Table 6. Decontamination and Treatment |
Agent
Type |
Decontamination |
First
Aid |
Other
Patient
Considerations |
Nerve |
- Remove clothing immediately
- Gently wash skin with soap and water
- Do not abrade skin
- For eyes, flush with plenty of water or normal saline |
- Atropine before other measures
- Pralidoxime (2-PAM) chloride |
- Onset of symptoms from dermal
contact with liquid forms may be delayed
- Repeated antidote administration may be necessary |
Asphyxiant/Blood |
- Remove clothing immediately
if no frostbite*
- Gently wash skin with soap and water
- Do not abrade skin
- For eyes, flush with plenty of water or normal saline |
- Rapid treatment with oxygen
- For cyanide, use antidotes (sodium nitrite and then sodium thiosulfate) |
- Arsine and cyanogen chloride may cause delayed pulmonary edema |
Choking/
Pulmonary-damaging |
- Remove clothing immediately
if no frostbite*
- Gently wash skin with soap and water
- Do not abrade skin
- For eyes, flush with plenty of water or normal saline |
- Fresh air, forced rest
- Semi-upright position
- If signs of respiratory distress are present, oxygen with or without
positive airway pressure may be needed |
- Other supportive therapy, as
needed
- May cause delayed pulmonary edema, even following a symptom-free
period that varies in duration with the amount inhaled |
Blistering/Vesicant |
- Immediate decontamination is
essential to minimize damage
- Remove clothing immediately
- Gently wash skin with soap and water
- Do not abrade skin
- For eyes, flush with plenty of water or normal saline |
- Immediately decontaminate skin
- Flush eyes with water or normal saline for 10-15 minutes
- If breathing difficulty, give oxygen
- Supportive care |
- Possible pulmonary edema
- Mustard has an asymptomatic latent period
- There is no antidote or treatment for mustard
- Lewisite has immediate burning pain, blisters later
- Specific antidote British Anti-Lewisite (BAL) may decrease systemic
effects of Lewisite
- Phosgene oxime causes immediate pain |
Incapacitating/
Behavior-altering
|
- Remove clothing immediately
- Gently wash skin with water or soap and water
- Do not abrade skin |
- Remove heavy clothing
- Evaluate mental status
- Use restraints as needed
- Monitor core temperature carefully
- Supportive care |
- Hyperthermia and self
-injury are largest risks
- Hard to detect because it is an odorless and non
-irritating substance
- Possible serious arrhythmias
- Specific antidote (physostigmine) may be available |
*For frostbite areas, do NOT remove any
adhering clothing. Wash area with plenty of warm water to release
clothing. |