Clinical Management of Mustard Gas Casualties

ED works quickly and causes tissue damage within a few minutes following exposure. Thus, removal from exposure and reduction of the effects of the remaining contamination by decontamination are of great importance. 

Decontamination of the eyes must take absolute priority in the early stages of management followed by management of the respiratory system. The latency of HD and the temperature effects of the toxicity make treatment of the actual presenting signs and symptoms difficult. 

There is no specific treatment for HD in the form of an antidote. Treatment is therefore based on early decontamination to reduce further damage, vital function life support and management of the skin and other epithelial bums. 

Early decontamination with saline or any other available solution is essential. 

The British CW manual JSP 312 notes that attempts to decontaminate the eyes more than 5 min post-exposure are likely to be valueless . 

---

Willems, I. (1989). Clinical management of mustard gas casualties. Annales Medicinal Militaris... 

Fig. 7-2. Erythema of the chest of an Iranian casualty as it appeared 5 days after his exposure to mustard. He also had a pulmonary injury with an associated bronchopneumonia due to infection with Haemophilus influenzae. The presence of a nasal oxygen catheter is indicative of the pulmonary insufficiency. Photograph Reprinted with permission from Willems JL. Clinical management of mustard gas casualties. Ann Med Milit Belg. 1989 3S 13.

Willems J. 1991. Clinical management of Mustard Gas casualties. Annales Medicinae Belgicae 3(Suppl.) l-61. 

Willems, J.L. (Ed.), 1989. Clinical Management of Mustard Gas Casualties University of Ghent Medical School and Royal School of the Medical Services, Ghent, Belgium. 

---