Module 4 Signs and Symptoms 1 Situation Assessment

Module 4 Signs and Symptoms 1

Situation Assessment • Known information regarding the chemical release • Recognition of the event based on signs and symptoms 2

Not All Signs and Symptoms May Appear Immediately • Manifestation based on: – dose, – duration, and – route of entry 3

Nerve Agent Exposure 4

Signs and Symptoms: Nerve Agent Vapor Exposure • Affects organs directly contacted by agent • Affects other organs as agent is absorbed into body systems • Signs and symptoms appear in seconds to minutes • Peak effects within 15 to 25 minutes after exposure stops 5

Signs and Symptoms: Mild Vapor Exposure • • • Pinpoint pupils (w/ or w/o redness, pain) Dim or blurred vision Runny nose Slight chest tightness Slight difficulty breathing Secretions (tears, nasal fluids, saliva, sweat, phlegm) • Nausea and vomiting 6

Signs and Symptoms: Moderate Vapor Exposure • • • Pinpoint pupils (w/ or w/o redness, pain) Dim or blurred vision Excessively runny nose Pronounced chest tightness Plentiful secretions Moderate to severe breathing difficulty Nausea and vomiting Diarrhea General muscle weakness 7

Signs and Symptoms: Severe Vapor Exposure • • Same as for moderate exposure, plus Loss of consciousness Convulsions Generalized rippling of muscles under skin Flaccid paralysis Cessation of breathing Involuntary urination or defecation 8

Signs and Symptoms: Liquid Nerve Agent on Skin • Effects differ from vapor exposure – Different signs and symptoms – Different timing of appearance • General rule: the more severe the exposure, the quicker effects appear 9

Signs and Symptoms: Mild Liquid on Skin Exposure • Sweating at site of exposure • Rippling of muscles under skin at site of exposure • Effects appear in 10 min to 18 hrs, depending on dose 10

Signs and Symptoms: Moderate Liquid/Skin Exposure • • Same as for Mild exposure, plus Nausea, vomiting, and diarrhea Generalized sweating Generalized weakness, tiredness, or ill feeling • Effects appear in 10 min to 18 hrs, depending on dose 11

Signs and Symptoms: Severe Liquid on Skin Exposure • • • Same as for Moderate exposure, plus Collapse Loss of consciousness Convulsions Severe respiratory difficulty Flaccid paralysis Cessation of breathing Involuntary urination or defecation Effects appear suddenly in 2 -30 min 12

Differential Diagnosis • Refers to distinguishing one disease from another when they produce similar signs and symptoms 13

Diseases Producing Symptoms Similar to Nerve Agent Exposure • Epilepsy • Gastroenteritis • Exposure to agricultural insecticides (organophosphates and carbamates) • • • Heat illness Emphysema Stroke Head trauma Drug overdose 14

VESICANT AGENT EXPOSURE 15

Signs and Symptoms by Route of Exposure • Agent vapor affects eyes, skin, and airways • Agent liquid on skin or eyes – Produces more severe effects than vapor – Does not normally affect airways • Large exposures via either route can affect internal body systems 16

Signs and Symptoms of Exposure to Mustard Agent Vapor • Agent contacts skin and eyes – Causes surface damage – Absorbed into body • Agent is inhaled into respiratory tract – Damages mucous membranes – Absorbed into body 17

Signs and Symptoms of Vapor Exposure on Eyes • Mild exposure – Tearing, itching, burning, gritty feeling, sensitivity to light – Effects appear in 4 -12 hrs • Moderate exposure – Same as for Mild exposure, plus reddening, swelling of lids, moderate pain – Effects appear in 3 -6 hrs • Severe exposure – Same as for Moderate, plus marked swelling of lids, possible damage to cornea, severe pain – Effects appear in 1 -2 hrs 18

Signs and Symptoms of Vapor Exposure on Skin • Mild exposure – Reddening of skin with itching, burning, and stinging • Severe exposure – Same as for Mild exposure, plus blisters • Effects appear in 2 -24 hrs 19

Signs and Symptoms of Vapor Exposure on Airways • Mild exposure – Runny nose; pain in throat, nostrils, sinus; sneezing; nose bleed; hoarseness; hacking cough – Effects appear in 6 -24 hrs • Moderate exposure – Same as for Mild exposure, plus, loss of voice, productive cough • Severe exposure – Same as for Moderate exposure, plus mild-to-severe breathing difficulty – Effects appear in 2 -6 hrs 20

Signs and Symptoms of Vapor Exposure on GI Tract • Nausea and vomiting • Effects appear a few hrs to 24 hrs after exposure 21

Signs and Symptoms of Liquid Exposure on Skin or Eye • Effects similar to those for vapor exposure but more severe and appear sooner – Eyes—tearing, itching, burning, gritty feeling, sensitivity to light, swelling of lids, damage to cornea, pain – Skin—reddening, itching, burning, stinging, blisters • Effects most apparent at exposure site 22

Signs and Symptoms of Liquid Exposure on Eyes • Effects same as for vapor exposure, but more severe • For severe exposure – Symptoms can appear within minutes – Can result in severe damage to cornea, loss of vision, or loss of eye 23

Signs and Symptoms of Liquid Exposure on Skin • Effects similar to those for vapor exposure, but more severe – Tissue damage is deeper – Tissue death may occur at exposure site • Injury comparable to third-degree burn 24

How Sulfur Mustard Agent Blisters Skin Normal skin Reddened skin Blistered skin 25

Sulfur Mustard Blisters 26

Other Possible Causes of Signs and Symptoms • Blister agent signs and symptoms could also apply to: – – hay fever chemical or thermal burns heavy tear gas exposure poison ivy, poison oak, and other contact allergies 27

Summary: Pop Quiz Match signs & symptoms on the left with the correct cause on the right • • Miosis Blisters on skin Breathing difficulty Extreme sore throat Runny nose Hearing loss Rippling muscles Swollen eyelids • • Nerve Agent Mustard Agent Either Neither 28

Summary: Pop Quiz Answers • • Miosis—Nerve agent Blisters on skin—Mustard agent Breathing difficulty—Either Extreme sore throat—Mustard agent Runny nose—Nerve agent Hearing loss—Neither Rippling muscles—Nerve agent Swollen eyelids—Mustard agent 29