Update: Status of patients from the JCO Criticality Accident

["Tosh Ushino" <tushino@icnpharm.com>]

RADSAFERS,

I don't know if anybody in the RADSAFEland is interested in this, but Japan's
Science and Technology Agency started posting medical updates on the two most
exposed workers. As before, (except for the 54-year old) they do not identify
who each status is for. I grouped the updates by the format (I think they match)
of the updates, and arranged them chronologically. Again, I apologize for not
getting the medical terms exactly correct. I will correct them as I learn the
terminology.

IF no one is interested, I will stop posting these so RADSAFE will not be
cluttered.

Tosh Ushino
ICN Dosimetry
tushino@icnpharm.com
                    ************************

Patient A:
------------------------
10/09/99
Blood pressure: 109/59
Pulse rate: 78/min.
Temperature:  36.8 C
Blood oxygen level: 99%
White blood cell count: 0/mm^3
Hemoglobin conc.:  9.5 g/dl
Platelet count: 43,000/mm^3

10/12/99 19:30
Pain in lips and oral cavity (lining of the mouth) has increased substantially,
but overall condition is as good as before.
No indication of infection.
Clear, conscious.
Blood pressure: 122/67
Pulse rate: 67/min. (no abnormality)
Temperature:  36.5 C
Blood oxygen level: 99%
White blood cell count: 30/mm^3
Hemoglobin conc.:  9.5 g/dl
Platelet count: 29,000/mm^3

10/13/99
Pain in lips and oral cavity (lining). Overall condition is as good as before.
No indication of infection.
Clear, conscious.
Blood pressure: 118/63
Pulse rate: 74/min. (no abnormality)
Temperature:  36.7 C
Blood oxygen level: 99%
White blood cell count: 20/mm^3
Hemoglobin conc.:  8.8 g/dl
Platelet count: 10,000/mm^3



Patient B:
----------------------
10/09/99
Due to the effect of sedative, patient is not entirely coherent.
Oxygen intake through lung decreasing.
Blood pressure: 136/60 mm Hg
Pulse rate: 104/min.
Respiration rate: 12/min.
Temperature: 37.5 C
White blood cell and platelet count continuing to decrease.
No indication of infection.
Received good advise from Dr. Gale.
Future direction of treatment: Ventilate, take precaution against infection.
Others: Vigilance must be maintained.


10/12/99 19:30
Providing sedative.
Blood pressure: 147/72 mm Hg
Pulse rate: 108/min.
Respiration rate: 16/min.
Temperature: 36.9 C
Continuing with ventilator. Since the previous day, providing hormone to assist
in tissue regeneration to repair lung impediment, chest X-ray reveal slight
improvement and there is improved oxygen intake through lungs.
Continued transfusion of red blood cells and platelets is required.
There is concern for complications due to infection, but thus far there is no
sign of infection.
No bowel movement or blood in stool.
Future direction of treatment: Continue with ventilation, prevent infection,
nutritional management, and transfusion.
Others: Fever and inflammation maybe masked by tissue regeneration hormone.
Vigilance must be maintained.

10/13/99 17:00
Providing sedative.
Blood pressure: 139/72 mm Hg
Pulse rate: 103/min.
Respiration rate: 19/min.
Temperature: 36.7 C
Continuing with ventilator.
Decrease in renal function, possibly result of medication.
Some bleeding from lining of mouth and stomach.
Continued transfusion of red blood cells and platelets is required.
There is concern for complications due to infection, but thus far there is no
sign of infection.
No bowel movement or blood in stool.
Future direction of treatment: Continue with ventilation, prevent infection,
nutritional management, and transfusion.
Others: Fever and inflammation maybe masked by tissue regeneration hormone.
Vigilance must be maintained.

10/14/99 17:00
No major change since the previous day.
Providing sedative.
Blood pressure: 138/70 mm Hg
Pulse rate: 106/min.
Respiration rate: 19/min.
Temperature: 37.3 C
Continuing with ventilator.
Decrease in renal function.
Some bleeding from lining of mouth.
Continued transfusion of red blood cells and platelets is required.
There is concern for complications due to infection, but thus far there is no
sign of infection.
No bowel movement or blood in stool.
Future direction of treatment: Continue with ventilation, prevent infection,
nutritional management, and transfusion.
Others: Vigilance must be maintained.


Patient C: (54-year old)
----------------------------
10/12/99
Temperature: 36.1 C
Blood pressure: 115/90
White blood cell and lymphocyte count remain stable.

10/14/99
Stable, conscious, clear.
Temperature: 36.0 C
Blood pressure: 110/80
White blood cell and lymphocyte count decreasing.



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