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Update (10/15): Status of patients from the JCO Criticality Accident
From: Tosh Ushino@ICN on 10/15/99 09:32 PM
To: radsafe@romulus.ehs.uiuc.edu
cc:
Subject: Update (10/15): Status of patients from the JCO Criticality Accident
RADSAFERS,
More updates. If you know what CRP (Patient A, 10/15) stands for, please let me
know what it means. Also, I've made minor corrections to previous updates.
Thank you.
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 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
Increased pain in lining of the mouth. 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
10/14/99
Reddening of lining of mouth thought to be from radiation damage. Severe pain in
the mouth. Ulceration (edema?) on inside lining of cheeks. No major change to
overall condition. No clear indication of infection. Platelet count increased
due to transfusion.
Blood pressure: 119/66 Pulse rate: 70/min. (no abnormality)
Temperature: 36.8 C Blood oxygen level: 98%
White blood cell count: 20/mm^3 Hemoglobin conc.: 8.9 g/dl
Platelet count: 70,000/mm^3
10/15/99
Sore inside mouth has worsened and there is fever and inflammation. No other
major change to overall condition.
Blood pressure: 114/65 Pulse rate: 75/min. (no abnormality)
Temperature: 37.5 C Blood oxygen level: 99%
White blood cell count: 10/mm^3 Hemoglobin conc.: 9.1 g/dl
Platelet count: 19,000/mm^3 CRP5.04 mg/dl (???)
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.
Treatment Direction: 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 ventilation. Since the previous day, providing hormone to assist
in tissue regeneration to repair lung impediment, chest X-rays 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.
Treatment Direction: 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.
Treatment Direction: 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 ventilation management. Diminished 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.
Treatment Direction: Continue with ventilation, prevent infection, nutritional
management, and transfusion.
Others: Vigilance must be maintained.
10/15/99 17:00
No major change since the previous day. Providing sedative.
Blood pressure: 158/76 mm Hg Pulse rate: 114/min.
Respiration rate: 13/min. Temperature: 38.1 C
Continuing with ventilation. Oxygen intake is good. Renal function stable. Some
bleeding from lining of mouth. Requiring transfusion of red blood cells and
platelets. Concern for complication from infection but thus far no indication of
infection. There was a bowel movement. Epilation observed.
Treatment Direction: Evaluating feasibility of ?direct feeding method to
intestine?(?). Ventilation management, infection prevention, nutrition
management, continued transfusion management, and detailed total body
management.
Others: Vigilance must be maintained.
Patient C: (54-year old)
----------------------------
10/09/99
Stable.
Temperature: 35.9 C Blood pressure: 110/70
White blood cell and lymphocyte count remain stable.
10/10/99
Stable.
Temperature: 35.5 C Blood pressure: 115/70
White blood cell and lymphocyte count remain stable.
10/11/99
Stable.
Temperature: 36.0 C Blood pressure: 120/80
White blood cell and lymphocyte count remain stable.
10/12/99
stable.
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.
10/15/99
Stable.
Temperature: 35.6 C Blood pressure: 115/75
White blood cell and platelet count decreasing.
Borrow marrow will be examined to assess recovery.
--------------------------------------------------------------------------
Toshihide "Tosh" Ushino, CHP Tel: (800) 548-5100 x2413
Product Development Manager Fax: (714) 668-3149
Dosimetry Div., ICN Biomedicals, Inc. Email: tushino@icnpharm.com
3300 Hyland Ave., Costa Mesa, CA USA 92626 tushino@hotmail.com
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