USAMRICD TECH MEMO 90 1 CLINICAL NOTES ON CHEM CASUALTY CARE

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Subject: USAMRICD TECH MEMO 90 1 CLINICAL NOTES ON CHEM CASUALTY CARE    

Unit: OTSG        

Parent Organization: HSC         

Box  ID: BX003205

Folder Title: CLINICAL NOTES ON CHEMICAL CASUALTY CARE                                                        

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              An 16 '90 11:42






              U5AMRTCD Technical Memorandum 90-1

                             d. Pulmonary effects: 100--500 mg-min/ou n (very
                             little data)
                             e. Lethality: No respiratory protection, 1500
                             mg-min/cu m (three times more toxic than cyanide)
                             Respiratory protection: 10,000 mgr-min/cu m
                        2.   Liquid on skin
                             a. Erythema and blister: 10 micrograms
                             b.  Lethal: 7 cjrams/70 kg man

                   D. Mechanism of toxicity
                        1.   In the presence of a polar solvent, (e.g., water)
                             mustards cyclize and are biologically very
                             reactive
                             a. React with almost every biologically important
                             functional group, e.g., sulfhydryl, imino groups,
                             amino groups, and with some enzymes, e.g.,
                             proteases
                             b. Major reason for toxicity is because mustards
                             are a@lating agents; they possess two chains
                             capable of undergoing cyclization and hence can
                             attach to two other molecules. It attaches to the
                             guanine nitrogen in DNA strands causing cross
                             linking and eventually cellular death.     (There is
                             much active research on DNA repair mechanisms as a
                             method of therapy.) Main mechanism of toxicity is
                             thought to be inhibition of DNA replication and
                             toxicity is in rapidly dividing cells
                   E. Clinical Effects: the major target organs are skin,
                        eyes, lungs, bone marrow and GI tract
                        1. Skin
                           a. There are no immediate clinical effects, i.e.,
                             no burning, stinging, or redness.
                             b. However, within minutes (usually stated as two
                             minutes) mustard will penetrate the skin and
                             become "fixed" to tissue components (proteins,
                             etc.); clinical effects will later occur.
                             Decontamination must be done within this time if
                             damage is to be prevented.
                             d.   in 2 to 24 hours later, erythema will occur
                             (characteristically 4-6 hours)
                             G.  About 2 to 36 hours later blisters (vesicles)
                             will appear
                             f. Within the first hour, as seen
                             microscopically, there is damage to endothelium of
                             capillaries and to superficial fibroblasts. Later
                             there is death of basal epidermal cells, a
                             generalized vascular l@, and invasion by
                             inflammatory cells.   The inflammatory response
                             reaches a maximum at  24-72 hours and healing
                             occurs over the next  10-30 days.

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Document 22 f:/Week-36/BX003205/CLINICAL NOTES ON CHEMICAL CASUALTY CARE/usamricd tech memo 90 1 clinical notes on chem c:12249609312728
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File Room = sep96_declassified
File Cabinet = Week-36
Box ID = BX003205
Unit = OTSG
Parent Organization = HSC
Folder Title = CLINICAL NOTES ON CHEMICAL CASUALTY CARE
Folder Seq # = 31
Subject = USAMRICD TECH MEMO 90 1 CLINICAL NOTES ON CHEM C
Document Seq # = 1
Document Date =
Scan Date =
Queued for Declassification = 01-JAN-1980
Short Term Referral = 01-JAN-1980
Long Term Referral = 01-JAN-1980
Permanent Referral = 01-JAN-1980
Non-Health Related Document = 01-JAN-1980
Declassified = 24-DEC-1996