Skin decontamination quantity

Decontamination Complete cleansing of the skin with soap and water at the earliest opportunity. If washing is impossible, use the M258A1, M258, or M291 skin decontamination kit. Symptoms may appear as late as 36 h after contact exposure, even if the skin is washed within an hour. In fact, a delay in onset of several hours is typical. Use this time to prepare for the possibility of a widespread outbreak 6-24 h after the attack. Decontaminate bulk quantities of BZ with caustic alcohol solutions. If BZ or other belladonnoids are used as free bases, decontamination will require a solvent, such as 25% ethanol, 0.1 N hydrochloric acid, or 5% acetic acid. 

SM is a lipophillic compound and rapidly penetrates the skin. Hence the decontamination has to be done immediately and should be complete. It is known that decontami-niation done 5 min after SM contact may not be beneficial as a sufficient quantity would have been absorbed by the skin (Vijayaraghavan et al, 2002). A number of proprietary formulations are available that can efficiently decontaminate SM. A useful decontaminant for mustard would be one which is readily available in large quantities, inexpensive, and potentially biodegradable (Table 60.3) (Cemy and Cemy, 1997). 

The clinical effects of lewisite are similar to those of mustard. However, unlike mustard, lewisite liquid or vapor produces irritation and pain upon contact. As with mustard, immediate decontamination will limit lewisite s damage to skin or eyes. A specific antidote for the systemic effects of the agent exists in the form of British Anti-Lewisite (BAL). BAL must be used under medical supervision owing to its own toxic properties. There is no need to have this antidote far forward, and it can be kept in modest quantities because of the minimum threat from lewisite. 

Casualties/personnel Remove contaminated clothing immediately. Remove as much of the agent from the skin as fast as possible without spreading the material. Wash the entire potentially exposed area with copious quantities of water. Small Areas Puddles of liquid must be contained by covering with vermiculite, diatomaceous earth, clay, fine sand, sponges, paper towels, or cloth towels. Place the absorbed material into containers with a high-density polyethylene liner. Decontaminate the area with copious amounts of aqueous sodium hydroxide solution (a minimum of 10... 

The CWS procured more than 10,000 gas casualty treatment kits. The contents of the 1945 kit, representing the best efforts of wartime medical research in the treatment of chemical agent injuries, and containing in lesser or greater quantities the material also found in the first-aid kit and veterinary set, included BAL ointment (for removal of arsenicals from the skin), petrolatum and amyl salicylate (for removal of mustard from the skin), sodium sulamyd (to prevent blister gas eye infection), copper sulfate solution (to remove WP particles from the skin), copper sulfate powder (to replenish solution), sulfadiazine tablets or penicillin (to prevent secondary infection), a floating white soap (for decontamination), BAL eye ointment (for any liquid blister gas contamination of eyes), eye and... 

The casualty must be removed from further exposure and decontaminated as soon as possible. Initial resuscitation may be needed with supplemental oxygen and airway maintenance. Clothing should be removed and skin irrigated with copious quantities of water. Overall treatment is similar to phosgene (p. 286-287). 

---