TREATMENT OF NAPP OVERDOSE 26 DEC 90

File: 123096_sep96_decls4_0002.txt
Page: 0002
Total Pages: 2

Subject: TREATMENT OF NAPP OVERDOSE    26 DEC 90                         

Unit: VAR. BUMED  

Parent Organization: BUMED       

Box  ID: BX303902

Folder Title: TREATMENT OF NERVE AGENT PYRIDOSTIGMINE PRETREATMENT OVERDOSE                                   

Document Number:          1

Folder Seq  #:          7




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         5

                                       Breathing, Circulation (ABC) and
                 perform basic Card opulmonary Resuscitation (CPR) as
                 necessary.

             b.  Second, assess NAPP overdose (i.e., number of tablets
                 ingested and the time since ingestion).
                 1)  Any suicide gestures/threats prior to event?
                 2)  Number of pills missing from blister pack if pack
                     is available?
                 3)  There should be significant peripheral
                     parasympathetic activity if more than 3 or 4 NAPP
                     tablets were taken (increased GI motility,abdominal
                     cramps, nausea, vomiting, diarrhea, salivation,
                     lacrimation, tracheobronchial secretions,
                     urination, excessive, sweating,
                     branchoconstriction, bradycardia, AV conduction
                     slowing, weakness, and pinpoint pupils).

             c.  Administer Atropine 2mg IM/IV every 15-20 minutes for.
                 severe overdose (Autoinjector or Bristoject) as
                 required until symptoms improve.

             d.  Do not give 2 PAM chloride; it has no value in
                 treatment of NAPP overdose.

             0.  if there is respiratory compromise, intubate and
                 ventilate. Be prepared for long duration ventilatory
                 assistance, perhaps as long as 24-36 hours.

             f.  If patient awake, induce- vomiting (Apomorphine, Ipecac,
                 NG tube) to evacuate ingested Pyridostigmine from
                 stomach. Consider gastric lavage if patient is
                 unconscious, but assure airway is protected.

             g.  Reassess ABC's/CPR. Secure airway as necessary and
                 arrange for evacuation/observation as appropriate.

             h.  Pychiatric follow-up as necessary.

rmation/discussion:

                 CDR J.B. Clark, MC,.              MAW Medical..












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Document 2 f:/Week-44/BX303902/TREATMENT OF NERVE AGENT PYRIDOSTIGMINE PRETREATMENT OVERDOSE/treatment of napp overdose 26 dec 90:1217960956163
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-44
Box ID = BX303902
Unit = VAR. BUMED
Parent Organization = BUMED
Folder Title = TREATMENT OF NERVE AGENT PYRIDOSTIGMINE PRETREATMENT OVERDOSE
Folder Seq # = 7
Subject = TREATMENT OF NAPP OVERDOSE 26 DEC 90
Document Seq # = 1
Document Date =
Scan Date =
Queued for Declassification = 01-JAN-1980
Short Term Referral = 01-JAN-1980
Long Term Referral = 01-JAN-1980
Permanent Referral = 01-JAN-1980
Non-Health Related Document = 01-JAN-1980
Declassified = 17-DEC-1996