Medical Aspects of Chemical Warfare (2008) - The Black Vault

Medical Aspects of Chemical WarfareabFig. 13-12. Mask confidence chamber operator after several hours of exposure to concentrated CS. Erythema and blisters arepresent in areas where the skin was exposed. This service member stated that this is the first time he neglected to showerafter training.Photograph: Courtesy of CG Hurst, US Army Medical Research Institute of Chemical Defense.remove them adequately from the skin surface. CR,CN and DM hydrolyze very slowly in water, evenwhen alkali is present. 24 Because these agents do notdecompose in water, washing with soap and water willonly remove them from surfaces. Run-off may produceirritation if it gets into the eyes, so the eyes should beclosed and head lowered during decontamination (ifthe agent is not already in the eyes). Environmentalcontamination from these agents may be persistentand difficult to remove. CS is insoluble in water butwill hydrolyze in water at a pH of 7, with a half-life ofapproximately 15 minutes at room temperature, andextremely rapidly in alkaline solution with a pH of 9,with a half-life of about 1 minute. 71Decontamination solutions used on human skinshould not be caustic to the skin. A solution containing6% sodium bicarbonate, 3% sodium carbonate, and 1%benzalkonium chloride was found to bring promptrelief of symptoms and to hydrolyze CS. 187 No formof hypochlorite should ever be used to decontaminateCS or other RCAs because it can react with CS to producemore toxic chemical byproducts and will furtherirritate tissues. 51 Applying water or soap and water toskin exposed to CS or OC but decontaminated mayresult in a transient worsening of the burning sensation,which should dissipate with continued waterflushing. 3,10 PS liquid can also be decontaminated withsoap and water, and clothing, which can trap vapor,should be removed. 188Water in limited quantities increases the painsymptoms from OC, which has a water solubility of0.090 g/L at 37° C. 24,189 Without decontamination, OCsymptoms should dissipate over time as the body’ssubstance P is diminished. OC resin can also be decontaminatedwith copious amounts of water, liquid soapand water, baby shampoo, alcohol, or cold milk. 22 OCin the eyes can be decontaminated with copious waterflushing, but symptoms may not dissipate for 10 minutes.A compress of cold milk, ice water, or snow canhelp reduce the burning sensation once the individualhas been decontaminated. 22 Substances with high fatcontent, such as whipped cream or ice cream, also aidin decontamination and help reduce pain. 22 AlthoughOC is soluble in vegetable oil and other hydrocarbons,and such solutions can more easily be washed off theskin, hydrocarbons must not be used with solutionsof OC and other RCAs such as CN. 24,190 Commerciallyavailable products, such as Sudecon DecontaminationWipes (Fox Labs International, Clinton Township,Mich); Bio Shield towelettes (Bio Shield, Inc, Raleigh,470