USAMRICD TECH MEMO 90 1 CLINICAL NOTES ON CHEM CASUALTY CARE

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Subject: USAMRICD TECH MEMO 90 1 CLINICAL NOTES ON CHEM CASUALTY CARE    

Unit: OTSG        

Parent Organization: HSC         

Box  ID: BX003205

Folder Title: CLINICAL NOTES ON CHEMICAL CASUALTY CARE                                                        

Document Number:          1

Folder Seq  #:         31









             U3AMUCD Technical   Memorandum 90-1


             Lathalltv:   Death  is due to failure of the respiratory system;
             b onchoconstriction and secretions in the airways, weakness of the
             r spiratory musculature, and inhibition of the respiratory center
             ,no the CNS all contribute.

             TMTMENT

             T e FIRST RULL? is the treatment of any type of toxic agent casualty
             ii to PROTECT YOURSELF.        This can be done by (1) wearing
             appropriate protective gear (mask, gloves, apron), or by (2)
             ipsuring the casualty is completely decontaminated (remember: a
             tiny droplet can be lethal).
             11   Decontamination of skin:       Can be done by various means
             iicluding the M258AI kit, alkaline solutions (dilute hydroxides),
             dilorinating solutions (hypochlorite, bleach at 0.5t), or copious
             amounts of water (which does not "neutralize'? the agent as the
             o:hers do, but dilutes and washes it away), Need to check (CAM or
             M@ paper) before handling casualty unprotected).
               ice nerve agent enters the body it is rapidly bound to
             apetyictoiinesterase, other enzymes, etc., and there is no hazard
             f@on blood and secretions (but unless decontamination has been
             thorough there may be agent remaining on skin, mucous membranes,
             ei:c.) .
               1
             2@   Drug therapy:    @troipine is drug of choice.     Blocks excess
             acetylcholine     at    muscarinic     sites.        Will     relieve
             btonchoconstriction and decrease GI motility, will dry secretions,
             will Dot have appreciable affect on skeletal muscle. Dose: Start
             W th 2 mg im (MARK 1) and continue until desired affect is
             Oitained.   May be given iv if available (see below, cardiac).
 hours.
             Atropine, given iv or im in less than heroic amounts, will have no
             to little effect on raiosis and should not be administered for
             m@osis. (In contrast, poisoning by O-P insecticides may require
               00 Tag/first 24 hours.)
             liMING: The administration of atropine to an individual who has
             w
             n t been exposed to a nerve agent will result in sweat inhibition
             a.Ad heat storage problems. This hazard increases as the ambient
             temperature increases above 85'F and if the individual is working
             (even walking) .       individuals must be warned about the
             indiscriminate use of atropine in the absence of a clear
             indication.
             Guidelines: continue administration until (a) secretions (mouth,
             n6se, lungs) are minimized, and (b) ventilation is adequate (if
             conscious, the casualty will tell you; if unconscious, ease of
             ventilation). This may require 10-15 mg over a 5-30 minute period.
             It is better to administer too much atropine (if the indication is
             c early established) than to have too much unantagonized nerve

                                               5

Document 22 f:/Week-36/BX003205/CLINICAL NOTES ON CHEMICAL CASUALTY CARE/usamricd tech memo 90 1 clinical notes on chem c:12249609312728
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-36
Box ID = BX003205
Unit = OTSG
Parent Organization = HSC
Folder Title = CLINICAL NOTES ON CHEMICAL CASUALTY CARE
Folder Seq # = 31
Subject = USAMRICD TECH MEMO 90 1 CLINICAL NOTES ON CHEM C
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 = 24-DEC-1996