In the immediate aftermath
of the sarin nerve agent attack in Tokyo, over 600 patients presented to St.
Luke’s Hospital within several hours after the release.With high numbers of vapor-exposed
patients presenting to a medical facility under these conditions, simple
clothing removal will eliminate 80% of the contaminant and will help reduce
the risk of secondary exposures from vapor off-gassing. This is also true for
liquid chemical or external radiation contamination.Showering with high-flow water will
greatly reduce the amount of contaminant remaining on the skin, minimizing
the risk of secondary exposure of healthcare providers handling these
casualties.Following this with a
soap-and-water scrub should eliminate all surface contamination.
Limited animal studies have
shown that the use of 0.5 percent hypochlorite solutions (bleach) in
decontaminating unabraded skin exposed to liquid sulfur mustard may
substantially reduce the size of the erythematous lesions, if performed
within the first five minutes following exposure.In all other circumstances, the use of copious amounts of water
(or soap and water) to flush contaminated skin is probably the best, most
expedient method of decontaminating casualties.Wound decontamination should always be performed with sterile
water or sterile saline, not hypochlorite solutions.
