Treatment

The treatment goals for radiation sickness are to prevent further radioactive contamination; treat life-threatening injuries, such as from burns and trauma; reduce symptoms; and manage pain.

Decontamination

Decontamination involves removing external radioactive particles. Removing clothing and shoes eliminates about 90 percent of external contamination. Gently washing with water and soap removes additional radiation particles from the skin.

Decontamination prevents radioactive materials from spreading more. It also lowers the risk of internal contamination from inhalation, ingestion or open wounds.

Treatment for damaged bone marrow

A protein called granulocyte colony-stimulating factor, which promotes the growth of white blood cells, may counter the effect of radiation sickness on bone marrow. Treatment with this protein-based medication, which includes filgrastim (Neupogen), sargramostim (Leukine) and pegfilgrastim (Neulasta), may increase white blood cell production and help prevent subsequent infections.

If you have severe damage to bone marrow, you may also receive transfusions of red blood cells or blood platelets.

Treatment for internal contamination

Some treatments may reduce damage to internal organs caused by radioactive particles. Medical personnel would use these treatments only if you've been exposed to a specific type of radiation. These treatments include the following:

• Potassium iodide (ThyroShield, Iosat). This is a nonradioactive form of iodine.

  Iodine is essential for proper thyroid function. If you're exposed to significant radiation, your thyroid will absorb radioactive iodine (radioiodine) just as it would other forms of iodine. The radioiodine is eventually cleared from the body in urine.

  If you take potassium iodide, it may fill "vacancies" in the thyroid and prevent the absorption of radioiodine. Potassium iodide isn't a cure-all and is most effective if taken within a day of exposure.

• Prussian blue (Radiogardase). This type of dye binds to particles of radioactive elements known as cesium and thallium. The radioactive particles are then excreted in feces. This treatment speeds up the elimination of the radioactive particles and reduces the amount of radiation cells may absorb.
• Diethylenetriamine pentaacetic acid (DTPA). This substance binds to metals. DTPA binds to particles of the radioactive elements plutonium, americium and curium. The radioactive particles pass out of the body in urine, thereby reducing the amount of radiation absorbed.

Supportive treatment

If you have radiation sickness, you may receive additional medications or interventions to treat:

• Bacterial infections
• Headache
• Fever
• Diarrhea
• Nausea and vomiting
• Dehydration
• Burns
• Sores or ulcers

End-of-life care

A person who has absorbed very large doses of radiation has little chance of recovery. Depending on the severity of illness, death can occur within two days or two weeks. People with a lethal radiation dose will receive medications to control pain, nausea, vomiting and diarrhea. They may also benefit from psychological or pastoral care.