USAMRICD TECH MEMO 90 1 CLINICAL NOTES ON CHEM CASUALTY CARE

File: 970101_sep96_decls27_0008.txt
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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








              U    CD Technical Memorandum 90-1


              17A: Atropine (im or iv) should not be given for miosis alone or
                   es of reversing miosis.     The only indication for treating
              TOS@,OSP is severe pain and the therapy should be local instillation
              of atropine or homatropine eye ointment. However, this may cause
              mprked visual impairment (particularly for near vision) for as long
              as 24 hours.


              GEN@ COMMENTS
              O@ce a casualty has received adequate atropine (dry secretions,
              ease of ventilation, either spontaneous or assisted) the outcome
               generally good. Ventilation may be required for several hours,
               ending on the effectiveness of pyridostigmine pre-trea@ent and
              e severity of exposure. The casualty will almost always survive
                  adequate amounts of atropine if (a) he has not stopped
              eathing, (b) he has not lost consciousness, and (c) he has not
              convulsed.
              "Loncr-term" ef facts: Af ter nerve agent exposure (exposure may
              nge from very nild--not necessitating drug therapy--to severe)
              r
              individuals have had various psychological effects lasting for as
              long as 6--S weeks. These include inability to concentrate as well
              a:p usual, forgetfulness, emotional disturbances, insomnia, etc.
              A.though mild, these may cause decrements in performance, depending
              on how demanding the task is.
                     A mild to moderate casualty should be adequately treated
              bk self or buddy aid and triaged as minimal (for return to duty
              soon) or delayed (if return to duty soon does not seem likely).
              A!severe casualty will be immediate if breathing or if ventilation
              can be undertaken if not breathing.
              I
tary urgency, the soldier's task,
              a#d the severity of exposure.    After a n'.1d exposure a treated
              casualty with miosis and possibly mild mental effects could well
              f;xe a rifle if the unit were under attackl he probably could not
              manage a radar screen or tracking device with these effects.
              Gnerally, one surviving a severe exposure will require non-
              intensive care for several weeks after the acute effects (generally
              ITsting 1--24 hours) have resolved.
              GEN   GUIDELINES FOR THERAPY

              After vapor exposure, effects maximize within 15 minutes after
              exposure ceases, so by the time the casualty is seen by a medic or
              a@ a later echelon of medical care the effects will be max @ I or
              pasibly the casualty might be improving. on the other hand, after
              s@in (percutaneous) exposure absorption may continue for hours
              (4pven after decontamination) and effects may increase in severity.

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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