Chloropicrin Poisoning Treatment & Management

Updated: Dec 05, 2013
  • Author: Kermit D Huebner, MD, FACEP; Chief Editor: Robert G Darling, MD, FACEP  more...
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Treatment

Prehospital Care

General considerations

The rescuer's protective equipment should be Level A (eg, triple gloves [polyethylene gloves and nitrile gloves over latex gloves], fully encapsulating chemical resistant suit and boots, hard hat, self-contained breathing apparatus). See the image below.

Level A suit (DuPont Tychem 10,000). Level A suit (DuPont Tychem 10,000).

Standard organic vapor filters used with gas masks or air-purifying respirators do not remove chloropicrin effectively.

Skin exposure

Immediately begin decontamination with running water. Flush for a minimum of 15 minutes.

Remove contaminated clothing, taking care not to contaminate eyes further.

Eye exposure

If possible, open victim's eyes while under gentle running water. Use sufficient force to open the eyelids. The victim must "roll" the eyes.

Flush for a minimum of 15 minutes.

Inhalation

Remove the victim to fresh air.

Provide assisted ventilation as needed to support pulmonary function.

Cover or remove gross contamination to avoid exposure to rescuers.

Ingestion

Do not induce vomiting.

Rinse mouth immediately with water.

Have the victim drink milk, egg whites, or large quantities of water if available.

Next:

Emergency Department Care

Skin exposure

If not completed in the field, continue decontamination with running water for at least 15 minutes.

Eye exposure

If not completed in the field, continue flushing for at least 15 minutes.

Inhalation

Continue assisted ventilation and initiate artificial ventilation as needed to support pulmonary function.

In severe respiratory compromise, ventilatory support is mandatory. If a PaO2 cannot be maintained greater than 60 mm Hg with a fraction of inspired oxygen (FIO2) less than or equal to 0.6, then add positive end-expiratory pressure in attempts to open previously closed alveoli.

For methemoglobinemia greater than 10-20%, consider administration of methylene blue 1-2 mg/kg as 1% solution intravenously over 5 minutes, followed by a 15-30 mL flush. [5]

Ingestion

Contact poison control for the most current information.

Do not induce vomiting.

Administer large quantities of water.

Do not give diluents to a patient who is convulsing, unconscious, or unable to swallow.

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