What steps should I take if a patient presents with symptoms suggestive of acute radiation syndrome?

Initial assessment of a patient presenting with symptoms suggestive of acute radiation syndrome (ARS) should prioritise rapid identification of exposure history, symptom onset, and severity, including nausea, vomiting, diarrhoea, skin erythema, and neurological signs, alongside vital signs monitoring to detect haemodynamic instability NICE NG116 Dainiak & Albanese 2022.

Immediate management involves stabilising airway, breathing, and circulation, with supportive care tailored to symptom severity. Early decontamination to remove radioactive material from skin and clothing is essential to reduce ongoing exposure NICE NG116 Dainiak & Albanese 2022.

Laboratory investigations should include a full blood count with differential to monitor for cytopenias, biochemical panels, and dosimetry assessments where possible to estimate radiation dose and guide prognosis NICE NG116 Dainiak & Albanese 2022.

Specialist referral to a regional radiation emergency centre or haematology service is critical for ongoing management, including consideration of haematopoietic growth factors, infection prophylaxis, and potential stem cell transplantation in severe cases NICE NG116 Dainiak & Albanese 2022.

Infection control measures and close monitoring for sepsis are vital due to immunosuppression from bone marrow damage NICE NG116 Dainiak & Albanese 2022.

Psychological support should be offered early, recognising the traumatic nature of radiation exposure and its sequelae NICE NG116.

Overall, the approach integrates UK clinical priorities of stabilisation, decontamination, and specialist referral with evidence-based interventions from recent literature emphasising haematopoietic support and infection management Dainiak & Albanese 2022.