RE: Update: Status of patients from the JCO Criticality Accident

[Perron Harvard C PSNS <perronh@psns.navy.mil>]

Please continue with the updates.  All to often there is no information
provided after the initial accident.

H. Perron
E-mail perronh@psns.navy.mil

-----Original Message-----
From: Tosh Ushino [mailto:tushino@icnpharm.com]
Sent: Thursday, October 14, 1999 11:21 PM
To: Multiple recipients of list
Subject: Update: Status of patients from the JCO Criticality Accident


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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