BLISTER AGENT EXPOSURE

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BLISTER AGENTEXPOSURE
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OBJECTIVES

• Identify the specific signs and symptoms of
  sulfur mustard agent exposure
• Identify the specific signs and symptoms of
  Lewisite exposure

CA148
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BLISTER AGENTS

• Destroy individual cells in target tissue
• Blisters (vesicles) most noticeable effect
• Sulfur mustard and Lewisite in Armys inventory
• Lewisite stored only at Deseret Chemical Depot

Blister
CA149
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HOW BLISTER AGENTS WORK

• Designed to inflict wartime casualties
• Affect skin tissue and especially harsh on soft
  membranes
• eyes lung tissue
• mouth tissue throat tissue
• Sulfur mustard greatest effect on warm, moist
  surfaces
• mucous membranes armpits
• groin buttocks
• knees and elbows creases fold of neck

CA150
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BLISTER AGENT EXPOSURE

• Liquid and vapors create extreme hazards
• The greater absorbed dose, the greater severity
  of skin and tissue damage
• Delayed reaction with little or no pain
• Burning, stinging, redness, or blisters usually
  delayed between 2 to 36 hours for sulfur mustard
• usually apparent between 4 - 8 hours
• Immediate pain for Lewisite

CA151
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ROUTES OF EXPOSURE

• Inhalation
• Ingestion

• Direct Contact

CA152
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INHALATION OF BLISTER AGENT

• Vapors enter body through respiratory system
• Direct access to lining of nose, throat, and
  bronchial tubes
• warm, moist membranes most vulnerable
• Prolonged exposure destroys mucous membrane
  lining
• internal inflammation
• bleeding that may lead to later infection of
  airways and lungs
• Most damage to upper airways
• with heavy exposure, lungs air sacs are injured
  and fill with fluids

Damage to air sacs may cause lungs to fill with
fluids
CA153
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DIRECT CONTACT WITHBLISTER AGENT

• Skin surface or eye touches liquid agent, surface
  where agent was deposited, or agent vapor
• Broken blister fluid non-irritating
• Does not cause blistering upon contact with skin
• Warmth and moisture increase effects
• between toes
• behind knees
• groin
• armpits
• behind ears

CA154
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INGESTION OF BLISTER AGENT

• Swallowing contaminated food, drink, placing
  contaminated items in mouth, or incidental
  hand-to-mouth contact
• Unlikely agent will contaminate food or drink

CA155
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SULFUR MUSTARD
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SULFUR MUSTARDSIGNS AND SYMPTOMS

• Severity of symptoms and how rapidly they develop
  greatly influenced by weather conditions
• hot, humid weather increases action of sulfur
  mustard
• Signs and symptoms characteristically delayed for
  hours

CA157
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SIGNS AND SYMPTOMS OFSULFUR MUSTARD EXPOSURE

• Eye Irritation/Inflammation
• Photophobia
• Reddening of Exposed Skin
• Blisters
• Inflammation of Respiratory Tract
• Gastrointestinal Effects
• Systemic Effects

CA158
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FACTORS AFFECTING SULFUR MUSTARD SIGNS AND
SYMPTOMS

• Characteristically delayed
• may appear within 1 - 2 hours with large exposure
  or if weather hot and humid
• Reaction time depends on the
• type of agent
• amount of agent person has been exposed to
• dose (how much a person has absorbed)
• duration of exposure
• route of exposure
• sensitivity of persons system

CA159
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FACTORS AFFECTING SULFUR MUSTARD SIGNS AND
SYMPTOMS

• Inhalation of sulfur mustard causes quicker
  reaction than direct contact exposure
• agent absorbed much faster in warm, moist areas
  of respiratory tract, nose, mouth, bronchial
  tubes

Effects greatest in warm, moist areas of
respiratory tract
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FACTORS AFFECTING SULFURMUSTARD SIGNS AND
SYMPTOMS

• Inhalation exposure effects occur after few hours
• accompanied by sneezing, coughing, and
  inflammation of trachea and bronchi
• Direct contact exposure effects usually delayed
• absorption may continue for hours even after
  decontamination

Not all signs and symptoms may appear . .
. Dose, duration, and route of exposure make a
difference
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OTHER POSSIBLE CAUSES

• Signs and symptoms may also be caused by
• hay fever
• burns (chemical, thermal, sun)
• tear gas exposure
• poison ivy, poison oak, and other contact
  allergies
• certain drugs

CA162
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INITIAL FIRST AID TREATMENT FORSULFUR MUSTARD
EXPOSURE

• Immediate removal from source of exposure
• Decontamination through washing and diluting
• Airway management may be needed as signs/symptoms
  develop

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TREATMENT FOR EYE CONTACT

• Speed Critical
• irreversible eye damage may be done very quickly
• flush eyes immediately with water
• tilt head to side
• pulling eyelids apart with uncontaminated fingers
  
• pouring water slowly into eyes
• Do not cover eyes with bandages
• Dark or opaque glasses shield eyes from light and
  provide relief from photophobia

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TREATMENT FOR SKIN CONTACTWITH SULFUR MUSTARD
Decontaminate, paying special attention to
eyelids neck creases armpits behind
knee between toes

• around the ears
• inside nose
• inside mouth
• groin

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LEWISITE
CA166