Decontamination nerve agent exposure

Pediatric exposures to vesicants can be quite toxic however, in contrast to nerve agent exposures, HD causes significantly greater morbidity than mortality. While mustard did not cause many deaths in WWI, death from HD exposure is usually due to massive pulmonary damage complicated by infection (bronchopneumonia) and sepsis. Children often show a quicker onset and greater severity of toxicity. Skin and eye toxicity occurs in the form of blisters or irritation that can result in blindness for the most severe cases. Except for lewisite, vesicant exposures must be managed with supportive care and rapid decontamination. 

Nerve agent intoxication requires rapid decontamination to prevent further absorption by the patient and to prevent exposure to others ventilation when necessary, as well as... 

Nerve agent intoxication requires rapid decontamination to prevent further absorption by the patient and to prevent exposure to others, ventilation when necessary, administration of antidotes, as well as supportive therapy. Skin decontamination is not necessary with exposure to vapor alone, but clothing should be removed to get rid of any trapped vapor. With nerve agents, there can be high airway resistance due to bronchoconstric-tion and secretions, and initial ventilation is often difficult. The restriction will decrease with atropine administration. Copious secretions which maybe thickened by atropine also impede ventilatory actions and will require frequent suctioning. For inhalation exposure to nerve agents, ventilation support is essential. 

The search for a noncorrosive decontamination of sensitive material and skin after exposure by toxic chemicals like pesticides and nerve agents, is an important but challenging task. Therefore, the development of cost-effective cleanup... 

Benton et al. (2006b, 2007) experimentally determined the LCtso and LC50 in male and female adult SD rats exposed whole body to VX vapor for 10, 60, and 240 min in a dynamic exposure chamber (Table 6.3) study protocol was similar to that for agent GB in the studies conducted by Mioduszewski et al. (2001, 2002a). Experiments testing the role of decontamination less than 24 h post-exposure provided clear evidence for percutaneous toxicity induced by whole-body vapor exposure to the persistent nerve agent VX. For severe and lethal VX vapor exposure effects, females were not more susceptible than males for the exposure durations examined. 

The choice of appropriate treatment for nerve agent intoxication depends on the agent as well as extent and route(s) of exposure. Very mild exposure to nerve agent vapor may necessitate only decontamination and observation severe exposure to vapor or liquid requires immediate decontamination, antidote administration, artificial respiration, monitoring, and supportive therapy over hours to multiple days (ATSDR, 2007 Sidell, 1997 Vale et al, 2007 Pulley and Jones, 2008). Convenient triage classifications have been developed by ATSDR (2007) in collaboration with the US Army Medical Research Institute of Chemical Defense. 

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