بررسی آثار رادیوبیولوژیکی و راهکارهای مراقبت‌های پزشکی بعد از انفجار هسته ای

Introduction: Individual exposure after a nuclear detonation (atomic bomb) delivers abundant doses with high dose rates to the people who were located near the nuclear detonation location or within the fallout zone. Effects of the radiation to the humans and animal models will be studied and a fundamental ground work of medical services and managing systems for such accidents would be provided in this article. Methods and Materials: This research is theoretical and analytical method that was performed by searching care proceedings, nuclear detonation, radiobiological effects, acute radiation syndrome and radiation accidents key words in the Google Scholar, Science Direct, PubMed and Scopus web sites in terms of content (Content Analysis). This article was written based on the 10 chosen articles which were found after the research in the internet web sites. Results: Whole-body doses >2 Gy which was found in the fallout zones or in the areas near the detonation location, can produce clinically significant acute radiation syndrome (ARS)(definite radiation effects), which classically involves the hematologic, gastrointestinal, cutaneous, and cardiovascular/central nervous systems. The severity and presentation of ARS are affected by several factors, including radiation dose and dose rate, inter-individual variability in radiation response, type of radiation (e.g., gamma alone, gamma plus neutrons), partial-body shielding, and possibly age, sex, and certain preexisting medical conditions. The combination of radiation with trauma, burns, or both (i.e., combined injury) confers a worse prognosis than the same dose of radiation alone. Supportive care measures, including fluid support, antibiotics, and possibly myeloid cytokines (e.g., granulocyte colony-stimulating factor), can improve the prognosis for some irradiated casualties. Available resources for the supportive and therapeutic cares were far less than demands of the extents of injuries and access to these resources for the patients and injured people will be very limited during the nuclear detonations and its consequences. Discussion and Conclusion: Because of the leakage and hard limitations in the resources availability for supportive and medical cares, it will be impossible to apply these cares and services for all of the patients and injured people after the nuclear detonation. It is necessary to determining the patients who must receive these cares. It is more appropriate to evaluate the absorbed dose of the all injured people by applying the biological dosimetry methods. Regarding to the patient symptoms and absorbed dose, type of the ARS syndrome will be determined. After the patients division, selected patients will be undergoing medical and supportive cares. For optimal use of available resources it is necessary to provide a general plan for doing these cares and services, guidance for training people who want to do medical and supportive cares for the radiation injured patients and building a database of the radiation accidents injured patient’s data. Long term radiobiological effects such as the cancer, teratogenesis, and heritable genetic effects were not evaluated and just initial effects of radiation were discussed in this study.