Phosgene Oxime Exposure Follow-up

Updated: Jun 24, 2016
  • Author: Erik D Schraga, MD; Chief Editor: Zygmunt F Dembek, PhD, MPH, MS, LHD  more...
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Follow-up

Further Outpatient Care

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  • Patients may be treated on an outpatient basis once respiratory symptoms have resolved and nonparenteral analgesics are adequate for pain control.

  • Instruct the patient on appropriate wound care techniques and provide close follow-up care to the patient to ensure adequate healing.

  • Ophthalmology follow-up care to ensure resolution of ocular injuries also is important.

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Further Inpatient Care

Pain associated with phosgene oxime (CX) exposure typically remains severe for several days. Consider admission for pain control. Admit any patients demonstrating significant respiratory symptoms for observation and supportive care.

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Inpatient & Outpatient Medications

Inpatient medications include the following:

  • Parenteral analgesics (eg, morphine, meperidine)
  • Broad-spectrum ophthalmic antibiotic ointments for eye injuries
  • Broad-spectrum topical antibiotic ointments for skin burns

Outpatient medications include oral analgesics (eg, codeine, oxycodone) if continued pain management is required after discharge and continued antibiotic ointments for eye and skin injuries until full healing has occurred.

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Transfer

Transfer to a higher-level medical center may be required for severe pulmonary CX injuries if the initial hospital is unable to provide the necessary intensive care support. Secure the airway and initiate ventilatory support prior to transfer.

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Complications

Potential complications include the following:

  • Scarring
  • Wound infections
  • Loss of vision
  • Death from severe respiratory injury
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Prognosis

Prognosis is generally good for minimal exposures. Severe and early respiratory distress portends a poor prognosis.

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Patient Education

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