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Lewisite
From WikEM
Contents
Background
- Abbreviation: L
- A blister chemical agent (vesicant) type of chemical weapon
- Arsenic-containing compound
Clinical Features
- Odor of geraniums
- Pain with immediate contact
- May turn skin grayish color around vesicles
Differential Diagnosis
Chemical weapons
- Blister chemical agents (Vesicants)
- Lewisite (L)
- Sulfur mustard (H)
- Phosgene oxime (CX)
- Pulmonary chemical agents
- Incendiary agents
- Cyanide chemical weapon agents
- Nerve Agents
- Acetylcholinesterase inhibitors
- Includes household and commercial pesticides (diazinon and parathion)
- G-series (sarin, tabun, soman) and V-series (VX)
- V-series high viscosity with oily consistency
Evaluation
Management
- British antilewisite (BAL) – chelating agent to reduce systemic effects from lewisite exposure.
- Won’t alter the blistering effects on skin or airway.
- Only used for patients with shock or severe pulmonary injury given BAL side effect
- Relative contraindications to BAL: Renal disease, pregnancy
