Li-Wei Lin, MD, Tzong-Luen Wang, MD, PhD

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Abstract ---Acute radiation syndrome is an acute illness caused by irradiation of whole body or a significant portion of it from electromagnetic waves or accelerated atom particles. It is a sequence of phased syndrome: prodromal phase, latent period, clinical illness and one of recovery or death. The extent and duration of symptoms depend on individual radiation sensitivity, type of radiation, and radiation dose absorbed. Increasing radiation dose will heighten the severity of symptoms and shorten the duration of each phase. The three clinical forms of acute radiation syndrome depending on radiation dose are hematopoietic, gastrointestinal and neurovascular. Hematopoietic syndrome produces lymphopenia first then pancytopenia and increases the risk of infection and bleeding. Gastrointestinal syndrome is characterized by loss of the villus structure of intestine and then development of severe GI bleeding, diarrhea and abdominal pain along with hematopoietic syndrome. Neurovascular syndrome happened minutes after exposure with symptoms of vomiting, hypotension, ataxia, confusion, and seizures. Fatality is near 100%. Emergency physicians must recognize the manifestations of radiation syndrome, so we can provide optimal management for radiation victims.