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Blister Agents (VESICANTS) FACT SHEET
HEALTH CARE WORKERS
Examples: Mustard (H), Distilled Mustard (HD), Nitrogen Mustard (HN1, HN2, HN3), Lewisite (L)
WHAT ARE BLISTER AGENTS
(VESICANTS)?
Blister Agents or mustard gases, refer to several
manufactured chemicals, including sulfur mustard and
Lewisite, that do not occur naturally in the environment
Mustard gas is actually a liquid and is not likely to
change into a gas immediately if it is released at ordinary
temperatures.
As a pure liquid, it is colorless and odorless, but when
mixed with other chemicals, it looks brown and has a
garlic-like smell.
Although volatility is low, vapors can reach hazardous
levels during warm weather. Sulfur mustards are
absorbed by the skin, causing erythema and blisters.
Ocular exposure to these agents may cause
incapacitating damage to the cornea and conjunctiva.
Inhalation damages the respiratory tract epithelium and
may cause death.
Characteristically, patients complain of eye, skin and
lung irritation.
WHAT ACTIONS ARE TAKEN FOR
PATIENTS WHO PRESENT WITH
POTENTIAL BLISTER AGENT EXPOSURE
Decontamination of the eyes and skin within 1 or 2
minutes after exposure is the most effective means of
decreasing tissue damage.
WHAT ARE THE SYMPTOMS OF
BLISTER AGENTS?
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Eye burning, pain
Reddening of skin
Blistering (especially around sweaty parts of the
body)
Convulsions
Respiratory failure
Sluggishness
Apathy
Lethargy
Coughing
Bronchitis
HOW ARE BLISTER AGENT DIAGNOSED?
Routine laboratory studies should be done for all
patients requiring admission. These include CBC,
glucose, and serum electrolytes. Chest x-ray and pulse
oximetry (or ABG measurements) are recommended for
inhalation exposures. A test for urine thiodiglycol, a
metabolite of mustard, can be performed at specialized
laboratories, but is not a routine laboratory measure.
CAN BLISTER AGENTS BE SPREAD FROM
PERSON TO PERSON?
People whose skin or clothing is contaminated with
sulfur mustard can contaminate rescuers and others by
direct contact or through off-gassing vapor.
WHAT MEDICAL TREATMENT IS GIVEN TO
PATIENTS EXPOSED TO BLISTER AGENT?
Patients arriving immediately from the scene of exposure
to sulphur mustard are not likely have signs. Immediate
symptoms may be seen with Lewisite exposure.
There is no antidote for sulfur mustard toxicity.
Decontamination of all potentially exposed areas within
minutes after exposure is the only effective means of
decreasing tissue damage. There is no antidote for
sulfur mustard toxicity. There is an antidote for Lewisite,
called BAL or British Antilewisite, but its use is reserved
for severe poisoning.
Medical treatment is supportive and similar to that
provided for thermal burns.
DO YOU NEED TO ISOLATE A PATIENT
WITH BLISTER AGENT EXPOSURE?
Yes. Prior to decontamination the patient should be
isolated to prevent secondary exposure to medical staff.
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