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

Identification and Diagnosis

United States Department of Defense

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

Approved for public release; Distribution is unlimited.

The listing of any non-Federal product in this CD is not an endorsement of the product itself, but simply an acknowledgement of the source.

Operational Medicine 2001

Health Care in Military Settings

Bureau of Medicine and Surgery
Department of the Navy
2300 E Street NW
Washington, D.C
20372-5300

Operational Medicine
Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
January 1, 2001

United States Special Operations Command
7701 Tampa Point Blvd.
MacDill AFB, Florida
33621-5323

This web version is provided by The Brookside Associates Medical Education Division. It contains original contents from the official US Navy NAVMED P-5139, but has been reformatted for web access and includes advertising and links that were not present in the original version. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense.

Operational Medicine 2001 Emergency War Surgery Second United States Revision of The Emergency War Surgery NATO Handbook United States Department of Defense

Identification and Diagnosis

Health Care in Military Settings

Operational Medicine 2001
Emergency War Surgery
Second United States Revision of The Emergency War Surgery NATO Handbook
United States Department of Defense