CME Information

Editorial Board

Lessons by Volume

Chemical Terrorism

By James A. Geiling, MD, FCCP

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**Table 1—**Phosgene*
Signs and Symptoms
Eye and airway irritation Dyspnea Chest tightness Delayed pulmonary edema
Detection
Odor of newly mown hay or freshly cut grass or corn Neither the M256A1 detector kit nor chemical-agent detector paper (M8 paper, M9 paper) is designed to identify phosgene, but the MINICAMS, Monitox Plus, Draeger tubes, Individual Chemical Agent Detector (ICAD), M18A2, M90, and M93A1 Fox will detect small concentrations of this gas.
Decontamination
Vapor: fresh air Liquid: copious water irrigation
Management
Termination of exposure ABCs of resuscitation Enforced rest and observation Oxygen with or without positive airway pressure for signs of respiratory distress Other supportive therapy as needed
From the Medical Management of Chemical Casualties Handbook*.⁶

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