Examination (Systemic)

Radiation syndrome manifests as an acute or delayed result of exposure of the whole body to high doses of ionising radiation.

It causes a non-specific clinical picture, including:

• Gastrointestinal effects
• Cardiovascular effects
• Neurological effects
• Haematological changes

The most vulnerable tissues are affected first, and the severity, speed of onset and duration of effects depend on dose. This can be broken down into four phases:

Prodromal phase

The typical picture starts with a prodromal phase lasting about 12 hours:

• Nausea
• Vomiting
• Weakness
• Fatigue
• Neurological signs

Latent phase

In the latent phase, which lasts 5-7 days, the patient seems to recover.

Period of obvious illness

The latent phase is followed by a period of obvious illness:

• Gingival bleeding
• Epistaxis
• Petechiae
• Systemic infections and gastrointestinal symptoms lasting up to 4 weeks

The risk of infection is highest at 25-35 days due to marrow suppression.

Recovery or death

The final stage is recovery or death.