injuries poisoning
Systemic Asphyxiant Chemical Warfare Agents
Diagnosis of Systemic Asphyxiant Chemical Injuries
Clinical evaluation Severely affected patients must be treated before testing is available, so diagnosis is mainly clinical. Laboratory findings include a decreased arteriovenous oxygen difference (due to higher-than-usual venous oxygen content) and high-anion-gap acidemia with increased lactate. All unconscious patients with a pulse are potentially salvageable and should be triaged for immediate medical treatment. Because patients with inhalational exposure usually do not get worse after removal from the contaminated environment, conscious patients who are reporting decreasing symptoms may be triaged as delayed (ie, able to tolerate a short delay while immediate casualties are being treated). 