"
tee
which sound clinical jedigment would dictate.
Sapplies and medications are those indicated
plays a large role in morbidity and mortality
among irradiated individuals, and bload,
plasma and other intravenous fluids will be re-
6.6
Relative Hazards of Beta and
Gamma Radiation From Fallout
Comme Beta Bruns to the skin and whole
body ganima radiation injury can be sustained,
as in the present experience. However, situstions may occur following fallout in which
prompt evacuation from the area would limit
the whole body dose to minimal levels, but in
which delay in decontamination of the skin
would permit severe radiation burns. The re-
verse situation is rt only conceivable but occurred to a limited extent in the Marshallese
and Americans. Those, who were inside, and
or completely clothed, received practically no
skin burns but received apparently the same
degree of whole body radiation. One might
also be exposed in the open, decontaminated
promptly and then enter a shelter because of
delay in exacuation. Under these circumstances, one would receive predominantly
whole body radiation injury.
In the course of the present accident the pres-
ence of some open skin burns did not seem to
exert a deleterious influence on the spontaneous
course of the hematologic depression. However, with more severe degrees of hematologic
quired te correct the shock, anemia and fleid
imbalance. These agents should be used, as in
all clinien? conditions, when clinical and laboratory tindings (if laboratory work is posible)
indicate their need.
Any marked prophylactic
value of theee agents has not been demonstrated,
and considerations of probable short supply in
the face of overwhelming demand would militate against their use in the absence of clear
clinical indications. There are no drugs spe-
cifie for radiation injury in man. Considerable
progress has been made in developing agents
effective in animals if given pri: to irradiation.
Of great experimental interest in post exposure therapy has been the development of
effective therapy by iniection of splenic and
hone marrow oreparatious.
However, the ex-
treme lability and genetic specificity of these
preparations indicates that these agents may
never be of practical value. In addition sub-
stitution therapy by transfusion of separated
platelets and neutrophiles to combat hemor-
rhage and infection is of experimental interest
but vt present techniques are not sufficiently
developed to warrant consideration of stockpiling.
There are no specific drugs for the treatment
uf beta lesions of the skin. Careful cleanli-
tee
OT Ne men tee
for any mass casaalty situation, and emphasie
should lie chiefly on the magnitude of the supply problem. Antibiotics will be required in
large amounts to combet the infection that