Medical Aspects of Chemical Warfare (2008) - The Black Vault

Introduction to the Chemical ThreatTHE role of the US ARMY MEDICAL RESEARCH INSTITUTE OF CHEMICAL DEFENSEUSAMRICD is the lead Department of Defense laboratorydealing with the medical aspects of chemicaldefense. It focuses on medical research, training, andeducation for medical chemical defense. USAMRICDactivity involves basic research, clinical studies, therapeutics,and other areas of research. USAMRICD alsopartners with major military and civilian organizationsthroughout the country and abroad.Development of Medical CountermeasuresUSAMRICD builds on basic research to supportsoldiers through the development of medical countermeasuresand therapeutics. Current projects includethe use of both simple and catalytic bioscavengers forprophylaxis and treatment of nerve agent casualties.Additional research areas of interest include the newoximes and neuroprotective compounds that mitigatethe effects of nerve agent exposure. Studies investigatingthe use of midazolam as a new generation nerveanticonvulsant are in advanced stages. There is anincrease in medical vesicant research to indentify thespecific biochemistry of injury as well as to developnovel protectants and treatments. Cyanide and pulmonaryagent research has been increasing in pace aswell. Other work at USAMRICD involves developingmedical diagnostics and personnel decontaminationresearch. Work on equipment and detection gear isconducted by USAMRICD’s partner institute, theEdgewood Chemical Biological Center.Education and Educational ProductsThe chemical casualty care division is responsiblefor training military medical personnel in the practiceof medical defense, medical decontamination, andtriage. It also provides education for other militarybranches, civilians, government agencies, and foreignnationals. Courses are accredited as continuing medicaleducation for physicians, nurses, and emergencymedical technicians, and for college credit.The courses taught onsite at the chemical casualtycare division include the Medical Management ofChemical and Biological Casualties Course, whichis produced jointly with the US Army Medical ResearchInstitute of Infectious Diseases. The courseconsists of lectures, a field exercise, and a uniqueprimate lab experience. It has been recognized asthe gold standard for this type of training by theOffice of The Surgeon General and the GovernmentAccountability Office. Other courses includethe Field Management of Chemical and BiologicalCasualties, which targets front echelon care. Thiscourse includes multiple field exercises to encourageproficiency in the field medical decontaminationstation. The Hospital Management of Chemical BiologicalRadiological Nuclear and Explosives Courseis a preparatory course for mass casualty chemical,biological, radiological, nuclear, and explosivesevents. It includes instruction on regulations regardingthese events and cooperation with civilian andmilitary authorities at other echelons.The chemical casualty care division is responsiblefor a large volume of educational products. Theseproducts include publication content for educationalmaterials as well as pocket manuals for the fieldmanagement of chemical casualties and medicalmanagement of chemical casualties. The chemicalcasualty care division produces several softwareproducts, such as reference materials, distance andonline training courses, educational games, and interactivesimulations.ORGANIZATION OF THIS VOLUMEAwareness and interest in weapons of mass destruction,medical chemical defense research, and educationand training of military personnel and civilians has increaseddramatically in the last few years. The need foran updated and resultant text dedicated to the medicalaspects of biological and chemical weapons would notfit into a single textbook. Hence, this text differs fromthe earlier version of the Textbooks of Military Medicine:Medical Aspects of Chemical and Biological Warfarebecause biological and chemical agents are discussedin separate volumes. This text is primarily relevantto military medicine; however, due to the increasedinterest in chemical casualty treatment that now existswithin civilian communities, the information providedwithin this text can be considered an excellent resourcefor both military and civilian healthcare providers.Chapters 2 through 4 offer greater depth concerningthe history of chemical warfare and the basic principlesof chemical warfare. “History of Chemical Warfare”takes a broad view of the historical context and significantevents in the field. “History of the ChemicalThreat” breaks the 20th century down into decade-longsegments and provides a fresh perspective on priormilitary and political developments. “The MedicalAspects of Medical Management” chapter has radicallychanged over the years and presents this history frommultiple perspectives. It includes detailed accountsof the chemical warfare management experience in5