Pediatric emergency medicine trisk 1987 1987
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effectively instituted before the magnitude of the internal contamination is fully
known.
TABLE 90.16
DOSE OF STABLE IODINE (SSKI a ) BY AGE
Age
Dose (po) (mg)
<1 mo
16
1 mo–3 yrs
3–18 yrs
32
65
>18 yrs
130
a SSKI
(saturated solution of potassium iodide).
If given soon after exposure, stable iodine (saturated solution of potassium
iodide [SSKI]) is effective for preventing the uptake of radioactive iodine by the
thyroid gland. Prompt administration of stable iodine should be considered if
there is a possibility of external contamination, or ingestion or inhalation of
radioactive iodine ( Table 90.16 ). Because radioactive iodine is volatile, it is
likely to be inhaled. If a contaminated child were brought to the ED after an
accident with a radiopharmaceutical truck carrying radioactive iodine,
administration of stable iodine would be appropriate. Of note, for a given internal
contamination level, the radiation dose to the thyroid for infants is eight or nine
times as large as that for adults. If further investigation revealed no radioactive
iodine, little harm would have been done by having administered the stable
iodine. A single dose of oral iodine is highly unlikely to cause any adverse
reactions, even in persons who have serious reactions to iodinated contrast agents
or seafood.
After a nuclear reactor accident that results in the release of a large amount of
radioactive iodine, three steps can be taken to minimize the adverse effects on the
public. First, the public should be sheltered or evacuated to prevent further
exposure via fallout or gaseous materials. Second, potassium iodide (KI) may be
administered if available. However, it is important to note that many of the
nuclear reactors in the United States do not house radioactive iodine, making KI a
non-useful treatment option. Third, the food supply should be monitored carefully
to prevent further ingestion of radioactive iodine or other radionuclides. If a
reactor accident occurs that involves contamination of the public, understandable
concern by members of the public will ensue. If this happens, emergency medical
