Arsenic vesicants medical

Medical Management Immediate decontamination after exposure is the only way to prevent damage to victims, followed by symptomatic management of lesions. Hospital care tends to be supportive. It should be repeated that liquid arsenical vesicants produce more serious lesions on dermal surfaces than do liquid mustard. In toxic victims, liberal fluids by mouth or intravenous, and high-vitamin, high-protein, high-carbohydrate diets could be indicated. For those victims where shock is in evidence, provide the usual supportive measures such as intravenous administration, blood transfusions, or other vascular volume expanders should be indicated. 

Fig. 12-1. (a) Erythema 25 hours after exposure to a high Ct (the product of concentration of vapor or aerosol time of exposure in this instance, 14,040 mg min/m3) of CS at 97°F and 100% humidity, (b) The same skin lesions at 45 hours, with vesication. Reprinted from Hellreich A, Goldman RH, Bottiglieri NG, Weimer JT. The Effects of Thermally-Generated CS Aerosols on Human Skin. Edgewood Arsenal, Md Medical Research Laboratories 1967 19. Technical Report 4075. 

Similar to the mustard agents, exposure prevention is the first line of defense against lewisite. Rapid decontamination is especially relevant to lewisite exposure due to the rapid development of pain (1-2 min) associated with lewisite exposure. Unlike other vesicants, an effective antidote for lewisite toxicity exists in the form of British anti-lewisite (BAL 2,3-dimercaptopropanol) which binds with arsenicals, thereby countering the lewisite-induced damage. Such chelation therapy is associated with notable side effects (e.g. renal effects) and requires carefiil medical management. More effective analogs of BAL have been developed with less significant side effects. 

---