Irritants - Riot Control Agents Workup

Updated: Aug 01, 2018
  • Author: Paul P Rega, MD, FACEP; Chief Editor: Zygmunt F Dembek, PhD, MPH, MS, LHD  more...
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Workup

Approach Considerations

Clinicians should don appropriate personal protective equipment (PPE) before triaging and assessing patients assumed to be contaminated with a riot control agent (RCA). Victims who have RCAs on clothes and exposed body parts require decontamination as a first step. 

Diagnosis of pulmonary irritant exposure is based on clinical findings. However, the following may provide useful information in some cases:

  • Arterial blood gas and capnography measurements allow for confirmation of adequate ventilation
  • A chest radiograph may be indicated in patients with significant respiratory complaints, especially if the offending agent is not known
  • Perform a slit lamp examination with fluorescein on patients with significant eye complaints, especially if the patient experienced a close-range exposure
  • An electrocardiogram (ECG) is indicated for patients with persistent respiratory complaints and/or chest discomfort, in the appropriate clinical setting
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Laboratory Studies

Laboratory studies are not indicated unless an exposure to a RCA was prolonged or the RCA-exposure diagnosis is in doubt.

Consider the following:

  • Complete blood cell (CBC) count
  • Serum chemistry profile
  • Liver function studies
  • Lactate level
  • Toxicology screen

 

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Other Tests

Consider the following:

  • ABG/capnography: Baseline for those with prolonged and severe respiratory symptoms
  • ECG: Particularly for the elderly patients or those with significant comorbidities

 

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Procedures

Consider the following:

  • Decontamination of skin and eyes
  • Basic and advanced airway techiques for evere respiratory compromise
  • Slit-lamp examination
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