Sulfur mustard medical management

Medical management of nitrogen mustard exposure is similar to that for sulfur mustard and involves prevention of exposure and, where exposure has occurred, decontamination and support therapy. The use of antioxidants in the treatment of nitrogen mustard toxicity is currently under investigation (Hardej and Billack, 2006). 

The second exception is that while an antidote is available for systemic effects of Lewisite exposure, there are no antidotes for nitrogen mustard or sulfur mustard toxicity, with one minor caveat if given within minutes after exposure, intravenous sodium thiosulfate may prevent death due to sulfur mustard exposure (25). Otherwise, the medical management for skin, ocular, and respiratory exposure is only supportive. One guideline physicians can follow is to keep skin, eye, and airway lesions free from infection. 

Until definitive medical therapeutics for sulfur mustard are fielded, the medical caregivers will have to rely on symptomatic treatments and sound medical judgments. Historically derived treatments, as presented in the Textbook of Military Medicine (Sidell et al., 1997) and the Medical Management of Chemical Casualties Handbook (1999) prepared by the Chemical Casualty Care Division of the U.S. Army Medical Research Institute of Chemical Defense, can also be of assistance. 

Rotenberg, J. (2003), Advanced management of nerve agent and sulfur mustard casualties, and children and chemical warfare agents, presented January 8, 2003 from a series Advanced Topics on Medical Defense Against Biological and Chemical Agents, sponsored by U.S. Army Medical Command and the Department of Veterans Affairs. 

Graham, J.S., Stevenson, R.S., Mitcheltree, L.W., et al., 2008. Concepts in the surgical management of sulfur mustard injuries. In 11th Medical Chemical Defence Conference, Munich, Germany. 

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