injuries poisoning
Vesicant Chemical Warfare Agents
Treatment of Vesicant Chemical Injuries
Decontamination Treat skin lesions similar to thermal burns Airway support as needed Skin decontamination should occur as soon as possible, preferably using Reactive Skin Decontamination Lotion (RSDL®). A 0.5% solution ofsodium hypochloriteis less effective but still useful if RSDL® is unavailable. Physical or mechanical decontamination can be tried, and soap and water, or high-flow low-pressure water alone, may be useful in expedient decontamination of mass casualties. Eyes and wounds should be flushed with sterile saline. Skin lesions are managed as thermal burns (see Initial wound care ). However, because fluid loss in patients exposed to vesicants is lower than in patients with thermal burns, less fluid should be used than is called for in the Brooke or Parkland fluid-replacement formulas for treating thermal burns. Scrupulous hygiene is important to prevent secondary infection. Antibiotic ointment should be applied to the edges of the eyelids to prevent lid adhesion. Supportive respiratory care, including attention to airway and breathing, is indicated for patients with respiratory manifestations (see Treatment ). Because nausea is cholinergic in origin, it can be treated with Bone-marrow suppression requires reverse isolation and treatment with colony-stimulating factors. The views expressed in this article are those of the author and do not reflect the official policy of the Department of Army, Department of Defense, or the US Government. 