Application of time to emesis data for primary triage of radiation accident victims

Relevance. The relevance of the study is due to the risk of developing large-scale radiation accidents with a large number of victims, who will need primary medical triage and early prediction of the severity of injury for correct routing from the source of sanitary losses. Intention. Validation of the method of estimating dose by time-to-emesis under various exposure conditions for pre-hospital triage of victims. Methodology. The object of the study is the data from State Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency (Moscow) database of acute radiation injuries. Results and Discussion: We have analyzed individual data for the victims of the 1986 Chernobyl disaster (114 persons) with a separate analysis of the irradiation conditions (short-term exposure for less than 20 minutes and prolonged exposure in selected groups), as well as the data from victims of other radiation accidents in the former USSR (26 persons) and 8 patients with total body radiotherapy without the use of antiemetics. It was shown that for the equal time-to-emesis intervals, predicted radiation injury is more severe in case of prolonged exposure vs short-term exposure. This may be due to varying rate of dose accumulation and so-called “unnecessary dose” effect – when the biological mechanism of vomiting has already been triggered against ongoing exposure. Results are presented as interval estimates of radiation injury severity by time-to-emesis for both short-term and prolonged exposures. We also have formulated two criteria for primary triage purposes in case of moderate or large numbers of victims due to large-scale radiation accidents. Conclusion. Recommendations for pre-hospital triage of victims are proposed.