ACTION TO TAKE IN THE EVENT OF EXTERNAL IRRADIATION Confirming and characterising the irradiation ARS appears further to whole-body irradiation at high doses, with clinical development in four phases. Questioning is a matter of urgency. Several clinical signs are associated with ARS, and the higher the dose received and the larger the body area concerned, the earlier they will appear. Five groups of victims named “groups I to V” are defined in decreasing order of severity. The most severe symptoms (group I) are: state of shock, cardiovascular collapse and loss of consciousness. The absence of early clinical signs in the victims (group V) does not exclude the possibility of irradiation at less than 1 Gy. Hospitalisation is not indispensable, but a biological assessment must be proposed in order to confirm whether or not irradiation has occurred. SEE SHEETS 11 15 Acute localised radiation syndrome results from exposure of a part of the body to an external source of radiation or the deposition of radioactive particles on the skin. The initial symptoms only appear for very high doses to the skin (the intensity and earliness of occurrence are a sign of severity: initial sensation of heat, dysesthesia, immediate pains, erythema, early oedema). Depending on the case, the initial phase is followed by a latent phase whose duration is inversely related to the dose of radiation received. The signs will appear successively according to the dose to the skin, starting with cutaneous erythema (4-5 Gy). 1. Carry out the dosimetric evaluation: biological dosimetry and physical dosimetric reconstruction SEE SHEET 15 2. Conduct the paraclinical examinations: Magnetic Resonance Imaging (MRI) and ultrasound scan of the injured zone. The recommendations of the dosimetry and radiopathology experts of the Institute of Radiation Protection and Nuclear Safety (IRSN) enable the prescription of these examinations to be adjusted according to the lesional appearance and the dosimetric evaluations. SEE SHEET 11 Acute radiation syndrome (ARS) Acute localised radiation syndrome 13 SHEET 48 MEDICAL RESPONSE IN NUCLEAR OR RADIOLOGICAL EMERGENCY
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