CLINICAL IDENTIFICATION AND MGMT OF BW CASUALTIES

File: 092496_sep96_decls2_0006.txt
Page: 0006
Total Pages: 9

Subject: CLINICAL IDENTIFICATION AND MGMT OF BW CASUALTIES               

Unit: OTSG        

Parent Organization: HSC         

Box ID: BX003204

Folder Title: CLINICAL IDENTIFICATION AND MANAGEMENT OF BW CASUALTIES                                         

Document Number:          1

Folder SEQ  #:         23







                                                                        UNCLASSIFIED

                                                                              ANNEX C TO
                                                                              0 SG OPS)483/2/7/4
                                                                              DATED L NOV 90


                           PULMONARY RESUSCITATION OF CASUALTIES WHO HAVE BEEN EXPOSED TO
                                             BIOLOGICAL WARFARE AGENTS

                   INTRODUCTION


                   1.  This paper is concerned solely with the pulmonary resuscitation of patients

                   exposed to Botulinum Toxin (BTX) and Anthrax. Both agents produce pulmonary
                   failure and will require respiratory support.
                      I


                   PATHOPHYSIOLOGY


                   2.  Clostridium Botulinum. Botulinum toxin (BTX) interferes with the pre-

                   synaptic release of acetylcholine from preganglionic nerve endings and at the

                   neuromuscular junction as opposed to nerve agents which inhibit the metabolism

                   of acetylcholine. BTX produces severe skeletal muscle paralysis within 18 hours
                   affecting peripheral, respiratory and facial, extrinsic ocular and pharyngeal
                   muscles, resulting in progressive respiratory failure, ptasis, loss of eye move-

                   ments, dysphoria and dysphagia. Intestinal ileus, loss of vagal cardiac

                   control, hypotension and loss of vasomotor response indicate dysfunction of

                   Parasympathetic and sympathetic nervous systems. Sensation is not impaired and

                   alteration of consciousness does not occur.


                   3.  Anthrax.  Following the ingestion or inhalation of the spores of bacillus

                   anthrax the patient will develop septic Shock. Speed of onset and severity of
e clinical problem is directly proportional to the dose absorbed and Inversely

                   proportional to the patients immunological resistance to anthrax. The respira-

                   tory problem will range between pneumonia and fulminating ARDS.




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Document 9 f:/Week-36/BX003204/CLINICAL IDENTIFICATION AND MANAGEMENT OF BW CASUALTIES/clinical identification and mgmt of bw casualtie:0920961557092
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-36
Box ID = BX003204
Unit = OTSG
Parent Organization = HSC
Folder Title = CLINICAL IDENTIFICATION AND MANAGEMENT OF BW CASUALTIES
Folder Seq # = 23
Subject = CLINICAL IDENTIFICATION AND MGMT OF BW CASUALTIE
Document Seq # = 2
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 = 20-SEP-1996