Table 5.
Primary scoring based on METREPOL during first 48 h.8
| Score 1 | Score 2 | Score 3 | |
|---|---|---|---|
| Average delay before symptoms appear | Less than 12 h | Less than 5 h | Less than 30 min |
| Cutaneous erythema | Nil | +/− | +++ before 3 h |
| Asthenia | + | ++ | +++ |
| Nausea | + | +++ | ++++ |
| Vomiting per 24 h | Maximum 1 | 1–10 | Above 10; and intractable |
| Diarrhea/number of stools per 24 h | Maximum 2–3; bulky | 2–9; soft | Above 10; watery |
| Abdominal pain | Minimal | Intense | Excruciating |
| Headache | Nil | ++ | Excruciating; signs of raised Intracranial Pressure |
| Temperature | Below 38 °C | 38–40 °C | Above 40 °C |
| Blood pressure | Normal | Normal; possible temporary decrease | Systolic below 80 |
| Temporary loss of consciousness | Nil | Nil | +/coma |
| Depletion of blood lymphocytes | |||
| At 24 h | Above 1500/mcl | Below 1500/mcl | Below 500/mcl |
| At 48 h | Above 1500/mcl Outpatient monitoring |
Below 1500/mcl Hospitalization for curative treatment |
Below 100/mcl Hospitalization multi-organ |
Adapted from: Akashi et al. Therapeutical management according to the European consensus conference. European approach for the medical management of mass radiation exposure. Available from https://sremc.files.wordpress.com/2012/11/ebmt-nac-pocket-guide2.pdf.