TABLE 2

Summary of Nonstochastic (Deterministic) Effects (5)

Syndrome	Summary
Hematologic	Dose: Approximately 1–10 Gy (100–1,000 rad)
	Clinical symptoms: General injury of blood-forming cells in bone marrow, which increases with increasing dose, leading to pancytopenia. This results in bleeding, anemia, hemorrhage, malaise, and severe, often fatal, infection.
	Treatment:
	0–1 Gy (0–100 rad)—Reassurance
	1–2 Gy (100–200 rad)—Reassurance and hematologic surveillance
	2–6 Gy (200–600 rad)—Blood transfusion and antibiotics
	6–10 Gy (600–1,000 rad)—Consider bone marrow transplant
	Without treatment, no one has survived a single abrupt dose of 5 Gy (500 rad) or higher. It is possible to survive the hematologic syndrome with a bone marrow transplant, but at higher doses all subjects will die from the gastrointestinal syndrome.
Gastrointestinal	Dose: Approximately 2–50 Gy (200–5,000 rad)
	Clinical symptoms: Nausea, vomiting, and diarrhea; prolonged diarrhea; dehydration; electrolyte imbalance; lethargy; anorexia; death above 10 Gy (1,000 rad) with no treatment.
	Treatment:
	2–6 Gy (200–600 rad)—Blood transfusion and antibiotics
	6–10 Gy (600–1,000 rad)—Consider bone marrow transplant
	10–50 Gy (1,000–5,000 rad)—Maintenance of electrolyte balance
	At about 2 Gy (200 rad), classic radiation sickness (nausea, vomiting, and diarrhea) may begin because of radiation injury to the gastric and intestinal mucosa.
Central nervous system	Dose: >50 Gy (>5,000 rad)
	Clinical symptoms: Ataxia, convulsions, lethargy, coma, death
	Treatment: Sedatives