Chemical Agents of Opportunity for Terrorism: TICs & TIMs

Chemical Agents of Opportunity for Terrorism
Training Support Package
Participant Guide
Slide 30
The diagnosis of Acute Radiation Syndrome requires a history of possible radiation
exposure, information about the onset of early symptoms (nausea and vomiting) and
serial complete blood counts (CBC) looking at the absolute lymphocyte count.
In the setting of an earlier occult radiation exposure, the diagnosis is more difficult.
However, similar to the situation described with heavy metal poisoning in the Delayed
Onset Toxin Module, a history of preceding gastrointestinal symptoms should be sought
in patients who present with skin changes, hair loss, or patterns of blood cell line
deficiencies that may suggest radiation as a potential cause.
The onset time of signs and symptoms (in particular vomiting and diarrhea) following
exposure correlates with the severity of exposure (more rapid onset equals larger
radiation dose) and with the prognosis (more rapid onset equals worse outcome).
The CBC is an assessment of the white blood cell (WBC), red blood cell, and platelet
count. The diff, or differential count, is a slightly advanced analysis that looks at the
types of white blood cells present. The WBC type of most importance is the lymphocyte
(other types of WBCs are the neutrophils, monocytes, and eosinophils – which are not
as sensitive to radiation effects as are the lymphocytes). Lymphocytes will drop quickly,
followed by neutrophils, platelets, then red blood cells.
December 2008 Version 2.0 Page 393