Zusammenfassung
Hautkampfstoffe sind, wie andere chemische Kampfstoffe, seit der Genfer Konvention von 1925 und der Konferenz von Paris zum Verbot von Chemiewaffen im Jahre 1989 verboten. Trotz solcher Verbote wurden weiterhin chemische Kampfstoffe produziert und auch eingesetzt. Ein Einsatz von Hautkampfstoffen durch Terroristen gegen die Zivilbevölkerung wäre eine bedeutende Herausforderung für das Gesundheitspersonal im Rettungsdienst und im Krankenhaus. Planungsstäbe von Rettungsdiensten und der Polizei müssen ein solches Szenario in ihren Vorbereitungen zur Gefahrenabwehr zugunsten der Zivilbevölkerung mit einbeziehen. Hautkampfstoffe wie Senfgas schädigen hauptsächlich die Haut, die Augen und die Atemwege durch chemische Verbrennungen. Sofortige Entfernung aus der Gefahrenzone und rasche Dekontamination sind die wichtigsten Maßnahmen bei der Soforthilfe von Senfgasopfern. Hautkampfstoffe haben eine niedrige Mortalität und eine hohe Morbidität mit langen Krankenhausaufenthalten. Die Behandlung von Kampfstoffopfern in Krankenhäusern besteht v. a. aus unterstützender Therapie. Die Krankheitsverläufe sind langwierig, und viele ehemalige Opfer haben jahrelange Folgeschäden. Es gibt keine Antidote gegen Hautkampfstoffe, außer gegen Lewisit, wogegen Britisch Anti-Lewisit (BAL) zur Verfügung steht.
Abstract
Like other chemical warfare agents, blistering agents have been prohibited since the Geneva Convention of 1925 and the Paris Conference on Prohibition of Chemical Weapons in 1989. Despite such prohibitions, chemical weapons continue to be produced and used. Terrorist use of blistering agents against a civilian population would be a significant challenge to healthcare providers in the prehospital and hospital setting, as well as to law enforcement officials. Emergency medical services and law enforcement planners should include such a scenario in their preparations in order to protect civilian populations. Blistering agents predominantly damage the skin, eyes, and respiratory system by causing chemical burns. The most important and immediate measures for victims of a blistering agent attack are quick removal from the exposure and decontamination of the affected individuals. Injuries from blistering agents produce low mortality but high morbidity, and are associated with long periods of hospitalization. The mainstay of therapy for victims is supportive care. The natural course of disease for vesicant injuries is protracted and many victims have disabilities for many years. There are no antidotes for blistering agents, other than British anti-lewisite (BAL) for lewisite.
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Bey, T.A., Walter, F.G. Senfgas, Stickstofflost, Lewisit und Phosgenoxim. Notfall & Rettungsmedizin 6, 327–336 (2003). https://doi.org/10.1007/s10049-003-0580-3
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DOI: https://doi.org/10.1007/s10049-003-0580-3