Because of its low water solubility, patients often inhale significant amounts of vapor before symptoms appear. History likely reveals multiple casualties with respiratory complaints. Some patients also may report irritation of the eyes or skin. Victims likely will have been involved in a mass gathering or military event within the last 24 hours. Patients may report explosions, smoke, or a gas cloud.
Patients inconsistently report the odor of newly mown hay.
Exposure to low concentrations of DP causes chest discomfort or dyspnea. Exposure to somewhat higher concentrations tends to cause lacrimation and irritation of the eyes and skin. Exposure to high concentrations quickly can cause pulmonary edema with cough, dyspnea, and production of frothy sputum. Signs include tachypnea, rales, and decreased oxygen saturations. Further cardiopulmonary decompensation can occur from noncardiogenic pulmonary edema, with respiratory failure, hypotension, and death.