Irritants - CS, CN, CNC, CA, CR, CNB, PS Workup

  • Author: Paul P Rega, MD, FACEP; Chief Editor: Robert G Darling, MD, FACEP   more...
 
Updated: Aug 29, 2011
 

Laboratory Studies

  • Arterial blood gas measurements allow for confirmation of adequate ventilation.
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Imaging Studies

  • A chest radiograph may be indicated in patients with significant respiratory complaints, especially if the offending agent is not known.
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Other Tests

  • Perform a slit lamp examination with fluorescein on patients with significant eye complaints, especially if the patient experienced a close-range exposure.
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Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

Paul P Rega, MD, FACEP  Assistant Professor, Department of Public Health and Preventive Medicine, The University of Toledo College of Medicine; Assistant Professor, Department of Emergency Medicine, The University of Toledo College of Medicine; Director of Emergency Medicine Education and Disaster Management, OMNI Health Services

Paul P Rega, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Mark Keim, MD  Senior Science Advisor, Office of the Director, National Center for Environmental Health, Centers for Disease Control and Prevention

Mark Keim, MD is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Rick Kulkarni, MD  Attending Physician, Department of Emergency Medicine, Cambridge Health Alliance, Division of Emergency Medicine, Harvard Medical School

Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: WebMD Salary Employment

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Robert G Darling, MD, FACEP  Adjunct Clinical Assistant Professor of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, F Edward Hebert School of Medicine; Associate Director, Center for Disaster and Humanitarian Assistance Medicine

Robert G Darling, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, American Telemedicine Association, and Association of Military Surgeons of the US

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors, Eric Mowatt-Larssen, MD, and David P Sole, DO, to the development and writing of this article.

References

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  2. Brone B, Peeters PJ, Marrannes R, et al. Tear gasses CN, CR, and CS are potent activators of the human TRPA1 receptor. Toxicol Appl Pharmacol. Sep 2008;231(2):150-6. [Medline].

  3. Karagama YG, Newton JR, Newbegin CJ. Short-term and long-term physical effects of exposure to CS spray. J R Soc Med. Apr 2003;96(4):172-4. [Medline].

  4. Watson K, Rycroft R. Unintended cutaneous reactions to CS spray. Contact Dermatitis. Jul 2005;53(1):9-13. [Medline].

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  9. Army, Marine Corps, Navy, Air Force. Military Chemical Compounds and Their Properties in Potential Military Chemical/Biological Agents and Compounds. January 2005. Available at www.mipt.org/pdf/Potential-Military-Chemical-Biological-Agents-Compounds.pdf. Accessed April 2, 2005.

  10. Bentur Y, Gomez J. Incapacitating agents: BZ, calmative agents, and riot control agents. In: Keyes DC, Burstein JL, Schwartz RB, et al, eds. Medical Response to Terrorism, Preparedness and Clinical Practice. Philadelphia, PA: Lippincott Williams & Wilkins; 2005.

  11. Blain PG. Tear gases and irritant incapacitants. 1-chloroacetophenone, 2-chlorobenzylidene malononitrile and dibenz[b,f]-1,4-oxazepine. Toxicol Rev. 2003;22(2):103-10. [Medline].

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  13. CDC. Riot Control Agent Poisoning. Centers for Disease Control and Prevention Web site. Available at www.bt.cdc.gov/agent/riotcontrol/agentpoisoning.asp. Accessed May 12, 2004.

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  15. Compton JA. Tear agents. In: Military Chemical and Biological Agents. 1987:208-252.

  16. Field Manual. Riot Control Agents. Treatment of Chemical Agent Casualties and Convention Military Chemical Injuries. Medical NBC Online Web site. Available at www.nbc-med.org/SiteContent/MedRef/OnlineRef/FieldManuals/fm8_285/Part_2/chapter7.htm. Accessed April 2, 2005.

  17. Lillie SH, Hanlon E, Kelly JM, eds. Potential Military Chemical/Biological Agents and Compounds (FM3-11.9). 2005.

  18. Nelson LS. Simple asphyxiants and pulmonary irritants. In: Goldfrank LR, Flomenbau NE, Lewin NA, eds. Goldfrank's Toxicologic Emergencies. Appleton & Lange; 1998:1523-1538.

  19. Sidell FR. Riot control agents. In: Textbook of Military Medicine. Part 1. 1997:307-324.

  20. USAMRICD. Riot Control Agents in Medical Management of Chemical Casualties Handbook. 3rd ed. USAMRICD. Available at: https://ccc.apgea.army.mil/sarea/products/handbooks/MMCC/mmccthirdeditionjul2000.pdf. July 2000.

  21. Weir E. The health impact of crowd-control agents. CMAJ. Jun 26 2001;164(13):1889-90. [Medline].

 
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