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Unformatted text preview: al Center 29 Summary Decontamination Treat like a burn patient Liberal use of analgesics Fluids and electrolytes (less than for standard burns) System specific treatment as necessary Clifton Yu, MD Department of Pediatrics Walter Reed Army Medical Center 30 But What About Children? Very little in literature Recent experience with childhood mustard exposure from Iran-Iraq War (Momeni and Aminjarahari, Int. J. Derm. Vol 33, March 1994) Earlier onset of skin lesions, more severe More frequent and severe opthalmic, pulmonary, and GI involvement Clifton Yu, MD Department of Pediatrics Walter Reed Army Medical Center 31 Skin Earlier lesions, more bullae First index case may therefore be a child Traditional decontamination with sodium hypochlorite (bleach) may be harmful to child's skin Use copious amounts of soap and water instead Clifton Yu, MD Department of Pediatrics Walter Reed Army Medical Center 32 Eyes More frequent and severe eye findings Same therapeutic interventions Clifton Yu, MD Department of Pediatrics Walter Reed Army Medical Center 33 Pulmonary Higher incidence of lung involvement Increased minute ventilation in children May have to intubate sooner Clifton Yu, MD Department of Pediatrics Walter Reed Army Medical Center 34 GI Increased involvement probably dose related Children more likely to have protracted emesis Atropine or other anti-cholinergic in ageappropriate doses may be helpful Clifton Yu, MD Department of Pediatrics Walter Reed Army Medical Center 35 Pediatric Exposure--Summary Earlier and more severe skin lesions (soap and water for decontamination) Pay early attention to eyes in virtually all children Be on lookout for earlier and more severe lung involvement May have to treat GI symptoms more aggressively (and watch for increase in dehydration) Clifton Yu, MD Department of Pediatrics Walter Reed Army Medical Center 36 BE PREPARED!!! ...and get ready for inhalants next week Clifton Yu, MD Department of Pediatrics Walter Reed Army Medical Center 37...
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