Medical response in a nuclear or radiological emergency

PHYSICAL CHARACTERISTICS Zirconium-95 ( 95Zr ) ▖Radioactive half-life: 64 d ▖Main types of radiation emitted: b- and g SOURCES OF EXPOSURE ▖Nuclear reactors (activation products) 95 Zr Zirconium EXPOSURE RISK ▖Irradiation ++ ▖External contamination ++ ▖Internal contamination ++ INTERNAL CONTAMINATION MEASUREMENT J Urine bioassay J Faeces bioassay J In vivo measurement Zirconium EMERGENCY TREATMENT Two treatments are possible. 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. 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 saline isotonic 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. 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 58

RkJQdWJsaXNoZXIy NjQ0NzU=