  • 1.1. Background
  • 1.2. Objective
  • 1.3. Scope
  • 1.4. Structure
• 2. GENERAL CONCEPTS OF RADIATION EMERGENCIES AND MEDICAL MANAGEMENT
  • 2.1. Types of radiation emergency
  • 2.2. Modes of exposure to radiation and radioactive sources
  • 2.3. Clinical and radiological triage
  • 2.4. Principles of medical management
• 3. EXTERNAL EXPOSURE
  • 3.1. Local radiation injury
    • 3.1.1. Diagnosis, medical assessment and dose estimation
    • 3.1.2. Treatment
    • 3.1.3. Medical follow-up
    • 3.1.4. Case study: The radiological accident in Nueva Aldea
  • 3.2. Acute radiation syndrome
    • 3.2.1. Diagnosis and classification
    • 3.2.2. Medical assessment and dose estimation
    • 3.2.3. Treatment
    • 3.2.4. Medical follow-up
    • 3.2.5. Case study: The accident at Fleurus, Belgium
• 4. CONTAMINATION WITH RADIONUCLIDES
  • 4.1. External contamination
    • 4.1.1. Management
    • 4.1.2. Decontamination of wounds
    • 4.1.3. Decontamination of body orifices
    • 4.1.4. Decontamination of intact skin
  • 4.2. Internal contamination
    • 4.2.1. Phases
    • 4.2.2. Health consequences
    • 4.2.3. Diagnosis and assessment
    • 4.2.4. Treatment
    • 4.2.5. Protective measures to avoid the spread of contamination
    • 4.2.6. Medical follow-up
    • 4.2.7. Case study: The radiological accident in Goiânia, Brazil
• 5. COMBINED RADIATION INJURIES
• 6. EMERGENCY COMMUNICATION AND MENTAL HEALTH ASPECTS
  • 6.1. Emergency communication during radiation emergencies
  • 6.2. Mental health aspects of radiation emergencies
    • 6.2.1. Psychosocial considerations related to the affected population
    • 6.2.2. Psychosocial considerations related to responders
• 7. RECORD KEEPING
• Appendix I MEDICAL PREPAREDNESS FOR RADIATION EMERGENCIES
• Appendix II BIOLOGICAL EFFECTS OF IONIZING RADIATION: BASIC INFORMATION FOR THE GENERAL PRACTITIONER
• REFERENCES
• ABBREVIATIONS
• CONTRIBUTORS TO DRAFTING AND REVIEW