There are three categories of predicted survival following a nuclear radiation disaster
namely; probable, possible and improbable. Triage of victims at the scene following decontamination is normally conducted using routine protocols for disaster triage. The presenting signs and symptoms will determine the potential for survival therefore the category of predicted survival during triage should be taken into careful consideration.
Patient survival is basically anchored on many aspects depending on the length of exposure to a radioactive substance, the kind of radioactive material the individual is exposed to and the prompt intervention treatment provided to victims under these circumstances. Secondly, survival from a nuclear radiation disaster is dependent on other predisposing factors such as the victim’s age and current physical health status such as existing medical conditions that may already compromised an individual’s immunity such as HIV-AIDS and other similar acute illnesses impairing an individual’s present immunity level.
Probable survival from radiation exposure
Probable survival from radiation exposure, survivors typically have either no initial signs and symptoms or will only exhibit minimal symptoms such as nausea and vomiting. These symptoms normally resolve within a few hours (6-12) hours. These patients should have a complete blood count examination and can be discharged with added instructions indicating when to come back for further evaluation should any of the initial symptoms recur or becomes worse. Basically, individuals with probable survival are those who are shortly exposed to a minimal radioactive material in a short period of time such as radioactive isotopes such as those used in cancer treatment.
Possible survival from radiation exposure
Possible survival is present among individuals with much severe presentation of nausea and vomiting that normally persists for 24-48 hours following exposure. These individuals experience a latent period during which leukopenia, thrombocytopenia, and lymphocytopenia will shortly follow in a matter of a few days to several weeks. Barrier precautions and strict protective isolation are implemented should the patient’s lymphocyte count reveal less than 1200/mm3, supportive therapy and treatment should include administration of blood and blood products, prevention of infection and provision of enhance nutrition either orally or parenterally if the individual cannot tolerate intake of nutritionally enhanced foods and supplements.
Improbable survival from radiation exposure
Survivors with improbable survivability are the ones who were exposed to more than 800 rad of total body penetrating irradiation. Individuals exposed to such high levels of radiation demonstrate an acute onset of vomiting, diarrhea and shock. Any neurologic symptoms suggest a lethal dose of radiation. These patients still require decontamination to prevent further contamination of the area and of others. Personal protection is very important because it is virtually impossible to fully decontaminate these patients; all of their internal organs have already been irradiated.
The survival time of these patients is variably different from person to person, however,
death usually ensues swiftly due to shock. If there are no neurologic symptoms, patients may be alert and oriented, very much similar to a patient with extensive burns. In a mass casualty situation, these patients would be triaged into the black category, wherein they will receive comfort measures and emotional support since these individuals stand little chance of surviving. Nevertheless improbable survival from radiation exposure in normal circumstances should be treated as extensively as possible, wherein the only exception is during a mass casualty event wherein resources are limited and only those with a high probability of surviving are given priority.