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:
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Arterial blood gas and capnography measurements allow for confirmation of adequate ventilation
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A chest radiograph may be indicated in patients with significant respiratory complaints, especially if the offending agent is not known
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Perform a slit lamp examination with fluorescein on patients with significant eye complaints, especially if the patient experienced a close-range exposure
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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:
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Complete blood cell (CBC) count
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Serum chemistry profile
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Liver function studies
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Lactate level
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Toxicology screen
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Other Tests
Consider the following:
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ABG/capnography: Baseline for those with prolonged and severe respiratory symptoms
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ECG: Particularly for the elderly patients or those with significant comorbidities
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Procedures
Consider the following:
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Decontamination of skin and eyes
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Basic and advanced airway techiques for evere respiratory compromise
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Slit-lamp examination
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