# Presentation: 362133

## BLISTER AGENTEXPOSURE

**BLISTER AGENT****EXPOSURE**

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

- Identify the specific signs and symptoms of Lewisite exposure

- CA148

**OBJECTIVES**

## BLISTER AGENTS

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

- CA149

- Blister

## 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

- 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

**HOW BLISTER AGENTS WORK**

## BLISTER AGENT EXPOSURE

**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

## ROUTES OF EXPOSURE

- CA152

**ROUTES OF EXPOSURE**

- Inhalation
- Ingestion

- Direct Contact

## INHALATION OF BLISTER AGENT

- CA153

**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, lung’s air sacs are injured and fill with fluids

- Damage to air sacs may cause lungs to fill with fluids

## DIRECT CONTACT WITHBLISTER AGENT

- CA154

**DIRECT CONTACT WITH****BLISTER 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

## 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

## SULFUR MUSTARD

- CA156

## SULFUR MUSTARDSIGNS 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

## SIGNS AND SYMPTOMS OFSULFUR MUSTARD EXPOSURE

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

- CA158

## 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 person’s system

- CA159

## 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

- CA160

- Effects greatest in warm, moist areas of respiratory tract

## FACTORS AFFECTING SULFURMUSTARD 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

- CA161

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

## OTHER POSSIBLE CAUSES

**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

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

- Decontamination through washing and diluting
- Airway management may be needed as signs/symptoms develop

- CA163

**INITIAL FIRST AID TREATMENT FOR****SULFUR MUSTARD EXPOSURE**

## TREATMENT FOR EYE CONTACT

**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

## TREATMENT FOR SKIN CONTACTWITH SULFUR MUSTARD

**TREATMENT FOR SKIN CONTACT****WITH SULFUR MUSTARD**

- around the ears
- inside nose
- inside mouth
- groin

- eyelids
- neck creases
- armpits
- behind knee
- between toes

- CA165

**Decontaminate, paying special attention to**

## LEWISITE

**LEWISITE**