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Emergency War Surgery NATO Handbook: Part I: Types of Wounds and Injuries: Chapter VI: Chemical Injury

Identification and Diagnosis

United States Department of Defense
Peer Review Status: Internally Peer Reviewed


Table 4 provides rough initial identification guidance based on the time lag between CW agent exposure and onset of symptoms and signs. Table 5 then aids in diagnostic differentiation once the early signs and symptoms of chemical exposure are established.

Table 4. - Time of Onset

Precipitous Onset

Rapid Onset

Delayed Onset

Choking Agent: CL

Inhaled Nerve Agent

Absorbed Nerve Agent

Blister Agent: L

Blood Agent

Inhaled Blister Agent

Incap Agent

Liquid in Eye: HD

Choking Agent: CX

Table 5. - Early Signs and Symptoms of Chemical Exposure

Signs/Symptoms
Causative Chemical Agent

CNS

convulsions

nerve; blood

confusion, odd behavior

incap

stupor

any agent

Respiration

copious oro-nasal secretions

nerve

chest pain, wheezing

nerve; choking; blister

frothy sputum

blister; choking

hyperpnea, dyspnea

choking; blister; blood

apnea

nerve; blood

cyanosis

blood; nerve; choking

Circulation

bradycardia

nerve; blood

tachycardia

blood; nerver; incap

shock

any agent

Skin

hot, dry, flushed

incap

vesication

blister

pain on contact

lewisite

muscle tremors

nerve

erythema

unknown liquid

GI/GU

involuntary evacuation

nerve

vomiting

any agent

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