The Treatment of Toxic Trauma

Abstract

Treatment for toxic trauma may require immediate life‐saving resuscitation which should be integrated into continuing antidote and other supportive treatment. For those severely affected by agents with short latency causing respiratory failure or arrest, effective management of the airway and provision of artificial ventilation are key priorities. There are a number of solutions to both, which will depend on the clinical skills of the medical responder, but the most-effective response remains endotracheal intubation and ventilation using a portable volume preset ventilator, capable of overcoming increased airway resistance and decreased lung compliance which are a feature of many forms of toxic trauma. Antidote treatment exists for a number of toxic agents including organophosphates and cyanide compounds. Treatment protocols and continuing investigations are considered. No antidotes exist for lung-damaging and vesicant agents but both proactive and reactive treatment measures are considered, with a view to limiting the possible longer-term consequences from exposure such as toxic pulmonary oedema and acute respiratory distress syndrome.