Acute Pediatric Radiation Injury-Where We Are Now, Where We Want To Be, How To Get There.

Acute pediatric radiation injury is fortunately rarely encountered in pediatric emergency medicine and trauma. Most reported experience with the condition has arisen from unanticipated, untoward events associated with radiation therapy for pediatric oncologic illness, as scientific study of pediatric outcomes following major radiation and nuclear events, such as Hiroshima, Nagasaki, Chernobyl, and Fukushima, has focused on long term morbidity, mostly with respect to thyroiditis and thyroid neoplasia, instead of acute care-for which data cannot be found in the English language scientific literature. As such, recent efforts have centered on development of medical countermeasures for pediatric patients based upon expert judgment, including but not limited to administration of antidotes and cytokines. The authors advocate for the creation of a multi-agency and multi-disciplinary working group to ensure the strategic mitigation of the critical gaps in preparedness and response to radiation injuries in children cited below.