Schep Leo J, Slaughter R J, McBride D I
National Poisons Centre, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
J R Army Med Corps. 2015 Jun;161(2):94-9. doi: 10.1136/jramc-2013-000165. Epub 2013 Dec 30.
2-Chloroacetophenone (CN), o-chlorobenzylidene malonitrile (CS) and oleoresin capsicum (OC) are common riot control agents. While serious systemic effects are uncommon, exposure to high concentrations may lead to severe complications and even death. The aim of this narrative review is to summarise all main aspects of the riot control agents CN, CS and OC toxicology, including mechanisms of toxicity, clinical features and management.
OVID MEDLINE and ISI Web of Science were searched for terms associated with CN, CS and OC toxicity in humans and those describing the mechanism of action, clinical features and treatment protocols.
CN, CS and OC are effective lacrimating agents; evidence for toxicity, as measured by the threshold for irritation, is greatest for CN, followed by CS and OC. Typically, ocular and respiratory tract irritation occurs within 20-60 s of exposure. Ocular effects involve blepharospasm, photophobia, conjunctivitis and periorbital oedema. Following inhalation, effects may include a stinging or burning sensation in the nose, tight chest, sore throat, coughing, dyspnoea and difficulty breathing. Dermal outcomes are variable, more severe for CN and include dermal irritation, bulla formation and subcutaneous oedema. Removal from the contaminated area and fresh air is a priority. There is no antidote; treatment consists of thorough decontamination and symptom-directed supportive care. Ocular exposure requires thorough eye decontamination, an eye exam and appropriate pain management. Monitoring and support of respiratory function is important in patients with significant respiratory symptoms. Standard treatment protocols may be required with patients with pre-existing respiratory conditions. Dermal exposures may require systemic steroids for patients who develop delayed contact dermatitis.
CN, CS and OC are effective riot control agents. In the majority of exposures, significant clinical effects are not anticipated. The irritant effects can be minimised both by rapid evacuation from sites of exposure, decontamination and appropriate supportive care.
2-氯苯乙酮（CN）、邻氯亚苄基丙二腈（CS）和辣椒油树脂（OC）是常见的防暴剂。虽然严重的全身效应并不常见，但暴露于高浓度下可能会导致严重并发症甚至死亡。本叙述性综述的目的是总结防暴剂CN、CS和OC毒理学的所有主要方面，包括毒性机制、临床特征和处理方法。
在OVID MEDLINE和ISI科学网中搜索与人类CN、CS和OC毒性相关的术语，以及描述作用机制、临床特征和治疗方案的术语。
CN、CS和OC是有效的催泪剂；以刺激阈值衡量的毒性证据，CN最大，其次是CS和OC。通常，接触后20 - 60秒内会出现眼部和呼吸道刺激。眼部效应包括眼睑痉挛、畏光、结膜炎和眶周水肿。吸入后，效应可能包括鼻子刺痛或灼烧感、胸部发紧、喉咙痛、咳嗽、呼吸困难和呼吸费力。皮肤反应各不相同，CN更严重，包括皮肤刺激、水疱形成和皮下水肿。首要的是将患者撤离污染区域并转移到新鲜空气中。没有解毒剂；治疗包括彻底去污和针对症状的支持性护理。眼部接触需要彻底眼部去污、眼部检查和适当的疼痛管理。对有明显呼吸道症状的患者，监测和支持呼吸功能很重要。对于有基础呼吸道疾病的患者，可能需要采用标准治疗方案。对于发生迟发性接触性皮炎的患者，皮肤暴露可能需要使用全身性类固醇。
CN、CS和OC是有效的防暴剂。在大多数暴露情况下，预计不会出现显著的临床效应。通过迅速从暴露场所撤离、去污和适当的支持性护理，可将刺激效应降至最低。
