Medical response in a nuclear or radiological emergency

PHYSICAL CHARACTERISTICS Yttrium-90 ( 90Y ) ▖Radioactive half-life: 2.7 d ▖Main types of radiation emitted: bSOURCES OF EXPOSURE ▖Nuclear reactors (fission products) ▖Nuclear medicine (therapeutic) french-nuclear-safety.fr/dosimetric-references 90 Y Yttrium EXPOSURE RISK ▖Irradiation + ▖External contamination ++ ▖Internal contamination + INTERNAL CONTAMINATION MEASUREMENT J Urine bioassay J Faeces bioassay J In vivo measurement Yttrium EMERGENCY TREATMENT Pentetate calcium trisodium No demonstrated clinical effectiveness, but usable due to its good tolerance profile. 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. IRSN-INRS radionuclide sheet: Radiation protection: radionuclides. Yttrium-90 ( irsn.fr). to find more DOSE COEFFICIENT REFERENCE Effective committed dose per becquerel incorporated, taken from the Order mentioned in Article R. 1333-24 of the Public Health Code: RADIONUCLIDE HANDBOOK • Emergency treatment of internal contamination RH 56

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