Presentation on theme: "VESICANTS. MILITARY VESICANTS  Mustards(H)  Sulfur (agent) (HD)  Nitrogen (chemotherapy) (HN)  Lewisite(L)  Phosgene Oxime(CX) NATO Codes. [slideplayer.com]

Overview: T Download Presentation An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other [slideserve.com]

If there is no agent present, then there will be no reaction. The reaction indicates whether a chemical agent is, or is not, present in the air. [luxfermagtech.com]

– PowerPoint PPT presentation Number of Views: 389 Avg rating: 3.0/5.0 less Transcript and Presenter's Notes Title: Phosgene Oxime Vesicants Blistering Agents 1 Phosgene OximeVesicants / Blistering Agents 2 Vesicants / Blistering Agents Phosgene Oxime [powershow.com]

It is relatively easy to synthesize and can exist in pure form as a white powder or yellowish powder depending on the impurities that are present. It is volatile, can exist as a liquid at room temperature, and has a high vapor pressure. [scholars.okstate.edu]

• Inflammation

  CX exposure results in immediate pain and inflammation, and it mainly affects skin, eye and respiratory system. There are no antidotes available against CX-induced injury and the treatment is only supportive. [ncbi.nlm.nih.gov]

  When inhaled, these agents produce inflammation of the lungs and the rest of the respiratory system. Death is rare and usually results from bacterial infection of the lungs. [nursing411.org]

  Skin damage with erythema, necrosis and inflammation following cutaneous exposure to CX and vesicants, e.g. sulfur mustard (SM; mustard gas), nitrogen mustard (NM) and lewisite (L), is similar; however, CX also causes severe skin injury with immediate [faseb.onlinelibrary.wiley.com]

  Within 24 hours Edema resolves Lesion becomes darkly pigmented Severe necrosis develops 13 Signs and Symptoms Sequence of skin damage Over 7 10 days Desquamation with necrosis Eschar formation Purulent discharge Necrotic lesions surrounded by intense inflammation [powershow.com]

• Disability

  Please enable JS and disable any ad blocker [chromatographyonline.com]

  Lethal gases can lead to disablement or death. Harassing agents don't cause casualties but disrupt enemy soldiers. [science.howstuffworks.com]

  A solitary lesion of limited extent may result in little or no disability if treated properly. d. [globalsecurity.org]

  In the later stages of the war, as the use of gas increased, the earliest military uses of chemicals were tear-inducing irritants rather than fatal or disabling poisons. [wikivisually.com]

  Definitions Related to the CWC Riot Control Agents (RCAs) A riot control agent is defined as any chemical not listed in a schedule which can produce sensory irritation or disabling physical effects rapidly in humans and which disappear within a short [opcw.org]

• Fever

  EFFECTS  Upper airway  Hemorrhage  Pain  Larynx  Hoarseness  Stridor 24 MUSTARD: DEATH  Usually pulmonary:  Damaged airways  Infection  Depressed immune system  Sepsis 25 MUSTARD: DIAGNOSTICS  Nonspecific  CBC  Early chemical pneumonitis: fever [slideplayer.com]

  Institute Lewisite Medical Melioidosis mg-kg muscle Mustard National Center nausea Nerve Agents Nuclear Regulatory Commission occur Odor person to person Ph.D Phosgene plague potential Preparedness protect Public Health pulmonary pulmonary agents Q fever [books.google.de]

  Article Keywords Keywords biological agent, chemical agent, anthrax, brucellosis, cholera, glanders, plague, tularemia, Q fever, smallpox, Venezuelan equine encephalitis, viral hemorrhagic fevers, botulinum, staph enterotoxin B, ricin, T-2 mycotoxins, [journals.lww.com]

  Abdominal pain, diarrhoea, fever, nausea, and vomiting. Aplastic anaemia (decreased formation of blood cells) or pancytopenia (decreased red or white blood cells and platelets ) leading to weakness, bleeding and infections. [dermnetnz.org]

  These include anorexia, nausea, vomiting, depression and fever and are far more prone to occur in hot than in temperate climates. [globalsecurity.org]

• Swelling

  Other system effects: Eye irritation, pain, swelling, and tearing may occur within 3 to 12 hours of mild to moderate exposure. [dermnetnz.org]

  Symptoms Mustard exposure symptoms may include the following: Skin burns, in which blisters can surface in as soon as 7-12 hours Eye burning, irritation and swelling (blindness can occur if exposed to high concentrations) Digestive tract problems such [alabamapublichealth.gov]

  Skin contact with phosgene oxime will cause swelling and itching hives that can also result in immediate and painful skin damage. Eye contact may result in severe pain and conjunctivitis. [patientsville.com]

  Effects (1) Eyes (a) Liquid form will cause rapid and devastating effects to the eye (b) Pain and blepharospasm (involuntary contraction of eyelid muscles) experienced upon contact (c) Swelling of the eyelids, conjunctiva and cornea (d) Eyelids will normally [medtrng.com]

  Exposure to moderate-to-high concentrations of phosgene (>3-4 ppm) can produce an immediate irritant reaction that typically lasts 3-30 minutes and includes the following: Lacrimation Conjunctival irritation/burning Burning sensation in mouth/throat Throat swelling [emedicine.medscape.com]

• Gastric Lavage

  Gastric lavage is contraindicated following ingestion of this agent due to the risk of perforation of the esophagus or upper airway. DELAYED EFFECTS OF EXPOSURE : Information is unavailable about the long term effects of exposure to phosgene oxime. [cdc.gov]

• Cough

  MANAGEMENT: SKIN  General supportive care  Debridement of burns  Frequent irrigation  Antibiotics: topical/systemic (cellulitis)  Systemic analgesics  Appropriate IV fluids and electrolytes  Burn Unit in Severe Cases 28 MANAGEMENT: AIRWAYS  Steam, cough [slideplayer.com]

  Absorbing phosgene oxime through the skin or inhaling it may result in fluid in the lungs with symptoms of shortness of breath and cough. Treatment There is no specific antidote or treatment that exists for exposure to mustard. [alabamapublichealth.gov]

  Some patients with severe coughs fail to develop serious lung injury, while others with little sign of early respiratory tract irritation develop fatal pulmonary edema. [fas.org]

  […] bacteria bacterium biological agents Biological Weapon Bioterrorism Blood Agents Botulism breathing cause Center for Environment Center for Infectious Centers for Disease chest tightness clothing colorless contagious contaminated Control and Prevention cough [books.google.de]

  Respiratory symptoms such as nose and sinus pain, cough, sore throat, and shortness of breath may occur within hours. Abdominal pain, diarrhoea, nausea and vomiting. [dermnetnz.org]

• Hoarseness

  […] only mild conjunctivitis  Return to duty in 2 weeks  15% moderate conjunctivitis  Return to duty 4-6 weeks  10% severe; under 1% with residual damage  0.1% “legal” blindness 23 MUSTARD: ACUTE EFFECTS  Upper airway  Hemorrhage  Pain  Larynx  Hoarseness [slideplayer.com]

  Severe pain, tearing and irritation in the eyes; possible temporary blindness (similar to that seen with lewisite) Irritation to the upper respiratory tract, causing runny nose, hoarseness and sinus pain. [alabamapublichealth.gov]

  Respiratory symptoms include immediate irritation to the upper respiratory tract, causing runny nose, hoarseness, and sinus pain. [dermnetnz.org]

  […] vapors Protective clothing worn (if any) Effects on surroundings (eg, other human or animal casualties) CX casualties typically report unbearable pain in exposed skin and eyes; difficulty with sight or blindness after ocular exposure; and sore throat, hoarseness [emedicine.medscape.com]

  If vesicant vapors are inhaled, the patient might experience hoarseness and stridor, severe cough, hemoptysis, severe dyspnea 170. [quizlet.com]

• Dyspnea

  Determining factors for return to the emergency department should include cough recurrence, dyspnea (especially resting dyspnea), and chest discomfort. [emedicine.medscape.com]

  If vesicant vapors are inhaled, the patient might experience hoarseness and stridor, severe cough, hemoptysis, severe dyspnea 170. [quizlet.com]

  INHALATION EXPOSURE : Immediate and incapacitating irritation, pain, and local tissue destruction of the upper airways; difficulty breathing or shortness of breath (dyspnea); and cough. [cdc.gov]

  These begin with cough (occasionally substernally painful), dyspnea, rapid shallow breathing and cyanosis. Nausea and vomiting may appear. As the edema progresses, discomfort, apprehension and dyspnea increase and frothy sputum develops. [fas.org]

• Pleural Effusion

  The respiratory lesions are similar to those produced by mustard except that in the most severe cases, pulmonary oedema may be accompanied by pleural effusion. 343. Systemic Effects. [globalsecurity.org]

• Exertional Dyspnea

  Many patients report ongoing exertional dyspnea for months or even years after phosgene exposure despite normalized chest radiographs. [emedicine.medscape.com]

• Diarrhea

  Bioterrorism Blood Agents Botulism breathing cause Center for Environment Center for Infectious Centers for Disease chest tightness clothing colorless contagious contaminated Control and Prevention cough Cryptosporidiosis Cyanide death Department of Health diarrhea [books.google.de]

  […] exposure symptoms may include the following: Skin burns, in which blisters can surface in as soon as 7-12 hours Eye burning, irritation and swelling (blindness can occur if exposed to high concentrations) Digestive tract problems such as abdominal pain, diarrhea [alabamapublichealth.gov]

  They damage the respiratory tract when inhaled and cause vomiting and diarrhea when ingested. [fas.org]

  When inhaled, vesicants harm the respiratory tract; when ingested, they can cause vomiting and diarrhea. (40) Although only a small percentage of blister agent victims die, blindness and permanent respiratory system damage are common. [publications.gc.ca]

• Thrombosis

  Inhalation and systemic absorption may cause pulmonary edema, necrotizing bronchiolitis and pulmonary thrombosis. Laboratory Diagnosis Routine laboratory studies should be done for all patients requiring admission. [sccgov.org]

  […] days Desquamation with necrosis Eschar formation Purulent discharge Necrotic lesions surrounded by intense inflammation 14 Signs and Symptoms Respiratory Tract Instant irritation Leads to pulmonary edema Necrotizing bronchiolitis and pulmonary venule thrombosis [powershow.com]

  Pulmonary edema may be accompanied by destruction of tissue and irritation of the airways (necrotizing bronchiolitis) and by blood clots in the lungs (pulmonary thrombosis). [cdc.gov]

• Chest Pain

  […] in exposed skin and eyes; difficulty with sight or blindness after ocular exposure; and sore throat, hoarseness, dyspnea, chest pain, and cough after respiratory exposure. [emedicine.medscape.com]

  Symptoms are dry burning of the throat, choking, chest pain, vomiting, labored breathing, and cyanosis. Description Phosgene is a colourless, reactive, non-flammable gas that is heavier than air with a musty hay odour. [chemicalbook.com]

• Blepharospasm

  Conjunctivitis, lacrimation, lid edema, blepharospasm 3. Pleasant smell of freshly mown hay 4. No distinct lab findings History 1. Used in WWI gas warfare 2. Developed by Russia and Germany before WWII 3. [medtextfree.wordpress.com]

  Eyes: Eye examination typically demonstrates conjunctivitis, lacrimation, lid edema, and blepharospasm after even minute exposures. More severe exposures can result in keratitis, iritis, corneal perforation, and blindness. [bionity.com]

• Lacrimation

  It also causes lacrimation in the eyes and even blindness. There is no antidote for phosgene oxime poisoning. Generally, any treatment is supportive. [bionity.com]

  Conjunctivitis, lacrimation, lid edema, blepharospasm 3. Pleasant smell of freshly mown hay 4. No distinct lab findings History 1. Used in WWI gas warfare 2. Developed by Russia and Germany before WWII 3. [medtextfree.wordpress.com]

  Eyes: Eye examination typically demonstrates conjunctivitis, lacrimation, lid edema, and blepharospasm after even minute exposures. More severe exposures can result in keratitis, iritis, corneal perforation, and blindness. [en.wikipedia.org]

• Eye Pain

  He developed diffuse skin erythema over most of his body, profound eye pain and photophobia, and blepharospasm. No blisters developed, but within several hours he noticed mild upper airway irritation and a dry cough. [mhmedical.com]

  Itching and pain may continue throughout the healing process. Other system effects: Severe eye pain and irritation, tearing, and possibly temporary blindness. [dermnetnz.org]

• Excessive Tearing

  EYE EXPOSURE : Immediate pain, inflammation of the membranes (conjunctivitis), corrosion of the cornea (keratitis), excessive tear production (lacrimation), vision loss, and temporary blindness. [cdc.gov]

• Skin Lesion

  Burning, irritation, wheal-like skin lesions, eye and airway damage 2. Conjunctivitis, lacrimation, lid edema, blepharospasm 3. Pleasant smell of freshly mown hay 4. No distinct lab findings History 1. Used in WWI gas warfare 2. [medtextfree.wordpress.com]

  Clinical data from our study showed that CX exposure leads to acute skin lesions (edema, erythema, necrosis, urticaria and blanching) as well as decreases in heart and respiratory rate, drop in body temperature, vasculature dilation and blood congestion [faseb.onlinelibrary.wiley.com]

  When mixed with another chemical agent (eg, VX), the rapid skin damage caused by phosgene oxime enables a greater dermal susceptibility to the second agent. [10] Physical Examination Skin A blanching, grayish skin lesion surrounded by an erythematous [emedicine.medscape.com]

  Eye lesions: Most are resolved within 14 days of exposure. b. Skin lesions: Deep skin lesions may be expected to heal in up to 60 days. Superficial lesions heal in 14-21 days. c. [globalsecurity.org]

  The most apparent toxic effect of blister agents is the damage they cause to skin. They produce slow-healing skin lesions which can blister, ulcerate and promote secondary infections. These blister agents are also called vesicants. [dermnetnz.org]

• Pruritus

  SKIN EXPOSURE : Immediate pain, whitening (blanching) of the skin surrounded by a red (erythematous) ring, local tissue death (necrosis), itching (pruritus), and hives (urticaria). Phosgene oxime is absorbed within seconds through the skin. [cdc.gov]

• Convulsions

  […] oxygen into the bloodstream Agents inhibit cell respiration; heart and central nervous system are susceptible Cyanogen chloride also greatly irritates eyes and lungs In moderate cases: vomiting dizziness deeper, more rapid breathing In severe cases: convulsions [publications.gc.ca]

  After severe exposure the casualty may lose consciousness and convulse within a minute without other obvious symptoms. Death is usually due to respiratory arrest requires prompt initiation of assisted ventilation to prevent death. [fas.org]

  Exposure (Hydrogen Cyanide), (Blood Agent) Signs and symptoms of cyanide exposure (1) Moderate, from low concentrations - within minutes (a) Transient increase in rate and depth of breathing (b) Dizziness (c) Nausea and vomiting (d) Headache (2) Severe (a) Convulsions [medtrng.com]

  If the person who is poisoned cannot wake up, has a hard time breathing, or has convulsions, call 911 emergency services. [cdc.gov]

If cardiogenic pulmonary edema is strongly suspected Findings on chest radiography are as follows: Initial films may be normal Early changes include hyperinflation and hilar enlargement Later changes are typical for noncardiogenic pulmonary edema See Workup [emedicine.medscape.com]

• Pleural Effusion

  The respiratory lesions are similar to those produced by mustard except that in the most severe cases, pulmonary oedema may be accompanied by pleural effusion. 343. Systemic Effects. [globalsecurity.org]

No specific treatment Relieve symptoms, prevent infection, promote healing Surgical treatment for necrotic lesions Treat pulmonary edema as indicated Recovery takes 1 - 3 months 6 months recovery time for burns 16 Treatment Caveats Eyes No topical anesthetics [powershow.com]

There are no antidotes available against CX-induced injury and the treatment is only supportive. [ncbi.nlm.nih.gov]

Treatment: Antidote – There is no antidote for sulfur mustard toxicity. Eye – Mild conjunctivitis beginning more than 12 hours after exposure is unlikely to progress to a severe lesion. [sccgov.org]

Notify CDC & local health dept Military Detection/Treatment Kits (See Chemical Agent ID/Detection) 1. [medtextfree.wordpress.com]

Decontamination, treatment, and handling properties[edit] Phosgene oxime is highly soluble in water. It is corrosive to metals and also decomposes on contact with metals. It is rapidly hydrolysed by alkaline solutions. [en.wikipedia.org]

Prognosis Prognosis is generally good for minimal exposures. Severe and early respiratory distress portends a poor prognosis. Morbidity and mortality for exposures to CX are dose dependent. [emedicine.medscape.com]

The presence or absence of these symptoms is of little value in immediate prognosis. [fas.org]

Course and Prognosis. Recovery takes 1 to 3 months. NEWS LETTER Join the GlobalSecurity.org mailing list [globalsecurity.org]

Alveoli may collapse, resulting in significant ventilation/perfusion (V/Q) mismatch, unless the patient receives ventilatory support with positive end-expiratory pressure (PEEP) Etiology Phosgene exposure may result from any of the following [11] : Small-scale [emedicine.medscape.com]

For example, skin exposure or intravenous (IV) injection of CX causes pulmonary edema, while injection into the portal vein produces hepatic necrosis but not pulmonary edema. [7] Epidemiology Mortality/Morbidity Morbidity and mortality for exposures to [emedicine.com]

Although CX is the most potent vesicating agent, it is one of the least studied chemical warfare agents and the pathophysiology as well as long term effects are largely unknown. [ncbi.nlm.nih.gov]

Pathophysiology The mechanism of toxicity for CX is uncertain. [7] Possible mechanisms of toxicity include necrotizing effects of the chloride component or a direct effect of the oxime or carbonyl groups. [emedicine.com]

Military interest as CX penetrates garments and rubber quicker than other chemical agents Pathophysiology 1. CX is urticant or nettle agent, causes corrosive type of skin and tissue lesion 2. [medtextfree.wordpress.com]

In the present study, we exposed the dorsal skin of SKH-1 hairless mice with neat CX for 0.5 and 1.0 min using two 12 mm vapor caps, and studied different parameters associated with its pathophysiology. [faseb.onlinelibrary.wiley.com]

[…] the more health care providers and everyone else involved with the health care industry know about this subject and the diseases and injuries these agents and weapons can produce, the more likely mankind will be able to successfully mute, survive, or prevent [books.google.de]

Centers for Disease Control and Prevention (CDC) Emergency Preparedness and Response, (2003, December 22). Includes Fact Sheets, Emergency Response Card, Medical Management Guidelines, and FAQ's about Phosgene Oxime. [osha.gov]

[…] inquiries: [email protected] The Centers for Disease Control and Prevention (CDC) protects people’s health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues [emergency.cdc.gov]

14 Signs and Symptoms Respiratory Tract Instant irritation Leads to pulmonary edema Necrotizing bronchiolitis and pulmonary venule thrombosis Pulmonary injury may result from severe skin exposures 15 Treatment No specific treatment Relieve symptoms, prevent [powershow.com]