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Phosgene Oxime Vesicants

Vesicants / Blistering Agents. Phosgene Oxime. Overview: Phosgene Oxime. Phosgene oxime (CX), a halogenated oxime, causes severe injuryCan be mixed with other agentsAn urticant or nettle agent, not a true vesicantLike vesicants, it can produce similar eye, lung, and skin damage . Overview: T

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Phosgene Oxime Vesicants

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    1. Phosgene Oxime Vesicants / Blistering Agents

    2. Vesicants / Blistering Agents Phosgene Oxime

    3. Overview: Phosgene Oxime Phosgene oxime (CX), a halogenated oxime, causes severe injury Can be mixed with other agents An urticant or nettle agent, not a true vesicant Like vesicants, it can produce similar eye, lung, and skin damage

    4. Overview: Toxicity Concentrations < 8% - little injury Higher concentrations - more severe damage For skin exposure, estimated LD50 is 25 mg/kg For inhalation, the estimated LCt50 is 1500 – 2000 mg-min/m3 Systemic toxicity possible, including hepatic and vascular necrosis

    5. Protective Equipment Ordinary clothing and surgical gear offer little or no protection Respirator, protective overgarments, gloves and overboots are required Penetrates rubber Requires frequent changes of protective gear

    6. Detection No automatic detectors available

    7. Decontamination Efficient and immediate Full absorption can occur within a minute Mixed with another agent Skin damage increases victim’s vulnerability to second agent Clothing contaminated by liquid CX poses an immediate danger of off-gassing vapors

    8. Decontamination Skin Physical absorption achieved with Fullers earth or talcum powder Inactivate chemically with alkaline agents Inactivation using chlorination is ineffective Use large amounts of water only if nothing else is available

    9. Decontamination Mucous Membranes and Eyes Flush immediately with water Flush the eyes with water, isotonic sodium bicarbonate (1.26%), or saline (0.9%)

    10. Signs and Symptoms Instant and severe pain Leads to the rapid use of protective gear and decontamination Victims have removed protective gear in an effort to relieve the pain

    11. Signs and Symptoms Eyes Immediate symptoms Pain, conjunctivitis, blepharospasm, blepharitis, lacrimation, and keratitis Severe damage Corneal damage Permanent blindness

    12. Signs and Symptoms Sequence of skin damage First minute Intense pain and itching Full absorption exposed area turns white circular zone of erythema Within an hour: area becomes edematous Within 24 hours Edema resolves Lesion becomes darkly pigmented Severe necrosis develops

    13. Signs and Symptoms Sequence of skin damage Over 7 – 10 days Desquamation with necrosis Eschar formation Purulent discharge Necrotic lesions surrounded by intense inflammation

    14. Signs and Symptoms Respiratory Tract Instant irritation Leads to pulmonary edema Necrotizing bronchiolitis and pulmonary venule thrombosis Pulmonary injury may result from severe skin exposures

    15. Treatment No specific treatment Relieve symptoms, prevent infection, promote healing Surgical treatment for necrotic lesions Treat pulmonary edema as indicated Recovery takes 1 - 3 months 6 + months recovery time for burns

    16. Treatment Caveats Eyes No topical anesthetics Use protective goggles, not bandages GI Do not induce emesis Give 4-8 ounces of milk or water Respiratory Tract Treat symptomatically -- be alert for pneumonia

    17. Long Term Medical Sequelae Unknown Related to the initial acute injuries Carcinogenicity and reproductive effects unknown

    18. Environmental Sequelae Highly reactive and volatile Non-persistent agent Environmental hazards unlikely

    19. Summary Urticant agent Skin, eye and pulmonary damage Mixing with other agents causes severe injury Immediate decontamination is critical

    20. Summary Instant intense pain Followed by tissue necrosis No specific antidote or treatment Relieve symptoms, prevent infection, promote healing Recovery takes 1 - 3 months Skin burns take over 6 months to heal

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