Buddy Aid.If you encounter a service member
suffering from severe signs of nerve-agent poisoning,
you should provide the following aid:
Mark the casualty, if necessary. Do not fasten the
Administer, in rapid succession, three sets of the
nerve-agent antidotes. Follow the procedures
for administration as described previously in the
NOTE: U s e t h e c a s u a l t y s o w n
autoinjectors when providing aid. Do not
use your injectors on a casualty. If you do,
you may not have any antidote available
when needed for self-aid.
Blister Agents (Vesicants)
Blister agents, or vesicants, exert their primary
action on the skin, producing large and painful blisters
that are incapacitating. Although vesicants are classed
as nonlethal, high doses can cause death.
Common blister agents include mustard (HD),
nitrogen mustard (HN), and Lewisite (L). Each is
chemically different and will cause significant specific
symptoms. They are all similar in their physical
characteristics and toxicology.
particularly insidious because they do not manifest
their symptoms for several hours after exposure. They
attack the eyes and respiratory tract as well as the skin.
There is no effective therapy for mustard once its
effects become visible.
Treatment is largely
supportive: to relieve itching and pain, and to prevent
M U S TA R D
( H D )
A N D
N I T R O G E N
MUSTARD (HN).HD and HN are oily, colorless or
pale yellow liquids, sparingly soluble in water. HN is
less volatile and more persistent than HD but has the
same blistering qualities.
Signs and Symptoms of Exposure.The eyes
are the most vulnerable part of the body to mustard gas.
Contamination insufficient to cause injury elsewhere
may produce eye inflammation. Because the eye is the
most sensitive part of the body, the first noticeable
symptoms of mustard exposure will be pain and a
gritting feeling in the eyes, accompanied by spastic
blinking of the eyelids and photophobia. Vapor or
liquid may burn any area of the skin, but the burns will
be most severe in the warm, sweaty areas of the body:
the armpits, groin, and on the face and neck. Blistering
begins in about 12 hours but may be delayed for up to
48 hours. Inhalation of the gas is followed in a few
hours by irritation of the throat, hoarseness, and a
cough. Fever, moist rales, and dyspnea may develop.
Brochopneumonia is a frequent complication. The
primary cause of death is massive edema or
mechanical pulmonary obstruction.
Treatment.There is no specific antidotal
treatment for mustard poisoning. Physically removing
as much of the mustard as possible, as soon as possible,
is the only effective method for mitigating symptoms
before they appear.
All other treatment is
symptomatic, that is, the relief of pain and itching, and
control of infection.
LEWISITE (L).Lewisite is an arsenical (an
arsenic-based compound). This blistering compound
is a light- to dark-brown liquid that vaporizes slowly.
Signs and Symptoms of Exposure.The vapors
of arsenicals are so irritating that conscious persons are
immediately warned by discomfort to put on the mask.
No severe respiratory injuries are likely to occur,
except in the wounded who are incapable of donning a
mask. The respiratory symptoms are similar to those
produced by mustard gas. While distilled mustard and
nitrogen mustard cause no pain on the skin during
absorption, Lewisite causes intense pain upon contact.
Treatment.Immediately decontaminate the
eyes by flushing with copious amounts of water to
remove liquid agents and to prevent severe burns.
Sodium sulfacetamide, 30 percent solution, may be
Figure 8-6.One set of used autoinjectors attached to a pocket