Vesicants percutaneous absorption

Casualties/personnel Speed in decontamination is absolutely essential. To be effective, decontamination must be completed within 2 minutes after postexposure. However, decontamination after the initial 2 minutes should still be undertaken in order to prevent additional percutaneous absorption of the agent leading to systemic toxicity. Remove all clothing as it may continue to emit "trapped" agent vapor after contact with the vapor cloud has ceased. Shower using copious amounts of soap and water. Ensure that the hair has been washed and rinsed to remove potentially trapped vapor. To be effective, decontamination must be completed within 2 minutes of exposure. If there is a potential that the eyes have been exposed to vesicants, irrigate with water or 0.9% saline solution for a minimum of 15 minutes. 

The vesicant properties of lewisite result from direct contact with the skin. Signs of dermal toxicity (pain, inflammation) may be experienced within a minute after exposure. Acute lethality is usually the result of pulmonary injury. Ocular exposure may result in corneal necrosis. Due to its lipophilicity, percutaneous absorption of lewisite is rapid and, at a sufficient exposure, may be associated with systemic toxicity characterized by pulmonary edema, diarrhea, agitation, weakness, hypothermia, and hypotension (lOM, 1993). The threshold for severe systemic toxicity in humans following dermal exposure to lewisite has been estimated at lOmg/kg (9.1-13.4 mg/kg) (Sollman, 1957). 

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