PHYSICAL CHARACTERISTICS Cobalt-57 ( 57Co ) ▖Radioactive half-life: 271.8 d ▖Main types of radiation emitted: e- and g Cobalt-58 ( 58Co ) ▖Radioactive half-life: 70.8 d ▖Main types of radiation emitted: b+ and g Cobalt-60 ( 60Co ) ▖Radioactive half-life: 5.3 years ▖Main types of radiation emitted: b- and g SOURCES OF EXPOSURE ▖57Co: nuclear medicine (diagnosis) ▖58Co: nuclear reactors (activation products) ▖60Co: nuclear reactors (activation product) – industrial and medical sources 60 Co Cobalt 58 Co Cobalt J Urine bioassay J Faeces bioassay J In vivo measurement Cobalt 57 Co Cobalt EMERGENCY TREATMENT FIRST-LINE TREATMENT Sodium calcium edetate PRESENTATION SODIUM CALCIUM EDETATE SERB®, 50 mg/ml, solution for IV injection. 10 ml vials containing 500 mg of Sodium calcium edetate. DOSAGE Adults: 2 vials by infusion in 250 ml of saline. Children according to their weight (as a guideline only): Weight Daily dosage < 18 kg ½ vial 18 to 30 kg ½ vial to 1 vial ≥ 30 kg 1 vial SECOND-LINE TREATMENT Pentetate calcium trisodium PRESENTATION Ca-DTPA 250 mg/ml, injectable solution. 4 ml vial (PCA – Central Pharmacy of the Armed Forces). DOSAGE Persons > 12 years: slow IV injection or infusion in 15 min of a half-vial of Ca-DTPA (i.e. 0.5 g), diluted in 100 to 200 ml of isotonic saline solution or 5% glucose solution, without exceeding 1 g/d. Children (< 12 years): slow IV injection or infusion 14 mg/kg, without exceeding 0.5 g/d. TREATMENTS COMPLEMENTARY TO INTRAVENOUS ADMINISTRATION ▪ Pulmonary contamination Adults – Children (to be used with caution): 1 g in a single administration by inhalation – nebulisation only (spray mist, 50/50 dilution of a 4 ml vial in sterile or saline water). ▪ Contaminated wounds Pour one or more vials over the wound. EXPOSURE RISK ▖Irradiation +++ ▖External contamination ++ 58Co and 60Co ▖Internal contamination +++ DOSE COEFFICIENT REFERENCE Effective committed dose per becquerel incorporated, taken from the Order mentioned in Article R. 1333-24 of the Public Health Code:INTERNAL CONTAMINATION MEASUREMENT french-nuclear-safety.fr/dosimetric-references RADIONUCLIDE HANDBOOK • Emergency treatment of internal contamination RH 15 INTERNAL CONTAMINATION MEASUREMENTS AND TREATMENTS Internal contamination: initial treatment 38SHEET In the event of confirmed (or suspected) internal contamination, the antidotes must be administered as soon as possible. Whatever the circumstances, the treatment of medical-surgical emergencies takes priority over the evaluation and treatment of contamination. Responders • Medical personnel + The radionuclides handbook sheets detail the initial treatment of a person who has, or is suspected of having, internal contamination. EMERGENCY TREATMENT Deferoxamine PRESENTATION DESFERAL® 500 mg. Powder and solvent for injectable solution.. DOSAGE IV administration by continuous infusion at the recommended rate of 15 mg/kg/h, for 4-6 h. The total IV dose must not exceed 80 mg/kg/24 h. This medication can be used for adults and children. When used in children, their growth and weight shall be checked regularly. CONTRAINDICATIONS ▖Pregnancy. ▖Severe renal impairment. PHYSICAL CHARACTERISTICS Aluminium-26 ( 26Al ) ▖Radioactive half-life: 7.2• 105 years ▖Main types of radiation emitted: b+ and g SOURCES OF EXPOSURE ▖Nuclear reactors (activation of stable aluminium) 26 Al Aluminium EXPOSURE RISK ▖Irradiation ++ ▖External contamination ++ ▖Internal contamination ++ INTERNAL CONTAMINATION MEASUREMENT J Urine bioassay J Faeces bioassay J In vivo measurement Aluminium DOSE COEFFICIENT REFERENCE Effective committed dose per becquerel incorporated, taken from the Order mentioned in Article R. 1333-24 of the Public Health Code: french-nuclear-safety.fr/dosimetric-references RADIONUCLIDE HANDBOOK • Emergency treatment of internal contamination RH 3 Using the radionuclides handbook • The treatments are classed in alphabetical order of the radionuclides. The dosages cover the first 24 hours of treatment. • Each sheet contains physical characteristics of the radionuclides, information on the sources, the risk of exposure and the available treatments. • The major contraindications or special warnings are specified in them. However, the precautions for use and adverse reactions are not detailed in this guide; they are indicated in the manufacturer's notice. A Aluminium .......................................... RH 3 Americium ........................................... RH 4 Antimony .............................................. RH 5 Arsenic ..................................................... RH 6 B Barium ..................................................... RH 7 Bismuth .................................................. RH 8 C Cadmium .............................................. RH 9 Caesium .............................................. RH 10 Calcium ................................................ RH 11 Californium ....................................... RH 12 Cerium ................................................... RH 13 Chromium .......................................... RH 14 Cobalt ..................................................... RH 15 Copper ....................................................RH 16 Curium ................................................... RH 17 E Erbium ................................................... RH 18 Europium ............................................ RH 19 F Fluorine ................................................ RH 20 G Gallium .................................................. RH 21 Gold .......................................................... RH 22 I Indium ................................................... RH 23 Iodine ...................................................... RH 24 Iridium ................................................... RH 25 Iron ............................................................ RH 26 L Lanthanum ....................................... RH 27 Lead .......................................................... RH 28 Lutetium .............................................. RH 29 M Manganese ....................................... RH 30 Mixture of fission products ............................................... RH 31 Mercury ................................................ RH 32 N Neptunium ........................................ RH 33 Nickel ...................................................... RH 34 P Phosphorous ................................... RH 35 Plutonium .......................................... RH 36 Polonium ............................................. RH 37 Potassium .......................................... RH 38 Praseodymium ............................. RH 39 Promethium .................................... RH 40 R Radium .................................................. RH 41 Ruthenium ....................................... RH 42 S Samarium ........................................... RH 43 Scandium ........................................... RH 44 Silver ........................................................ RH 45 Sodium .................................................. RH 46 Strontium ........................................... RH 47 Sulphur .................................................. RH 48 T Technetium ...................................... RH 49 Tellurium ............................................. RH 50 Thallium ............................................... RH 51 Thorium ................................................ RH 52 Tritium ................................................... RH 53 U Uranium ............................................... RH 54 Y Ytterbium ........................................... RH 55 Yttrium .................................................. RH 56 Z Zinc ........................................................... RH 57 Zirconium ........................................... RH 58 Recommendations for the emergency treatment of internal contamination according to the radionuclides concerned (in alphabetical order). RADIONUCLIDE HANDBOOK 110 MEDICAL RESPONSE IN NUCLEAR OR RADIOLOGICAL EMERGENCY
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