15 SHEET ACTION TO TAKE IN THE EVENT OF EXTERNAL IRRADIATION Evaluating the dose received EXAMINATION INDICATIONS REQUIREMENTS HLA I and II tissue typing and phenotyping of erythrocytes (red blood cells) In anticipation of a bone marrow transplant if necessary To be performed rapidly if the estimated whole-body dose is likely to cause radiationinduced bone marrow suppression. AMeasurement of amylase level in plasma Indicator of irradiation of the salivary glands and the upper body To be carried out in case of very severe and localised irradiation. Follicle-stimulating hormone (FSH) level in plasma Indicator of the irradiation of the gonads and lower body To be carried out in case of very severe and localised irradiation. Measurement of phosphorous-32 in skin appendages or sodium-24 by whole-body radiation measurement or in the blood Estimation of the doses due to neutrons To be carried out in the event of a criticality accident. OTHER EXAMINATIONS The prescribing of these examinations is to be discussed according to the type and severity of the accident, requesting the expert advice of IRSN if necessary. IN PRACTICE It is mandatory to contact IRSN before taking and dispatching any samples for chromosomal aberration analyses IRSN duty engineer 24/24h 7/7d, in case of radiological emergency: +33 6 07 31 56 63 Volume of the sample • at least 15 ml of blood, • placed in at least 2 tubes. Procedure Method of sampling: take the blood using an aseptic technique on lithium heparin without separator gel. Immediately shake the tube for 30 s to 1 min to ensure good mixing. Delivery time Deliver the sample to the laboratory without fail within 48 hours after taking the sample, accompanied by the forms provided by IRSN (to be filled out). The sample must not be frozen under any circumstances. Transport The sample shall be transported at room temperature (minimum: 4°C – maximum: 37°C) and protected against impacts. On the outer packaging, indicate: "Urgent biological samples – keep at room temperature". MEDICAL RESPONSE IN NUCLEAR OR RADIOLOGICAL EMERGENCY 51
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