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and vomiting on the day of exposure,
In this group there is no further evidence
of effects of the exposure except the hematologic (blood) changes that can be detected by serial studies of the blood with particular reference to lymphocytes
and pletelets.
The lymphocytes reach low levels early, within 48 hours, and may
stow little evidence of recovery for many months after exposure,
may show some depression during the second and third week,
variation ig encountered.
The granulocytes
However, considerable |
The late fall in the granulocytes, during the 6th or
7th week, may occur and should be watched for,
Platelet counts reach lowest levels
on approxdmetely the 30th day at the time when taximum bleeding was observed in
Japanese who were exposed at Hiroshima and Nagasaki.
This time trend in the plate-
let count and the development of henorrhage is in merked contrast to that seen in
laboratory animals where platelets reach their lowest levels between the 10th and
15th days and henorrhage occurs scortly thereafter.
In this group inidviduals with neutrophil counts below 1000 per cubic mm,
may be complete by asymptomatic.
L,kewise, patients with platelet counts of 75,000
per cubic ma. or less may show no external signs of bleeding.
It 4s well known that all defenses against infection are lowered, even by sublethal doses of radiation, ami thus, patients with severe hematologic depression
snould be kept under close observation and administered appropriate therapy as in-
dicated.
There is ressonably good animal experimentation to indicate that sublethally
exposed colonies of animals are ::ore susceptible to endemic and epidemic infection.
The numbers of individuals in group 3 (Survival probable) will be greater than
in group 2 (Survival Possible) and the nuxber in group 2 will be creater than in
sroup 1 (Survival improbable).
Group 1 casualties will be telplessly injured.
Group 2 casualties will be able to help in their own care to a limited extent.
Group 3 casualties will be useful and a roderate amount of work will not be harmful.
No therapy; other than observation is needed for this group.
The rest of my comments will be focused on the fallcut accident that occurred
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