Incorporation of Radioisotopes into Cells and Organs - Illustration

• External Contamination
  • Full Body
  • Partial Body
  • Wound Contamination with Radioactive Shrapnel
• Internal Contamination
  • Via Respiratory Tract
  • Via Digestive Tract
  • Via Radioactive Dust in Open Wounds
• Incorporation

Patient Management:

• Incorporation
  • After inhalation, ingestion, or wound contamination, small radioisotope particles may be transported via blood or lymphatics into cells, tissues, and organs.
  • Isotopes can be alpha-, beta-, or gamma-emitting.
  • Radioisotopes can be incorporated into one or more organs specific for that isotope, (e.g. thyroid, lungs, kidneys, bones/bone marrow, or liver/spleen) resulting in exposure at that site.
  • Medical countermeasures called decorporation agents or other procedures (e.g., diuresis) may be needed to remove radioisotopes that have been incorporated into tissues.
  • Toxic effects of radioisotopes may be due to their chemical and/or radiological properties.
  • How to diagnose
    • If after external decontamination, an appropriate radiation survey meter continues to identify significant residual radioactivity, suspect internal contamination.
    • Swab each nostril separately to help estimate level of internal (lung) contamination
    • Collect ≥70 mL spot urine sample for isotope measurement
      • Instructions for sample collection, labeling, packaging and shipping (HHS/CDC)
    • Consider total body radiation survey with modified hospital nuclear medicine equipment