Chemical Agents of Opportunity for Terrorism: TICs & TIMs

Chemical Agents of Opportunity for Terrorism
Training Support Package
Participant Guide
Slide 27
Dosimetry is a method to gauge the severity of radiation exposure. Based on the specific
syndrome that develops, the clinician and health physicist can determine the dose range
to which a patient was exposed. In general, the higher the dose, the greater the severity
of early effects and the greater the possibility of life threatening effects. Each of these
syndromes represents an increasing exposure to radiation and carries a greater risk of
adverse or fatal outcomes. We will discuss a few of them in more detail.
1. Subclinical – while tissue damage may occur, no overt symptoms are expected and the body
should be able to repair damage that has been done.
2. Hematopoietic syndrome - characterized by bone marrow dysfunction with decreased
lymphocyte, polymorphonuclear (PMN) white blood cells, and platelets, resulting in immunodeficiency,
increased infectious complications, bleeding, anemia, and impaired wound healing.
3. Cutaneous (Skin) syndrome - can occur with other syndromes; characterized by loss of
epidermis (and possibly dermis) with "radiation burns."
4. Gastrointestinal syndrome - characterized by loss of cells lining intestinal crypts and loss of
mucosal barrier, with alterations in intestinal motility, fluid and electrolyte loss with vomiting and
diarrhea, loss of normal intestinal bacteria, sepsis, and damage to the intestinal microcirculation,
along with the hematopoietic syndrome.
5. Cerebrovascular/Central Nervous System (CNS) syndrome - primarily associated with effects
on the vasculature and resultant fluid shifts. Signs and symptoms include vomiting and diarrhea
within minutes of exposure, confusion, disorientation, cerebral edema, hypotension, and
hyperpyrexia. Requires massive exposure and is fatal in short time.
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