Preliminary Evaluation of Clinical Radiation Injury (Thoma-Wald Diagnostic Classification System)

where:

• 1 Gray reflects an absorbed dose of 1 J/kg, or 100 rads.

Procedure:

(1) Observe and record the time of onset of clinical signs and symptoms relative to exposure.

(2) Perform daily complete blood counts (CBC) with differential.

Question 1: Did

(a) nausea, vomiting, diarrhea occur within minutes of exposure, and

(b) ataxia, disorientation, coma and shock occur within minutes to hours of exposure?

If yes, then injury group V (supralethal) with exposure > 50 Gy.

If no, then go to Question 2.

Question 2: Did

(a) nausea and vomiting occur within 2 days of exposure, and

(b) some derangement of the CBC (white blood cell, red blood cell and/or platelet counts) occur within 2 days of exposure?

If no, then injury group I (asymptomatic) with exposure < 1.25 Gy.

If yes, then go to Question 3.

Question 3: Did the leukocyte and lymphocyte counts show marked derangement in 3 days of exposure?

If no, then injury group II (mild injury) with exposure 1.25 to 2.50 Gy.

If yes, then go to Question 4.

Question : Did

(a) diarrhea occur within 4 days of exposure, and

(b) a marked platelet derangement within 6-9 days of exposure?

If yes, then injury group IV (lethal) with exposure > 5 Gy.

If no, then injury group III (serious injury) with exposure 2.5 to 5.0 Gy.