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









                  CD Technical Memorandum 90-1


            agent.    There is no need f or routine continued administration
            after casualty is stable, but may need prn for increased
            secretions, GT symptoms,
            A, secondary drug is pralidoxime chloride (2-PA14Cl; Protopam
            c@loride).     Acts by removing agent from enzyme if "aging"
            (Irreversible binding) has not occurred. This happens within 2
            in nutes with GD (soman), so pralidoxime is relatively ineffective
            r@
              or GD ("aging" occurs hours and days after GB and VX) .         Dose-
            690 mg (2 ml) in MARX 1. Give with atropine for first three doses;
               further pralidoxime for an hour. Give 3 Protopan injectors at
            ho'@ly intervals if it appears ef f ective.     Has little effect on
            mliscarinic sites; may decrease muscular fasciculations or increase
            ll"cular strength.
            310 Ventilation: 'With use of pyridostigmine as pro-treatment it
            l@ felt that breathing will not stop and ventilatory support will
            nopt be necessary. However, if ventilation is necessary one should
            be aware that the initial resistance in the lung is quite high due
            to bron@oconstriction and secretions.        Atropine will decrease
            tt is.
            4t   Convulsions:    Af ter a large exposure to any nerve agent:
            convulsions will occur.     convulsions are a manif estation of the
            n6urotoxicity of these agents, which way occur via the excitotoxic
            glutaminergic pathway. Diazepan, which is in the chemical Casualty
            Tteatment Chest, should be administered with the third MARK I if
            t@o casualty requires three MARK Its together (see below). Xt is
            felt that diazepam will prevent or decrease the seizure activity
            @d decrease or prevent brain damage.       if an individual has not
yridosticjmine pre-treatment, convulsive activity stops
            within minutes because respiration stops and the casualty becomes
            f @accid (whether electrical seizure activity continues is unknown).
            D@pite lack of visible convulsive (seizure) activity undex these
            circumstances, diazepan should be administered as suggested.
              1
            5 It Cardiac rhythm;   A nerve agent may cause bradycardia (vagal
            effect), tachycardia (ganglionic, or sympathetic, effect), and
            various   arrhythmias     (various    degrees    of    heart    block;
            i4ioventricular rhythm). Ktropine -may initially cause transient
            A+V dissociation or other transient arrhythinias.       once adequate
            atropine is given there will be a sinus tachycardia and usually
            4are are no other further rhythm disturbances.
            I atropine is administered iv to a hypoxia (cyanotic) patient,
            t ere is a risk of ventricular fibrillation; hence, the first
            atropine should be im and oxygenation undertaken before atropine
            i given iv.

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