EM · Radiation and chemical exposure

Radiation and chemical exposure

Also known as CBRN exposure · Acute radiation syndrome · Nerve agent poisoning · Sulfur mustard exposure · Chemical casualty management

Radiation and chemical exposure — the receiving-hospital side of a CBRN incident. The topic pairs two threats the Fellowship candidate must hold together: ionizing radiation, whose whole-body dose produces the acute radiation syndrome (prodromal nausea and vomiting within hours, marrow suppression and pancytopenia over days to weeks, cutaneous burns), and the chemical warfare and industrial agents — nerve agents that inhibit acetylcholinesterase, the vesicant sulfur mustard, and cyanide. The single most tested decision is decontamination before any casualty crosses the emergency-department threshold: remove the clothing to clear the majority of the contaminant, shower with water and soap, contain the runoff, and protect the staff in personal protective equipment. The antidotes are narrow and must be named with dose and route — atropine 2 mg and pralidoxime 30 mg per kilogram for the nerve agent, hydroxocobalamin 5 g for cyanide, and no antidote at all for mustard, where decontamination and supportive burns care are everything. ACEM-primary, globally tagged.