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File: 123096_sep96_decls7_0002.txt
Subject: PREVENTION AND TREATMENT OF NERVE AGENT POISONING
Unit: VAR. BUMED
Parent Organization: BUMED
Box ID: BX303902
Folder Title: PREVENTION AND TREATMENT OF NERVE AGENT POISONING
Document Number: 1
Folder Seq #: 14
UNCLASSIFIED 47
FM.8-285t44AVMED P-504]/AFM 160-11
ment dangerous to handle without a protective eral hours. In the presence of a nerve agent chal-
mask and impermeable protective gloves. Water lenge. the effectiveness of atropine is markedly
and food supplies suspected of contamination or reduced and the duration of the agent is signifi-
water from open sources in any area where a nerve cantly shortened. Therefore. more frequent dosesof
agent attack has occurred SHOULD NOT be con- atropine will be required to achieve and maintain
sumed. Only food products that are known to be atropinization.
from asafesourceor that have been certified assafe (2) 2 PAM Cl. Depending on the degree of
and wholesome should be used. Also, only water intoxication. a 600-mg intramuscular injection will
delivered through the normal supply sy@sh@ bp-,effective-ia6 to a@utesand willmaintairkpeak.
be used. Contaminated food may be reclaimed (app effectiveness for I hour or more. If the system is
D) and materiel decontaminated (app B). unchallenged by a nerve agent. a6OO-mg intramus-
d. Approval of food and water for human con- cular injection will remain in the circulatory sys-
sumption is a medical responsibility. tem for several hours without apparent effect.
c. Sympto?w Produced by the A ?Uidotes.
2-8. Effects of Nerve Agent Antidotes (1) A tropine.
(a) The administration of a single dose of 2
(1) Atropine. Antropine inhibits the action of mg (I automatic injector) of atropine to an individ-
the excess acetylcholine at the muscarinic sites ual zjho has absorbed minimal or no nerve agent
(parasympathetic and some central nervous system produces mild symptoms, including dryness of the
sites). but not at the nicotinic sites (skeletal muscle, skin. mouth, and throat, with slight difficulty in
most autonomic ganglia) and some central nervous swallowing. The individual may have a feeling of
system synapses. As a result, atropinehasa marked warmth. slight flushing, rapid pulse, some hesitancy
inhibitoryeffecton theperipheral muscarinicblock- of urination, and an occasional desire to belch. The
ade but no effect on the peripheral neuromuscular pupils may be dilated slightly but react to light. In
paralysis. Used alone. it has little influence on the some individuals. there m4y be mild drowsiness
mortality rate in the potentially fatal apneic cases andslownessof memory and ability to recall. Recip-
foi which assisted ventilation is many times more ients of atropine may have the feeling that their
effective. However. the combination of adequate body movements are slow and their near vision is
atropinization plus assisted ventilation is se@eial blurred. Some individuals may be mildly relaxed.
-times more effective in saving life as assisted venti- ThesesymptomsshQuid notinterferewithordinary
lation alone. activity. except in the occasional individual who
y reactive to the "sensation.,
(2) 2 PAM Cl. 2PAM Cl is -an'oxi -mewhich effectsofatropine(particularly thefgeling,ofdrows-
increases the effectiveness of drug therapy in poi- iness). However. menta@ r@action may be slightly
soningby some-but not all-'cholinesterase inhibi- slowed down (for this reason, a%7iators must7not fly
tors. Unlike atropine, 2 PAM Cl acts by reactivat-- an aircraftafter taking atropine until cleared by
ing the inhibited choiinesterase at nicotinic sit'es. the flightsurgeon). If the administration of 2'm'gof
thusrl-rievfng@ sketetarifeuroffibscular block. as' atropine Fs repea@dvvfthfn afi-fiour without nerve
well as reactivating the cholinesterase at musca- agent challenge, the gyrnptoms become moderate.
rinic sites-. Tbe-role of the2 PAM Cl is-to block in-d In most of these individuals. there will be some
reverse the bondingof the nerve agenton thecholi- central nervous system symptoms (such as. drowsi-
nesterase. Oximes must begiven early in the poison- ness. fatigue. slowness of memory and ability to
irtg. since after a short period of time (different for recall, the feeling that body movements are slow,
each type of nerve agent) they may no longer be blurringof near vision); but they can continueordi-
effective. nary activity with some loss of efficiency. Near
NOTE vision may be impaired for as long as 24 hours.
2 PAM Cl varies in its effectivenessagainst NOTE
nerve a@eit isiei"@@irr the While @richitre'nged db@of atropi@e
may allow individuals to continue normal
duties. they must be closely monitored for
b. Rate of Absorption. possible heat injury. This is particularly
(1) Atropine. A 2-mg intramuscular injection important when operating in MOPP 4 pos-
will reach peak effectiveness in 3 to 10 minutes, ture and the individuals'ability to perspire
then blood concentrations will decline. If the system is reduced due to atropine.
is unchallenged by a nerve agent. a 2-mg intramus-
cular injection will cause atropine effects for sev- Theexception toallowordinaryactivity to continue
2-10
UNCLASSIFIED
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Document 11 f:/Week-44/BX303902/PREVENTION AND TREATMENT OF NERVE AGENT POISONING/prevention and treatment of nerve agent poisonin:1217960956196
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-44
Box ID = BX303902
Unit = VAR. BUMED
Parent Organization = BUMED
Folder Title = PREVENTION AND TREATMENT OF NERVE AGENT POISONING
Folder Seq # = 14
Subject = PREVENTION AND TREATMENT OF NERVE AGENT POISONIN
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