I’m entering a few months prep for the UK and Ireland exit exam in Emergency Medicine: the FRCEM. I’ll be adding lots of little notes on pearls I’ve learned along the way. A lot of my revision is based around the Handbook of EM as a curriculum guide and review of contemporary, mainly UK guidelines. I also focus on the areas that I’m a bit sketchy on. With that in mind I hope they’re useful.
You can find more things on the FRCEM on this site here.
Be sure to read the prior post that fits with this one.
There’s also a prior post on the site from ages ago.
And there’s a couple of FOAMed sites too
Types of Exposure
- someone exposed to radiation eg xrays or gamma rays and now removed from site of exposure poses no exposure risk to anyone else
- someone contaminated with radioactive material (eg Homer leaving the power plant in the original Simpsons intro) poses an ongoing risk and needs detailed decontamination
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clinical features
- clinical features
- early (within a few hours)
- malaise
- GI symptoms
- time to emesis from exposure has some prognostic value (eg within 2 hrs indicates possible lethal dose)
- latent period
- perhaps a few days without symptoms
- late
- haematological collapse
- GI collapse
- neurological syndrome (almost universally fatal)
- early (within a few hours)
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How would you manage a patient and what is the prognosis?
- our role is largely decontamination and supportive
- check the absolute lymphocyte count as that’s one of the most useful prognostic things to trend
- a bone marrow transplant has been helpful in the haematological syndrome but as yet ha not been included in FRCEM OSCEs…
- Prognosis
- >2 Gy: Oh crap but you’ll hopefully be OK
- >10 Gy: switch off the lights on your way out…
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