Based on recent recommendations, the following guidelines apply to medical personnel operating in austere field conditions. The lymphocyte level can be used as a biological dosimeter to confirm the presence of pure radiation injury, but not in combined injuries. If the physician has the resources of a clinical laboratory additional information can be obtained to support the original working diagnosis suggested by the presence of prodromal symptoms. These patients should be hospitalized to minimize the complications from hemorrhage and infection that will present within 2-3 weeks postexposure. All of these patients need to be hospitalized for the inevitable pancytopenic complications.
Survival is very unlikely.
Most have received severe injuries to their gastrointestinal and car diovascular systems and will not survive for more than two weeks. In the event of combined injuries, the diagnostic use of lymphocytes may be unreliable. It should be borne in mind that those with severe burns or multisystem trauma often develop lymphopenia. It is difficult to establish an early definitive diagnosis. Therefore, it is best to utilize a simple, tentative classification system based on three possible categories of patients as discussed below.