Chemical Warfare (cont.)
Mustards Treatment and Prognosis
Treatment of mustard exposure is based on symptoms. Because the effects of mustards typically are delayed, people with complaints immediately after exposure may have an additional injury.
- For those with signs of upper airway obstruction, doctors may treat by using a tube in the person's throat or perform surgery to open the airway.
- Mustard-induced burns are especially painful. Doctors will use strong pain relievers. Adequate burn care is essential, because skin lesions heal slowly and are prone to infection. Severe burns may require removal of dead tissue, irrigation, and placement of antibiotics, such as silver sulfadiazine, directly on the burned area. The victim may need a tetanus shot.
- Severe eye burns may be treated with daily irrigation, topical antibiotic solutions, topical corticosteroids, and drugs that dilate the pupil. Petroleum jelly may be applied to prevent eyelids from sticking together. More severe corneal injuries may take as long as 2-3 months to heal. Permanent visual problems are rare.
- Although no antidotes currently are available to treat mustard toxicity, several agents are under investigation.
- Victims with bone marrow suppression following mustard exposure may be treated with medication to stimulate the bone marrow, such as granulocyte colony-stimulating factor.
Victims with significant respiratory tract burns usually require admission to the hospital’s intensive care unit. Also, victims with several skin burns will be admitted to the burn unit for burn care, pain relief, and supportive care. Blood cell counts will be monitored for 2 weeks following significant exposures. Most people recover completely. Only a small fraction have long-term eye or lung damage. About 2% of those exposed to sulfur mustard in World War I died, mostly due to burns, respiratory tract damage, and bone marrow suppression. Sulfur mustard is known to cause cancer, yet a single exposure causes only a small risk.
Medically reviewed by Jon Glass, MD; American board of Psychiatry and Neurology
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Medically Reviewed by a Doctor on 8/5/2014
Jeffrey L Arnold, MD, FACEP
Francisco Talavera, PharmD, PhD
Raymond J Roberge, MD, MPH, FAAEM, FACMT
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