Lewisite
Background
- Abbreviation: L
- A blister chemical agent (vesicant) type of chemical weapon
- Arsenic-containing compound
Clinical Features
- Odor of geraniums
- Pain with immediate contact
- May turn skin grayish color around vesicles
Differential Diagnosis
Chemical weapons
- Blister chemical agents (Vesicants)
- Lewisite (L)
- Sulfur mustard (H)
- Phosgene oxime (CX)
- Pulmonary chemical agents (Choking agents)
- Incendiary agents
- Cyanide chemical weapon agents (Blood agents)
- Prussic acid (AKA hydrogen cyanide, hydrocyanic acid, or formonitrile)
- Nerve Agents (organophosphates)
- Acetylcholinesterase inhibitors
- Household and commercial pesticides (diazinon and parathion)
- G-series (sarin, tabun, soman)
- V-series (VX)
- Lacrimating or riot-control agents
- Pepper spray
- Chloroacetophenone
- CS
Evaluation
Management
- British antilewisite (BAL) – chelating agent to reduce systemic effects from lewisite exposure.
- Won’t alter the blistering effects on skin or airway.
- Only used for patients with shock or severe pulmonary injury given BAL side effect
- Relative contraindications to BAL: Renal disease, pregnancy
Disposition
See Also
External Links
References
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