Napalm Exposure Clinical Presentation

  • Author: Lisandro Irizarry, MD, MPH, FAAEM; Chief Editor: Robert G Darling, MD, FACEP   more...
 
Updated: Apr 23, 2012
 

History

  • Exposure history usually is obvious, with the individual recounting the sounds of an explosion and the unbearable pain associated with the burns of exposure.
  • Napalm produces carbon monoxide as a by-product of combustion. Thus, also evaluate individuals exposed to burning napalm for carbon monoxide exposure. In particular, consider individuals who are found with altered levels of consciousness near burning napalm to have been exposed to toxic levels of carbon monoxide until proven otherwise.
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Physical

  • Immolation, asphyxiation, and burns are the mechanisms by which incendiary weapons kill or wound.
  • Immolation results in a rapid decrease in blood pressure leading to unconsciousness and death.
  • Asphyxiation usually occurs as a result of napalm ignition, which results in a rapid deoxygenation of surrounding air. This rapid deoxygenation results in an atmosphere of approximately 20% carbon dioxide.
  • Severe burns (second and/or third degree) are frequently found in areas exposed to burning napalm. Injuries related to the thermal elevation of the air temperature may result in respiratory embarrassment.
  • Burning napalm raises the ambient environmental temperature and has been known to cause the deaths of individuals in raid shelters as a result of radiant heat and dehydration. This was a frequent cause of death in the bombing raids carried out over Hamburg, Germany, during World War II. The result of this phenomenon frequently was referred to as Bombenbrandschrumpfleichen (incendiary-bomb–shrunken bodies).
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Contributor Information and Disclosures
Author

Lisandro Irizarry, MD, MPH, FAAEM  Chair, Department of Emergency Medicine, Brooklyn Hospital Center; Assistant Professor, Department of Emergency Medicine, Weill Cornell School of Medicine

Lisandro Irizarry, MD, MPH, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Medical Toxicology, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Mollie V Williams, MD  Assistant Clinical Professor, Fellow in Disaster Preparedness, Department of Emergency Medicine, State University of New York Downstate Medical Center, Brooklyn

Mollie V Williams, MD is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

José Eric Díaz-Alcalá, MD, FAAEM,  Consulting Staff in Medicine Service, Division of Emergency Medicine/Medical Toxicology, Veterans Affairs Caribbean Healthcare System; Medical Director, Puerto Rico Poison Control Center, San Juan, Puerto Rico

José Eric Díaz-Alcalá, MD, FAAEM, is a member of the following medical societies: American Academy of Clinical Toxicology, American Academy of Emergency Medicine, and American College of Medical Toxicology

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.

References

  1. Napalm. Globalsecurity.org. Available at http://www.globalsecurity.org/military/systems/munitions/napalm.htm. Accessed July 3, 2007.

  2. Bullens EF. Chemicals in combat. Armed Forces Chem J. 1952;5(4):4-7.

  3. Fieser LF. Napalm. Indust and Engin Chem. 1946;38:768-773.

  4. Harvey F. Air war in Vietnam. Flying. 1966;5:38-95.

  5. Hollingsworth EW. Use of thickened gasoline in warfare. Armed Forces Chem J. 1951;4(6):26-32.

  6. McLean AD. Burns and military clothing. J R Army Med Corps. Feb 2001;147(1):97-106. [Medline].

  7. Napalm. Wikipedia. Available at http://en.wikipedia.org/wiki/Napalm. Accessed July 3, 2007.

  8. Reich P, Sidel VW. Current concepts. Napalm. N Engl J Med. Jul 13 1967;277(2):86-8. [Medline].

 
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