ACUTE RADIATION SYNDROME (ARS)

Introduction: Although background radiation from terrestrial and cosmic sources account for most of an individual’s exposure, in a time of geopolitical uncertainty, exposures to larger radiation doses are a looming threat. Acute radiation syndrome (ARS) consists of three distinct physiologic presentations of whole-body exposure which are dose-dependent: hematopoietic, gastrointestinal and neurovascular.

Methods: The three presentations of ARS are described with a particular focus on pathophysiology, radiobiology and potential remedies. By the end of the presentation, participants will be able to identify the three presentations, their unique signs and symptoms, and potential methods of prevention. Participants will also have a rudimentary appreciation of the triage process associated with ARS.

Findings: The hematopoietic presentation of ARS occurs at the lowest whole-body doses. Survival is greatest for individuals with this presentation. The gastrointestinal presentation occurs at intermediate doses. With treatment intervention, fatality can be reduced. The neurovascular presentation occurs at supra-lethal doses. Survival is unlikely.

Conclusions: ARS, also known as radiation poisoning or radiation sickness, is well described. A basic understanding of ARS including pathophysiology, radiobiology and mitigation may prove useful as the potential for larger dose exposures increases.