Chemical warfare agents
Fact Sheet 10:Lung Gas Phosgene (Carbonyl chloridechloroformyl chloride)
Phosgene is a colorless gas, which may form a white cloud. It has a particular smell of new-mown hay. Phosgene vapor is heavier than air and may travel along the ground
Signs and Symptoms:
Phosgene can be absorbed into the body by inhalation. It is corrosive to the eyes, the skin, the respiratory tract. It causes lacrimation, coughing and choking as well as tightness in the chest with pain and conjunctivitis. Nausea and vomiting. Signs and symptoms of pulmonary oedema can follow a latent period of 30 mins to 24 hrs. Anoxia, circulatory collapse can quickly follow.
No specific antidote exists for phosgene inhalation. Diuretics play a limited role in the treatment of phosgene inhalation injury, since they tend to reduce fluid loss into the lungs via the damaged alveolar-capillary membrane. Conversely, diuretics may cause hypotension in hypovolemic patients receiving positive pressure ventilation. Steroids are not effective in phosgene inhalation injury. Patients with hyperactive airways usually benefit from aerosolized bronchodilator therapy.
Provide the patient with fresh air, ensure adequate rest. Sit in half upright position. If breathing has stopped, give artificial respiration. Mouth-to-mouth resuscitation should be used when mask-bag or oxygen delivery systems are not available. Do not use mouth-to-mouth resuscitation when facial contamination exists. Seek medical attention Immediately.
Patients with noncardiogenic pulmonary edema following inhalational phosgene exposure require further care in an intensive care unit setting. Initiate or continue standard treatment for noncardiogenic pulmonary edema, including the reversal of hypoxemia with supplemental oxygen and positive pressure ventilation.
Seek medical attention Immediately. Immediately flush eyes with plenty of water for 10-15 minutes
Seek medical attention Immediately. Don respiratory protective mask and remove contaminated clothing. Immediately wash contaminated skin with copious amounts of soap and water, 10% sodium carbonate solution, or 5% liquid household bleach. Rinse well with water to remove excess decontaminant.
"Fact Sheets on Chemical Warfare Agents, SDE/SEARO, World Health Organization,