Presentation
History
Victims of diphosgene (DP) exposure likely will have been involved in a mass gathering or military event within the last 24 hours that resulted in mass casualties with respiratory complaints. Patients may report explosions, smoke, or a gas cloud. Patients inconsistently report the odor of newly mown hay.
Presenting complaints may include the following:
-
Patients report irritation of the eyes or the skin.
-
Exposure to low concentrations of DP tends to cause lacrimation and irritation of the eyes and skin.
-
Exposure to somewhat higher concentrations causes chest discomfort and dyspnea; pulmonary edema often does not manifest until a few hours have passed, and the symptoms are aggravated by physical effort [7]
-
Exposure to high concentrations can quickly cause pulmonary edema with cough, dyspnea, and production of frothy sputum. Signs include tachypnea, rales, and decreased oxygen saturations.
-
Further cardiopulmonary decompensation can occur from noncardiogenic pulmonary edema, with respiratory failure, hypotension, and death.
-
Direct eye exposure to diphosgene liquid can cause corneal abrasions, ulcers, or perforation. Direct skin exposure to diphosgene liquid can cause burns.
Next:
Physical Examination
Physical findings include the following:
-
Lacrimation and irritation of the eyes and skin - Direct eye exposure to diphosgene (DP) liquid can cause corneal abrasions, ulcers, or perforation.
-
Direct skin exposure to diphosgene liquid can cause burns.
-
Chest discomfort
-
Tachycardia
-
Tachypnea
-
Dyspnea
-
Frothy sputum
-
Cough
-
Wheezing
-
Noncardiogenic pulmonary edema (decreased oxygen saturation)
-
Respiratory failure
-
Hypotension
Previous
Media Gallery
of
0
