TRIAGE AND EMERGENCY MEDICAL MANAGEMENT OF THE ACUTE RADIATION SYNDROME

A. Trzos, Wiktoria Kudła, Karol Łyziński
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Abstract

Introduction: Medical personnel of the state Emergency Medical Services (EMS) will be the first element involved in providing assistance to victims of radiation incidents. Triage, initial diagnosis and further patient medical management will depend on their actions. In many radiation incidents, initial radiation triage and early diagnostics will be carried out in the emergency department (ED) or trauma center (TC). Extended triage, diagnosis of ARS and proper treatment will be continued in specialist centers. The aim: To present a model of patient medical management including initial triage and early diagnosis of ARS that can be carried out at the ED and TC. Material and methods: The initial medical procedures prepared by expert groups were presented. The choice of procedures was made in terms of the possibility of their application by the EMS teams in Poland. Particular attention was paid to the method of initial triage, based on the clinical condition and laboratory diagnostics. Results: Based on the material collected, the path of the initial medical procedure was presented. Variants of the radiation triage, interpretation of clinical parameters and results of laboratory tests are presented. The methods of initial treatment and the method of qualification for specialist treatment, and new methods of treating patients were also described. Conclusions: An adequate evaluation of radiation incidents, determining the absorbed dose of ionising radiation and ARS, as well as initial triage seem to be crucial skills of the EMS workers.
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急性放射综合症的分诊及紧急医疗管理
导言:国家紧急医疗服务(EMS)的医务人员将是向辐射事故受害者提供援助的首要因素。分诊、初步诊断和进一步的病人医疗管理将取决于他们的行动。在许多放射事故中,最初的放射分类和早期诊断将在急诊科(ED)或创伤中心(TC)进行。专科中心将继续进行扩展的分诊、急性呼吸道感染的诊断和适当治疗。目的:提出一个病人医疗管理模式,包括可在急诊科和急诊科进行的ARS的初步分类和早期诊断。材料和方法:介绍了专家组编制的初步医疗程序。程序的选择是根据在波兰的紧急医疗服务小组应用这些程序的可能性作出的。特别注意的是初步分类的方法,根据临床情况和实验室诊断。结果:在收集资料的基础上,提出了初始医疗程序的路径。变体的放射分类,临床参数的解释和实验室测试的结果提出。介绍了初步治疗方法和专科治疗的资格认定方法,以及治疗患者的新方法。结论:充分评估辐射事件,确定电离辐射和ars的吸收剂量,以及初步分类似乎是EMS工作人员的关键技能。
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