Heart rate, respiratory rate, and BP should be monitored regularly Doppler evaluation may be helpful in cases of vasospasm, which may complicate assessment of BP and subsequent fluid management True hypotension may require pressor support and ICU care for treatment of multisystem organ failure Electrical or lightning injury in a pregnant woman can pose a risk to the pregnancy and evaluation by an obstetrician is warranted RADIATION INJURIES Goals of Treatment The goals of treatment are to decontaminate the patient without contaminating healthcare providers and to recognize early signs of radiation injury The emergency physician should be aware of the basic principles and management of radiation incidents in order to recognize when it happens, know procedures for triage and decontamination of victims, alleviate public fears and psychological trauma about potential incidents, and prevent mismanagement of potential victims Frequent training and drills can ensure that the ED staff has the knowledge, procedural skills, and supplies to deal with possible victims exposed to radiation accidents CLINICAL PEARLS AND PITFALLS No survivable radiation injury requires direct immediate lifesaving treatment, hence medical staff should focus their attention on injuryrelated, life-threatening conditions The greatest risk of whole-body radiation exposure after to weeks when bone marrow depression reaches its nadir Risk of contamination of ED staff is usually minimal Emergency preparedness for radiation injuries is crucial to managing these incidents and preventing widespread panic among staff and the public Understanding and anticipating the number of casualties and the severity/type of injuries that are most likely to occur is critical for the emergency provider Current Evidence Types of Radiation