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Update (11/17): Status of patients from the JCO Criticality
More updates. Mr. A's condition is very critical.
I have been asked where I find the medical updates of these JCO victims. Here
are the URLs.
JCO Accident Updates at: http://www.sta.go.jp/genan/jco/jco.html
Updates for Mr. A at: http://www.sta.go.jp/genan/jco/jcotoiga.html
Updates for Mr. B at: http://www.sta.go.jp/genan/jco/jcotoika.html
Updates for Mr. C at: http://www.nirs.go.jp/report/jco/index.html
Unless you have your Internet browser enabled for Japanese, you will get garbage
on the screen. To view Japanese characters on screen, you can do one of these
things (there must be others but I don't know them).
If you are using MS Internet Explorer Version 5, you can enable Japanese
Language.
If you are not using Internet Explorer, you can download a demo version of NJWIN
Internet Viewer 1.68 at http://www.njstar.com/
Tosh Ushino
ICN Dosimetry
==========================================================================
RBC = Red Blood Cell WBC = White Blood Cell BP = Blood Pressure
Temp = Temperature Pulse = Pulse Rate Resp = Respiration rate
CRP = C-reactive protein
Mr. A: 18 Sv
------------------------------------------------------------------------------
11/11/99 17:00
BP: 150/90 mm Hg, Pulse: 132/min., Resp: 25/min., Temp: 38.8 C
Continuing with sedative and ventilation. No major change to respiratory
function. Renal function recovering little at a time. WBC count in small blood
vessels is 17,100/mm^3. No major change to areas of injuries due to radiation
burn. Continuing problem with radiation damage to intestine (Volume of stool in
diarrhea was 2,255 gram from midnight to 4:00 PM ). No clear indication of
infection.
Treatment Direction: Prevention of infection of areas with radiation burn.
Continue ventilation management, infection prevention, nutrition management,
continued transfusion management, and detailed total body management.
Others: Continue vigilance.
11/12/99 17:00
BP: 125/65 mm Hg, Pulse: 125/min., Resp: 20/min., Temp: 39.0 C
Continuing with sedative and ventilation. No major change to respiratory and
renal functions. WBC count in small blood vessels is 14,200/mm^3. Fluid seeping
from the areas of injuries due to radiation burn (2,390 gm during the previous
day). Continuing problem with radiation damage to intestine (Volume of stool in
diarrhea was 3,262 gram from midnight to 4:00 PM ). No clear indication of
infection.
Treatment Direction: Prevention of infection of areas with radiation burn.
Continue ventilation management, infection prevention, nutrition management,
continued transfusion management, and detailed total body management.
Others: Continue vigilance.
11/13/99 17:00
BP: 142/78 mm Hg, Pulse: 130/min., Resp: 20/min., Temp: 39.2 C
Continuing with sedative and ventilation. No major change to respiratory, renal
and liver functions. WBC count in small blood vessels is 12,000/mm^3. Increase
in volume of fluid seeping from the areas of injuries due to radiation burn.
Radiation damage to intestine and skin is extremely critical problem at this
time (Volume of stool in diarrhea was 1,400 gram from midnight to 4:00 PM ). No
clear indication of infection.
Treatment Direction: Prevention of infection of areas with radiation burn.
Continue ventilation management, infection prevention, nutrition management,
continued transfusion management, and detailed total body management.
Others: Continue vigilance.
11/14/99 17:00
BP: 120/64 mm Hg, Pulse: 128/min., Resp: 26/min., Temp: 38.6 C
Continuing with sedative and ventilation. No major change to respiratory, renal
and liver functions. WBC count in small blood vessels is 13,400/mm^3. Fluid
continuing to seep out from the areas of injuries due to radiation burn.
Radiation damage to intestine and skin is extremely critical problem at this
time (Volume of stool in diarrhea has decreased to 800 gram from midnight to
4:00 PM ).
Treatment Direction: Prevention of infection of areas with radiation burn.
Continue ventilation management, infection prevention, nutrition management,
continued transfusion management, and detailed total body management.
Others: Continue vigilance.
11/15/99 17:00
BP: 155/95 mm Hg, Pulse: 130/min., Resp: 21/min., Temp: 38.6 C
Continuing with sedative and ventilation. Fluid in lungs and stomach has
increased and oxygen intake has decreased. Renal function has decreased again.
WBC count in small blood vessels is 12,000/mm^3. Increase in volume of fluid
seeping out from the areas of injuries due to radiation burn (3,238 gm over a
day). Problem with radiation damage to intestine continues (Volume of stool in
diarrhea was 1,350 gram from midnight to 4:00 PM ). No clear indication of
infection.
Treatment Direction: Prevention of infection of areas with radiation burn.
Continue ventilation management, infection prevention, nutrition management,
continued transfusion management, and detailed total body management.
Others: Overall condition is critical, requiring continued vigilance.
11/16/99 17:00
BP: 126/78 mm Hg, Pulse: 134/min., Resp: 22/min., Temp: 39.4 C
Continuing with sedative and ventilation. Respiratory, renal and liver functions
are trending down. WBC count in small blood vessels is 12,000/mm^3. Continuing
problem with volume of fluid seeping out from the areas of injuries due to
radiation burn, and diarrhea continues. Radiation damage to intestine and skin
is extremely critical problem. Because of this, patient requires massive amount
of fluid and transfusion of blood products daily.
Treatment Direction: Prevention of infection of areas with radiation burn.
Continue ventilation management, infection prevention, nutrition management,
continued transfusion management, and detailed total body management.
Others: Overall condition is very critical, requiring continued vigilance.
11/17/99 17:00
BP: 129/82 mm Hg, Pulse: 126/min., Resp: 19/min., Temp: 38.0 C
Continuing with sedative and ventilation. Respiratory, renal and liver functions
trending down. WBC count in small blood vessels is 11,000/mm^3. Continuing
problem with volume of fluid seeping out from the areas of injuries due to
radiation burn, and diarrhea continues. Radiation damage to intestine and skin
is extremely critical problem. Because of this, patient requires massive amount
of fluid and transfusion of blood products daily.
Treatment Direction: Since graft versus host disease cannot be completely ruled
out, appropriate treatment will be initiated. Prevention of infection of areas
with radiation burn. Continue ventilation management, infection prevention,
nutrition management, continued transfusion management, and detailed total body
management.
Others: Overall condition is very critical, requiring continued vigilance.
Mr. B 10 Sv
-------------------------------------------------------------------------
11/11/99
No major change to overall condition, skin condition, or examination result.
Unconscious, lucid but drowsy.
BP: 148/92 Temp (peak): 38.1 C WBC count: 19,460/mm^3
11/12/99
Vomited once today.
BP: 150/80 Temp (peak): 38.4 C WBC count: 21,370/mm^3
11/13/99
No major change to overall condition, skin change, and examination result.
(There is some sort of viral infection and they are providing anti-viral drug.)
BP: 135/88 Temp: 38.0 C WBC count: 20,700/mm^3
11/14/99
No major change to overall condition, skin change, and examination result.
Conscious, lucid.
BP: 140/90 Temp: 38.1 C WBC count: 23,000/mm^3
11/15/99
No major change to overall condition and examination result, but skin change
(damage) spreading. Conscious, lucid. Area of skin peeling is large, and is
covered with topical dressing. Patient experiences extreme pain while dressing
is changed. Since this is a slow process that takes long time, the patient's
agony is great.
BP: 140/82 Temp: 38.3 C WBC count: 21,200/mm^3
Since the patient's condition has become relatively unchanging, unless there is
major change, we will henceforth update the patient condition three times a week
on Monday, Wednesday and Friday.
11/17/99
No major change to overall condition, skin change, and examination result.
Conscious, lucid.
BP: 122/88 Temp: 38.3 C WBC count: 22,500/mm^3
Mr. C: 2.5 Sv
------------------------------------------------------------------------
11/09/99: Stable. Temp: 36.2 C, BP: 122/75 mm Hg
11/10/99: Stable. Temp: 36.0 C, BP: 95/73 mm Hg
11/11/99: Stable. Temp: 36.0 C, BP: 102/70 mm Hg
11/12/99: Stable. Temp: 36.0 C, BP: 104/68 mm Hg
11/13/99: Stable. Temp: 36.0 C, BP: 125/85 mm Hg
11/14/99: Stable. Temp: 36.0 C, BP: 130/65 mm Hg
11/15/99: Stable. Temp: 36.0 C, BP: 118/80 mm Hg
-------------------------------------------------------------------------
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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