Chemical Agents of Opportunity for Terrorism: TICs & TIMs

Chemical Agents of Opportunity for Terrorism
Training Support Package
Participant Guide
Slide 26
This chart shows the time course of ARS. The higher the dose, the shorter the time to
symptom onset and the more severe the symptoms. Radiation symptoms follow a typical
pattern (toxidrome). Typically, the first symptoms of ARS are nausea, vomiting, and
diarrhea. The delay to onset is very important in predicting the dose. Symptom onsets <
1 hour after exposure indicates a large radiation dose. Lower doses are associated with
delays up to 48 hours. These symptoms will last for hours up to several days, and may
come and go. Many of the initial signs and symptoms of radiation illness are
nonspecific, and could be misdiagnosed as a viral syndrome, or gastroenteritis. The
person may improve (particularly with supportive treatment) during what is termed the
latent stage, after which he or she may become sick again with fatigue, fever from
infection due to bone marrow toxicity (which also causes thrombocytopenia), recurrent
gastrointestinal symptoms, and even seizures and coma in very high dose exposures.
This seriously ill stage may last from a few hours up to several months with lower doses.
Recovery depends on the dose and can be improved with advanced medical care.
December 2008 Version 2.0 Page 389