question: What is happening to someone dying of Radiation poisoning?
comment: Sunburn - ultraviolet radiation penetrates past the outer (dead cell) layers of your skin, and the photons of UV light interact with the atoms in the sensitive biological chemistry compounds inside the live cells in the deeper layers of your skin, causing unwanted chemical reactions that kill the cell. It it's a "burn" like a "chemical burn" - reactions destroy the cells. X-rays penetrate even more; they're used for x-ray imaging at hospitals because they go right through skin and muscles and are stopped by the denser bones. An x-ray can basically deliver its energy anywhere inside your body, and the sudden chemical reactions could kill the cells... or just destroy some of the DNA and possibly cause the cell to "malfunction" (cancer). Nuclear radiation (gamma) goes through your body as if it were transparent air. You need lead, or a big thickness of less dense materials (cement, water) to stop it. Again, same thing, unwanted chemical reactions that can disrupt your cells and kill them, like a severe fire burn, on the inside. It's painful because your organs are dying, and pain is what your body uses to tell you this. Think severe sunburn or fire burn blisters, inside your organs. Cells bursting, forming blisters, etc.
passages: BULLET::::3. Neurovascular. This syndrome typically occurs at absorbed doses greater than , though it may occur at . It presents with neurological symptoms such as dizziness, headache, or decreased level of consciousness, occurring within minutes to a few hours, and with an absence of vomiting. It is invariably fatal.
  
  Early symptoms of ARS typically includes nausea and vomiting, headaches, fatigue, fever, and a short period of skin reddening. These symptoms may occur at radiation doses as low as . These symptoms are common to many illnesses, and may not, by themselves, indicate acute radiation sickness.
  
  Section::::Signs and symptoms.:Skin changes.
   Section::::"Walking Ghost phase".
   BULLET::::2. Gastrointestinal. This syndrome often follows absorbed doses of . The signs and symptoms of this form of radiation injury include nausea, vomiting, loss of appetite, and abdominal pain. Vomiting in this time-frame is a marker for whole body exposures that are in the fatal range above . Without exotic treatment such as bone marrow transplant, death with this dose is common. The death is generally more due to infection than gastrointestinal dysfunction.
   Signs and symptoms of radiation poisoning
  
  The symptoms of radiation poisoning includes a phenomenon where, following a dose of ionizing radiation, a person may have a period of apparent health, lasting for days or weeks, despite a terminal illness. The lag time of the effects of even severe radiation poisoning are a result of many biological processes, manifesting damage in different ways.
   Section::::History.:Notable incidents.
   Section::::Diagnosis.
  
  Diagnosis is typically made based on a history of significant radiation exposure and suitable clinical findings. An absolute lymphocyte count can give a rough estimate of radiation exposure. Time from exposure to vomiting can also give estimates of exposure levels if they are less than 10 Gray (1000 rad).
  
  Section::::Prevention.
  
  Section::::Prevention.:Time.
   BULLET::::- October 2011 – At a hospital in Rio de Janeiro, 7-year-old girl was treated for acute lymphoblastic leukemia with whole brain radiation. The prescriptions were done manually in a form with no formal peer review process. Because of an error in the registration of the number of sessions, she received the full dose in each session of radiotherapy. Even with early toxicity, the doctor refused to assess the patient, because some of the complaints were usual. The full treatment was finished in about 8 sessions and the girl was admitted with radiation burns. She developed frontal lobe necrosis and died in June 2012. After an investigation, the physicist, technician, and physician were charged with manslaughter.
   The radiation generally occurs from a source outside the body, is applied over minutes with most of the body being exposed, and involves a total dose of greater than 0.7 Gy (70 rads). It is generally divided into three types: i) bone marrow syndrome (0.7 to 10 Gy); ii) gastrointestinal syndrome (10 to 50 Gy); and iii) neurovascular syndrome (50 Gy). Sources of such radiation may include nuclear reactors, cyclotrons, and certain devices used in cancer therapy. The cells that are most affected are generally those that are rapidly dividing. Diagnosis is based on a history of exposure and symptoms. Repeated complete blood counts (CBCs) can indicate the severity of exposure.
   BULLET::::- February 2008-August 2009 – A software misconfiguration in a CT scanner used for brain perfusion scanning at Cedar Sinai Medical Center in Los Angeles, California, resulted in 206 patients receiving radiation doses approximately 8 times higher than intended during an 18-month period starting in February 2008. Some patients reported temporary hair loss and erythema. The U.S. Food and Drug Administration (FDA) has estimated that patients received doses between 3 Gy and 4 Gy.
  
  Section::::2010s.
   The outcomes for the 46 most contaminated people are shown in the bar chart below. Several people survived high doses of radiation. This is thought in some cases to be because the dose was fractionated. Given time, the body's repair mechanisms will reverse cell damage caused by radiation. If the dose is spread over a long time period, these mechanisms can mitigate the effects of radiation poisoning.
  
  Section::::Health outcomes.:Other affected people.
   BULLET::::1. Hematopoietic. This syndrome is marked by a drop in the number of blood cells, called aplastic anemia. This may result in infections due to a low amount of white blood cells, bleeding due to a lack of platelets, and anemia due to too few red blood cells in the circulation. These changes can be detected by blood tests after receiving a whole-body acute dose as low as , though they might never be felt by the patient if the dose is below . Conventional trauma and burns resulting from a bomb blast are complicated by the poor wound healing caused by hematopoietic syndrome, increasing mortality.
   Acute radiation syndrome (ARS), also known as radiation sickness, is a collection of health effects due to exposure to high amounts of ionizing radiation over a short period of time. Within the first days symptoms may include nausea, vomiting, and loss of appetite. This may then be followed by a few hours or weeks with little symptoms. After this, depending on the total dose of radiation, people may develop infections, bleeding, dehydration, and confusion, or there may be a period with few symptoms. This is finally followed by either recovery or death. The symptoms can begin within one hour and may last for several months.
   Treatment of acute radiation syndrome is generally supportive care. This may include blood transfusions, antibiotics, colony stimulating factors, or stem cell transplant. If radioactive material remains on the skin or in the stomach it should be removed. If radioiodine was breathed in or ingested, potassium iodide may be recommended. Complications such as leukemia and other cancers among those who survive are managed as usual. Short term outcomes depend on the exposure dose.
   Nausea and vomiting generally occur within 24–48 hours after exposure to mild (1–2 Gy) doses of radiation. Headache, fatigue, and weakness are also seen with mild exposure.
   Section::::Eligibility.
   Classically acute radiation syndrome is divided into three main presentations: hematopoietic, gastrointestinal, and neurological/vascular. These syndromes may or may not be preceded by a prodrome. The speed of onset of symptoms is related to radiation exposure, with greater doses resulting in a shorter delay in symptom onset. These presentations presume whole-body exposure and many of them are markers that are not valid if the entire body has not been exposed. Each syndrome requires that the tissue showing the syndrome itself be exposed. The gastrointestinal syndrome is not seen if the stomach and intestines are not exposed to radiation. Some areas affected are:
   Gastrointestinal death is caused by a dose of radiation between 10 and 50 Gray. Whole body doses cause damage to epithelial cells lining the gastrointestinal tract and this combined with the bone marrow damage is fatal. All symptoms become increasingly severe, causing exhaustion and emaciation in a few days and death within 7–14 days from loss of water and electrolytes.
  
  The symptoms of gastrointestinal death are:
  
  BULLET::::- gastrointestinal pain
  
  BULLET::::- anorexia
  
  BULLET::::- nausea
  
  BULLET::::- vomiting
  
  BULLET::::- diarrhea
  
  Section::::Radiation poisoning.:Central nervous system death.
   BULLET::::- August 2000 – March 2001; at the Instituto Oncologico Nacional of Panama, 28 patients receiving treatment for prostate cancer and cancer of the cervix received lethal doses of radiation due to a modification in the protocol for measuring radiation used without a verification test. The negligence, unique in its scope, was investigated by the IAT from May 26 – June 1, 2001.
   More information on bone marrow shielding can be found in the Health Physics Radiation Safety Journal article Selective Shielding of Bone Marrow: An Approach to Protecting Humans from External Gamma Radiation, or in the Organisation for Economic Co-operation and Development (OECD) and the Nuclear Energy Agency (NEA)'s 2015 report: Occupational Radiation Protection in Severe Accident Management.
  
  Section::::Prevention.:Reduction of incorporation.
   BULLET::::- October 26, 1991 – Nesvizh, Belarus – An operator at an atomic sterilization facility bypassed the safety systems to clear a jammed conveyor. Upon entering the irradiation chamber he was exposed to an estimated whole body dose of 11 Gy, with some portions of the body receiving upwards of 20 Gy. Despite prompt intensive medical care, he died 113 days after the accident.
   BULLET::::- April 1993: accident at the Tomsk-7 Reprocessing Complex, when a tank exploded while being cleaned with nitric acid. The explosion released a cloud of radioactive gas. (INES level 4).
  
  BULLET::::- 1994: Tammiku, Estonia; one fatality from disposed caesium-137 source.
  
  BULLET::::- August — December 1996: Radiotherapy accident in Costa Rica. Thirteen fatalities and 114 other patients received an overdose of radiation.
  
  BULLET::::- 1996: an accident at Pelindaba research facility in South Africa results in the exposure of workers to radiation. Harold Daniels and several others die from cancers and radiation burns related to the exposure.
   The human body contains many types of cells and a human can be killed by the loss of a single type of cells in a vital organ. For many short term radiation deaths (3 days to 30 days), the loss of two important types of cells that are constantly being regenerated causes death. The loss of cells forming blood cells (bone marrow) and the cells in the digestive system (microvilli, which form part of the wall of the intestines) is fatal.
  
  Section::::Management.
   Radiation poisoning, also called "radiation sickness" or a "creeping dose", is a form of damage to organ tissue due to excessive exposure to ionizing radiation. The term is generally used to refer to acute problems caused by a large dosage of radiation in a short period, though this also has occurred with long-term exposure to low-level radiation. Many of the symptoms of radiation poisoning occur as ionizing radiation interferes with cell division. There are numerous lethal radiation syndromes, including prodromal syndrome, bone marrow death, central nervous system death and gastrointestinal death.
  
  Section::::Radiation poisoning.:Prodromal syndrome.
   Section::::Effects.:Long term.
  
  Late or delayed effects of radiation occur following a wide range of doses and dose rates. Delayed effects may appear months to years after irradiation and include a wide variety of effects involving almost all tissues or organs. Some of the "possible" delayed consequences of radiation injury, with the rates above the background prevalence, depending on the absorbed dose, include carcinogenesis, cataract formation, chronic radiodermatitis, decreased fertility, and genetic mutations.
   Section::::Signs and symptoms.:Cancer.
  