Biomedical Engineering Reference
In-Depth Information
areas should be cleansed using an appropri-
ately diluted hypochlorite solution (0.5%) or
copious amounts of plain soap and water.
Potentially contaminated clothing should be
removed by personnel with PPE, away from
non-contaminated patients.
II. Principles of Treatment
a. General supportive measures
i. ABCs
ii. Maintain respirations and hearbeat
iii. Lowering temperature (for patients
with fever)
iv. Relieve pain
v. Secure IV access
b. Use of barrier techniques
i. Surgical masks
ii. Gowns
iii. Goggles
iv. Gloves
v. Observe body substance isolation
c. Antibiotic therapy—most bacterial,
chlamydial and rickettsial diseases
respond well to antibiotic therapy. The
choice of antibiotic will depend on many
factors including specific threat, evidence
or suspicion of antibiotic resistance, ease
in which drug can be manufactured.
in a liquid state but are usually released as a gas.
They are toxic in either form. All nerve agents
act in the same manner, they block the re-uptake
of acetylcholine by the nerve endings, thereby
creating an endless “stimulation” of the nervous
system. Nerve agents are organophosphates and are
closely related to insecticides.
Signs and Symptoms of Nerve Agent Poisoning
Vapor small exposure
: Miosis, rhinorrhea, mild
difficulty in breathing
Vapor large exposure
: Sudden loss of conscious-
ness, seizures, apnea, flaccid paralysis, copious
secretions, miosis
Liquid on skin, small to moderate exposure
:
Localized sweating, nausea, vomiting, feeling of
weakness.
Liquid on skin, large exposure
: Sudden loss
of consciousness, seizures, convulsions, apnea,
flaccid paralysis, copious secretions.
Patients may complain of dim vision and or
eye pain (due to miosis) a mnemonic device to
remember is SLUDGE for Salivation, Lacrima-
tion, Urination, Defecation, GI Motility and Eyes
(Miosis).
Decontamination of Nerve Agent Poisoning
The patient should be washed with large amounts
of water and clothing removed. The patient needs
to be decontaminated before treatment and trans-
port can begin. Do NOT transport contaminated
patients to the hospital.
III. These are patients who are ill. Treat them as
you would any other patient with an illness,
with a large emphasis on decontamination
and prevention of cross contamination. As a
general rule, there will not be an antidote
available for field use.
Protocol for Management of Nerve Agent
Poisoning
I. Assure your own safety
II. Maintain adequate airway control
a. These patients may need aggressive
airway and ventilation control due to
bronchoconstriction and secretions
b. Ventilation of these patients may be diffi-
cult prior to the administration of the anti-
dotes.
III. Maintain patient's respirations as needed
IV. Maintain patient's circulation as needed
Chemical Agents
There are five types of chemical agents: nerve
agents, vesicants, cyanide, pulmonary agents and
riot control agents [8,9].
They are each discussed in more detail below.
Nerve Agents
Nerve agents are the most toxic of all chemical
agents. Examples of nerve agents are Sarin, Tabun,
VX, and Soman. They are stored and transported
