Biomedical Engineering Reference
In-Depth Information
involved, treatment is aimed at supportive therapy
and immediate decontamination.
V. Establish IV access (normal saline, KVO)
VI. Administer Mark I kits as outlined below:
a. Vapor exposure
i. Mild (Miosis, dim vision, headache,
rhinorrhea, salivation, dyspnea)
1. 1 Mark I kit
a. 2mg of atropine
b. 600mg of pralidoxime chlo-
ride (2-Pam)
ii. Severe (all of the above plus
severe dyspnea or apnea, muscular
twitching, seizures or paralysis, loss
of consciousness, loss of bladder or
bowel control)
1. 3 Mark I kits
a. 6mg atropine
b. 1800mg pralidoxime chlo-
ride (2-Pam)
2. Diazepam (Valium) 10mg
b. Liquid on skin exposure
i. Mild/moderate (muscle twitching at
site of exposure, sweating at site
of exposure, nausea, vomiting, and
weakness)
1. 1 to 2 Mark I kits (depending on
severity of symptoms)
a. 2-4mg atropine
b. 600-1200mg pralidoxime
chloride (2-Pam)
ii. Severe (All of the above plus, severe
dyspnea, apnea, muscular twitching,
seizures, loss of consciousness, paral-
ysis, loss of bowel or bladder
control)
1. 3 Mark I kits
a. 6mg atropine
b. 1800mg pralidoxime chlo-
ride (2-Pam)
2. Diazepam (valium) 10mg
Decontamination of Vesicant Agents
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.
Immediate decontamination after exposure is the
only way to prevent symptoms.
Protocol for Treatment of Vesicant Agent
Exposure
I. Assure your own safety (the patient must be
decontaminated prior to treatment)
II. Maintain adequate airway control
a. Administer high flow oxygen (15 lpm)
III. Maintain patient's respirations as needed
IV. Maintain patient's circulation as needed
V. Establish IV access (normal saline, KVO)
VI. Bandage blisters as needed.
Cyanide
Cyanide is a rapid acting lethal agent, it is however,
limited in its military usefulness due to the high
amounts needed for lethal doses and its high
volatility. Death can occur in 6-8 minutes after
exposure to high amounts of cyanide.
Signs and Symptoms of Cyanide Poisoning
Moderate
—transient increase in rate and depth
of breathing, Dizziness, Nausea, Vomiting and
Headache.
Severe
—transient increase in rate and depth of
breathing within 15 seconds, Convulsions within
30 seconds, Apnea within 2-4 minutes, cardiac
arrest within 4-8 minutes, also intense irritation of
the eyes, nose, and airways.
Vesicants/Blister Agents
Vesicants or blister agents include Mustard Gas,
Lewisite and Phosgene Oxime (CX gas). Mustard
has a latent period of up to several hours, while
Lewisite and Phosgene exposures show imme-
diate signs and symptoms. Regardless of the agent
Cyanide Decontamination
Skin decontamination is not usually necessary, as
the liquid is extremely volatile (evaporates easily).
However, wet clothing should be removed and
