7-9. Blister Agents

Table of Contents

Blister agents (vesicants) include mustard (H and HD), nitrogen mustards (HN), lewisite (L), and other arsenicals, mixtures of mustards and arsenicals, and phosgene oxime (CX). Blister agents may act on the eyes, mucous membranes, lungs, and skin. They burn and blister the skin or any other body parts they contact. Even relatively low doses may cause serious injury. Blister agents damage the respiratory tract (nose, sinuses, and windpipe) when inhaled and cause vomiting and diarrhea when absorbed. Lewisite and CX cause immediate pain on contact. However, mustard agents are deceptive as there is little or no pain at the time of exposure. Thus, in some cases, signs of injury may not appear for several hours after exposure.

• a . Protective Measures. Your protective mask with hood and protective overgarment provide protection against blister agents. If it is known or suspected that blister agents are being used, STOP BREATHING, put on your mask and your protective overgarment.

CAUTION

Large drops of liquid vesicants on the protective overgarment ensemble may penetrate it if allowed to stand for an extended period. Remove large drops as soon as possible.

• b. Signs and Symptoms of Blister Agent Poisoning.
• • (1) Immediate and intense pain upon contact with L, LH (lewisite and mustard) mixture, and CX. No initial pain upon contact with mustard.
  • (2) Inflammation and blisters (burns) resulting in tissue destruction. The severity of a chemical burn is directly related to the concentration of the agent and the duration of contact with the skin. The longer the agent is in contact with the tissue, the more serious the injury will be.
  • (3) Vomiting and diarrhea. Exposure to high concentrations of vesicants may cause vomiting or diarrhea.
  • (4) Death. The blister agent vapors absorbed during ordinary field exposure will probably not cause enough internal body (systemic) damage to result in death. However, death may occur from prolonged exposure to high concentrations of vapor or from extensive liquid contamination over wide areas of the skin, particularly when decontamination is neglected or delayed.
• c. First Aid Measures.
• • (1) Use your M291 Skin Decontaminating Kit to decontaminate your skin and use water to flush contaminated eyes. Decontamination of vesicants must be done immediately (within 1 minute is best).
  • (2) If blisters form, cover them loosely with a field dressing and secure the dressing.

CAUTION

Blisters are actually burns. DO NOT attempt to decontaminate the skin where blisters have formed, as the agent has already been absorbed.

• • (3) If you receive blisters over a wide area of the body, you are considered seriously burned. Seek medical assistance immediately.
  • (4) If vomiting occurs, the mask should be lifted momentarily and drained — while the eyes are closed and the breath is held — and replaced, cleared, and sealed.
  • (5) Remember, if vomiting or diarrhea occurs after having been exposed to blister agents, seek medical assistance immediately.