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<p><strong>You Are Here:</strong> <span class="crumb_link"><a href="/" class="crumb_link">AHRQ Archive Home</a> > <a href="/prep/" class="crumb_link">Public Health Preparedness Archive</a> > <a href="." class="crumb_link">Pediatric Terrorism and Disaster Preparedness</a> > Table 5.3</span></p>
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<td height="30px"><span class="title"><a name="h1" id="h1"></a>Pediatric Terrorism and Disaster Preparedness </span></td>
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</tr>
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<tr>
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<td><div id="centerContent"><p><strong>Public Health Emergency Preparedness</strong></p> <div class="headnote">
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<p>This resource was part of AHRQ's Public Health Emergency Preparedness program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.</p>
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<p>This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: <a href="https://info.ahrq.gov/">https://info.ahrq.gov</a>. Let us know the nature of the problem, the Web address of what you want, and your contact information. </p>
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<p>Please go to <a href="https://www.ahrq.gov/">www.ahrq.gov</a> for current information.</p></div>
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<h3>Table 5.3. Representative Classes of Industrial Chemicals—Summary of Pediatric Management Considerations</h3>
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<table border="1" cellspacing="0" cellpadding="3" width="80%">
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<tr valign="top">
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<th scope="col" width="17%"><strong>Agent</strong></th>
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<th width="22%" scope="col"><strong>Clinical Findings </strong></th>
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<th width="20%" scope="col"><strong>Onset</strong></th>
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<th width="21%" scope="col"><strong>Decontamination</strong></th>
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<th width="20%" scope="col"><strong>Management<sup><a href="#notea">a</a></sup></strong></th>
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</tr>
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<tr valign="top">
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<td scope="row">Strong acids/bases.</td>
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<td><em>Eye:</em> caustic injury<br />
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<em>Skin:</em> chemical burns<br />
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<em>GI:</em> chemical burns of mouth, larynx, esophagus, stomach.</td>
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<td>Rapid.</td>
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<td><em>Eye, skin:</em> immediate copious water irrigation<br />
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<em>GI:</em> defer, immediate emergency department referral.</td>
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<td>Supportive care, early endoscopy for significant ingestion; antibiotics and steroids controversial, should be individualized, consult Poison Control Center<sup><a href="#notea">a</a></sup>.</td>
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</tr>
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<tr valign="top">
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<td scope="row">Respiratory tract irritants (e.g., ammonia, HCl and HF gases).</td>
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<td>EENT and respiratory tract irritation with cough, chest pain, dyspnea, wheeze (possible pulmonary edema in severe cases).</td>
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<td>Rapid.</td>
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<td>Move to fresh air.</td>
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<td>Supportive respiratory care (consider nebulized calcium gluconate solution for HF, consult Poison Control Center).</td>
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</tr>
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<tr valign="top">
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<td scope="row">Fentanyl and other opioids.</td>
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<td>CNS and respiratory depression, miosis.</td>
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<td>Rapid.</td>
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<td>Move to fresh air (for aerosol exposure), consider AC for ingestion, consult Poison Control Center.</td>
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<td>Supportive care, naloxone (0.01-0.1 mg/kg).</td>
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</tr>
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<tr valign="top">
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<td scope="row">Cellular asphyxiants (e.g., phosphine, sodium azide).</td>
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<td>Cough, dyspnea, headache, dizziness, vomiting, tachycardia, hypotension, severe metabolic acidosis; may progress to coma, seizures, death; may have delayed onset pulmonary edema with phosphine.</td>
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<td>Rapid (except pulmonary edema with phosphine).</td>
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<td>Move to fresh air (consider AC for ingested sodium azide—caution with vomitus, which may emit toxic hydrazoic acid fumes; consult Poison
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Control Center).</td>
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<td>Airway, breathing, and circulatory support; 100% oxygen.</td>
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</tr>
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<tr valign="top">
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<td scope="row">Arsine.</td>
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<td>Severe hemolysis.</td>
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<td>2-4 hr.</td>
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<td>Move to fresh air.</td>
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<td>Supportive care, enhance urine flow, consider alkalinization, consult Poison Control Center.</td>
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</tr>
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</table>
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<p class="size2"><a name="notea" id="notea"></a><sup>a</sup> Monitor respiratory status and blood pressure.</p>
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<p class="size2"><strong>Note:</strong> Remember airway, breathing, circulation, decontamination/drugs. Consider oxygen, bronchodilators, nasogastric tube/drainage, ophthalmic analgesia, mydriatics, temperature control. If prolonged impairment of consciousness, electroencephalogram (EEG) (to rule out nonconvulsive status epilepticus) and imaging.</p>
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<p class="size2"><strong>Source:</strong> Adapted from Rotenberg JS, Newmark J. <em>Pediatrics</em> 2003;112:648-58.</p>
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<p class="size2"><a href="pedchap5.htm#Tab5.3">Return to Document</a></p>
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<p> </p>
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