NAVMED P-5010-8 - Navy Medicine - U.S. Navy

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8-26 CHAPTER 8. NAVY ENTOMOLOGY AND PEST CONTROL TECHNOLOGY 8-29 b. Skin Contamination (1) Flood the skin with water. (2) Direct a stream of water onto the contaminated area while removing the patient's clothing. (3) Do not use chemical antidotes. 8-27. First Aid For Internal Poisoning From Pesticides In the event of internal pesticide poisoning, render first aid as follows: a. When possible obtain immediate, onthe-spot services of a physician. If this is not possible, administer the antidote recommended on the label of the pesticide container, then rush the victim to the nearest medical facility. Never attempt to administer an oral antidote to an unconscious victim. b. In the event no specific antidote is recommended on the label of the pesticide container, administer the treatment as recommended on the "Emergency Medical Treatment for Acute Pesticide Poisoning Chart" until the services of a physician are available. c. If the victim is cold, cover him/her with a light blanket. To avoid burns, hot objects should not be used to warm the patient. d. In the event the victim stops breathing or breathing becomes difficult, administer the appropriate artificial respiration. 8-28. First Aid For Poisoning By Fumigants In the event of poisoning by toxic gases, render first aid as follows: a. Quickly move the victim to a source of fresh air (outdoors if possible). c. Remove contaminated clothing, but keep the patient warm. d. If the prompt services of a physician are not available, administer the antidote recommended on the label of the fumigant container. e. In the event the victim stops breathing, or if breathing becomes difficult, administer mouthto-mouth artificial respiration. 8-29. Organophosphorus Pesticide Poisoning and Suggestions For Treatment Organophosphorus pesticides cause irreversible cholinesterase inhibition. Examples include: chlorpyrifos, diazinon, dichlorvos, malathion, and naled. a. Signs and Symptoms (1) Mild. Headache, dizziness, weakness, anxiety, pupillary contraction, blurred vision, and nausea. (2) Moderate. Nausea, salivation, lacrimation, abdominal cramps, diarrhea, vomiting, sweating, slow pulse, muscular tremors, and respiratory compromise. (3) Severe. Respiratory difficulty, pinpoint and non-reactive pupils, pulmonary edema, cyanosis, loss of sphincter control, muscle spasms, convulsion, coma, and eventual death due to respiratory failure. b. Antidote (1) Adults. After cyanosis is overcome, give 2 to 4 mg of atropine sulfate intravenously (IV). Repeat doses at 5 to 10 minute intervals until signs of atropinization appear. Maintain treatment for 24 hours or longer if necessary. A total of 25 to 50 mg or more may be necessary during the first day. b. Call a physician promptly, or rush the victim to the nearest medical facility. 8-26 9 Nov 2004
8-29 CHAPTER 8. NAVY ENTOMOLOGY AND PEST CONTROL TECHNOLOGY 8-31 (2) Children. Give atropine sulfate in proportion to body weight, approximately 0.05 mg/kg. (3) Support therapy. 2-PAM (Pralidoxime Chloride or Protopam Chloride). (a) Adult dose – 1 gm IV slowly. (b) Infant dose – 250 mg IV slowly. Note. Contraindicated treatment compounds include: aminophylline, barbituates, morphine, phenothiazine tranquilizers, theophylline, or any respiratory depressant. 8-30. Carbamate Pesticide Poisoning and Suggestions For Treatment a. Commonly used pesticides that exhibit reversible cholinesterase inhibition include carbaryl, dimetilan, and propoxur. b. Signs and symptoms of poisoning include pupillary constriction, salivation, profuse sweating, lassitude, loss of muscle coordination, nausea, vomiting, diarrhea, epigastric pain, and tightness in chest. c. Antidote (1) Adults. After cyanosis is overcome, give 2 to 4 mg of atropine sulfate IV. Repeat doses at 5 to 10 minute intervals until signs of atropinization appear. Maintain treatment for 24 hours or longer if necessary. 8-31. Organochlorine Pesticide Poisoning and Suggestions For Treatment a. Organochlorine pesticides are central nervous system depressant/stimulants. They include benzene hexachloride (BHC), chlordane, DDT, dieldrin, heptachlor, and lindane. The exact mode of actions of these chemicals is not known. In general they act on the central nervous system to stimulate or depress, varying by compound. Repeated doses may affect liver and kidney functions. b. Signs and symptoms. Within 20 minutes to 4 hours, the following may occur: headache, nausea, vomiting, restlessness, tremor, apprehension, convulsions, coma, respiratory failure, and death. Do not induce vomiting if the ingested poison is principally an organic solvent (e.g., kerosene). c. Treatment (1) Lavage stomach with 2-4 liters of tap water. Induce catharsis with 30 gm sodium sulphate in 1 cup of water. (2) Administer barbituates in appropriate doses repeated as necessary for restlessness or convulsions. (3) Avoid oils, oil laxatives, and epinephrine (adrenalin). Do not give stimulants. (4) Give calcium gluconate (10% in 10 ml ampules) IV every 4 hours. (2) Children. Give atropine sulfate in proportion to body weight, approximately 0.05 mg/kg IV. Note. 2-PAM is contraindicated in carbamate insecticide poisoning. Also avoid aminophylline, barbiturates morphine, phenothiazine, tranquilizers, and theophylline. 9 Nov 2004 8-27
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NAVMED P-5010-8 - Navy Medicine - U.S. Navy

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