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File: 123096_sep96_decls7_0010.txt
Page: 0010
Total Pages: 11

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
                FMAS-285/NAVMED P-5041/AFM 160-17

                2-20. Signs and Symptoms of Pyridostig-                       continue the NAPP medication based on threat.
                         mine Overdose and All-ergic R-e-                     The intelligence officer or chemical officer and the
                         actions                                              surgeon act as advisors to the commander in mak-
                                                                              ing his decision if a chemical nerve agent threat
                Although nodetrimental effects are expected at the                   (for example. the enemy having nerve agents
                recommended dosage, depending on the length of                exists
                                                                              in the combat zone or the probability of their use).
                time and the amount of medication taken as well as
                individual physiologic variations, certain persons            After 3 days of self-administration of the medica-
                might experience adverse reactions from pyrido-               tion by the service member. combat conditions
                @gmine. - -                                                   should.@reev@ed-by @comn=der ancthis
                   a. Signs and symptoms of overdose and/or al ler-           staff for a determination whether to continue the
                gic reactions are-                                            medication or not. However. orders to discontinue
                    (1) Abdominal cramps.                                     the pretreatment CAN and SHOULD be made at
                    (2) Nausea.                                               any time. depending on the situation. If the pre-
nd blister
                    (4) Skin rash.                                            pack must be ordered while the service member
                    (5) Weakness, muscle cramps. and muscular                 completes the administration of the 7 days (21
                twitching.                                                    tablets)and isissved thesecond packon the7thday.
                    (6) Dimness of vision due to pinpointed pupils.           ADMINISTRATION OFTHE MEDICATION BE-
                   b. If any of the above signs/symptoms 6ccur. the           Y.OND21 DAYSISNOTRECOMMENDED WITH-
                service member should consult unit medical per-               OUT A THOROUG14 EVALUATION OF THE
                sonnel as soon- as possible.                                  SITUATION. However. the magnitudeof thethreat
                                                                              may outweigh any possible adverse side effects and
                2-2j. Emergency.Treatment Admin-                              indicate continuance of the pretreatment.
                         isterect by Medical Personnel for                        (2) Train the service members that the NA@P
                         Pyridos         ine Adverse Side Ef-                 must be faitbfuljy' taken as directed to enhance
                         fects, tillme
                                  A      rgic Reactions, and                  their survivability if they are exposed to Eknerve
                         Overdose                                             agent. Service members must be trained to adrnin-
                Orainarily'. 'discontinuing pyridostigmine should             ister the NAPP during the day and at night, ind
                be adeq5ate to alleviate the signs and symptoms of            while in -M6PP 4 should these procedures become
                adverse side eff;cts, alleriie reactions, and ovei-           necessary.
oras                   (3) Issue appropriate unit SOPs'foi the recen-
                long as 24 hours: however, after the blood level              tionand decontaminationof theNAPPblisterpack
                peaksinabout4 hours.theeffectsof thgm-edicaction-             @ring personnel decontamination and overgar-
                diminish gradually.                                           ment exchange.
                   a Emergency treatment for an overdose of Pyri-               b. Combat, CombatSupport, and CombatService
                dostigmine requires the administration of atropine            Support Units will-
                in adequ@dosestoomprcomp-@&oline@cc@.                             (1) Obtain @ NAPPs thrpugh medical supply
                Initially. the 2-mg atropine auto-injector found in           channels.
                the M8fk I kit should be used, In most eases, this                (2) Maintain aquantity-of the-NAPPscommen-
                will be sufficient. Further adibinistration of atro-         -su-rale@iththebasisof issue rateof I week'ssupply
                pine may be necessary to control the cholinergic              perservice member. An additional week'ssupplyof
                effects of pyridostigmine. If additional atropine is          NAPPs will be maintained in the unit area. Autho-
                required. 2.ing -sl;ourd be administered by medical           rized quantities -will be commensurate with the
                personnel every 15 to 20 minutes, thereby permit-             latest doctrine and concept for use.
                ting the pi:evious injection of atropine to exert its             (3) Store the NAPPs-for individual issue. and.
                anticholinergic effect prior to the next injection.           immediate replacement as the end items are util-
                   b. Severe cases may require assisted ventilation           ized, or as they exceed their labeled shelf life. The
                             stured,.refr+,@ed iir tempera-.
                the pretreatment medication was administered                  tures ranging from 35 to 46 'F (2 to8 'C). If the
                every 8 hours as directed.                                    medication isremoved from refrigeration foratotal
                   c. When stabilized the patient should be evacu-            of 6 months, itshould beassumed that it has lost its
                ated for further observation and treatment.                   potency and should not be used.
                                                                                  (4) Issue the NAPPs to the service member at
                2-22. Responsibilities                                        the time the chemical protective ensemble is ex-
                   a. The corps/division/wing commander will-                 pected to be opened for use.
                    (1) Decide whether to begin, continue, or dis-              c. Unit medical personnel will-

                2-18
                                                                  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