BLISTER AGENTS

Course overview

SULFUR MUSTARD (DICHLORETHYLSULPHIDE) AND NITROGEN MUSTARD ARE BLISTERING AGENTS, OR VESICANTS, THAT HAVE BEEN USED IN CHEMICAL WARFARE SINCE BEFORE THE NINETEENTH CENTURY. THEIR HISTORICAL USE IS MOST OFTEN REFERENCED IN REGARD TO THE FIRST AND SECOND WORLD WARS. THE HARBINGER OF SULFUR MUSTARD EXPOSURE IS THE SUBTLE ODOR OF ONIONS, HORSERADISH, OR GARLIC. WHEN EXPOSED TO SULFUR MUSTARD, SKIN AND MUCOUS MEMBRANES BLISTER, CAUSING PAINFUL AND DISFIGURING BURNS AND AIRWAY AND PULMONARY INJURY AND EDEMA. SYSTEMIC MANIFESTATIONS CAN OCCUR WITH HIGHER DOSES OR LONGER DURATION OF EXPOSURE. TREATMENT IS MOSTLY SUPPORTIVE AND REQUIRES DEFINITIVE CARE AT BURN SPECIALTY CENTERS FOR OPTIMAL WOUND MANAGEMENT AND SKIN GRAFTING, AS NEEDED. THIS ACTIVITY DESCRIBES THE EVALUATION AND MANAGEMENT OF BLISTER AGENT TOXICITY AND HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL TEAM IN IMPROVING CARE FOR AFFECTED PATIENTS.