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

Indexpsychological effect of, 2, 19–20stockpile management, 3–4tactical and strategic use of, 132terrorist threat, 4timeline of agents, 2–3toxin comparison, 616–617US stockpile agent destruction (table), 143volatility of, 134–135, 168wind and weather considerations, 80, 117, 131, 135–136Chemical weapons agreementsBiological Weapons Convention, 137–138Chemical Weapons Convention, 138–145Geneva Protocol, 136–137UN Disarmament Committee, 137US-Soviet weapons destruction agreement, 138Chemical Weapons Conventionbasic tenets, 139chemical demilitarization, 141–145, 766development of, 138disarmament provisions, 3fentanyl and, 419governmental proliferation threat, 145implementation issues, 140–141inspection and verification, 140noncompliance issues, 140, 141nongovernmental proliferation, 145prohibition on the use of tear gas in combat, 66, 431, 442ratification of, 138–139, 157schedule and category of chemicals and chemical weapons(table), 139schedule of implementation plan (table), 140scheduling issues, 139–140, 157signing of, 65, 157“toxin” definition, 614Chemically protected deployable medical systemcomposition of, 584–585description, 584M28 collective protection equipment, 585Chen, K.K.cyanide poisoning research, 383, 384–385Children. See Infants and childrenChinaancient use of toxic smoke, 10, 12, 78chemical weapon production, 48incapacitating agent use, 443invasion by Japan in 1937, 46Chlorineaccidental release of, 131, 134advantages of as a weapon, 126, 342Battle of Loos and, 18–19clinical presentation of exposure to, 672–673combined with phosgene, 341development of, 14discovery of, 116general mechanisms of toxic gas exposure (figure), 347nerve agents compared with, 181nonmilitary uses, 342pediatric population and, 673Second Battle of Ypres and, 14–18, 21, 80–82signs and symptoms of exposure, 359treatment for inhalation of, 353, 673US production of, 117“white star” mixture with phosgene, 19–20World War I use, 2, 14–19, 21, 80–82, 83Chloroacetophenonenonmilitary uses, 342overall effects of, 342Yemen Civil War and, 57, 58ChloroperoxidaseVX nerve agent and, 250Chloropicrinaccidental release of, 443, 455agricultural uses, 443, 455characteristics of PS, CN, DM, and CR (table), 458–459chemical structure (figure), 456chloropicrin syndrome, 456clinical effects, 456–457deployment methods, 456development and properties of (exhibit), 20earliest reported description involving chemical warfare onthe AEF (exhibit), 22introduction of, 20long-term effects, 457mechanism of action, 455physical characteristics, 456physiological effects, 456safes and vaults and, 455severe medical complications, 457synthesis of, 117, 443toxicity of, 443US production of, 117World War I use, 25–26, 455Chlorovinylarsonous acidlewisite exposure and, 728published analytical approaches for the analysis of CVAA inurine (figure), 729sample preparation methods for gas chromatographic/massspectrometric analysis of CVAA (exhibit), 730ChlorpromazineLSD intoxication treatment, 417Cholinesterase analysiscolorimetric assays in the clinical laboratory, 702, 704electrometric ChE assay, 704Ellman assay, 702huperzine A, 704–706laboratory and field assays routinely used by the US Armyand their required processing (figure), 703mass spectrometry, 701–702organophosphorus compounds, 701–706pretreatment therapy for nerve agent poisoning, 704–706Test-Mate kit, 702, 704Walter Reed Institute of Research Whole Blood Assay, 702, 705Cholinesterase inhibitors. See also Nerve agents; specific agentsblood cholinesterases, 161–166case report: accidental exposure of a man to liquid soman(exhibit), 162–163, 312cholinesterase in tissue, 158compounds, 158–159development of, 46–47diagram of neuromuscular conduction (figure), 160mechanism of action, 159–161pharmacology of, 158–168reversible and irreversible types, 156Cholinesterasesequine serum butyrylcholinesterase, 245fetal bovine serum AChE, 245plasma-derived human butyrylcholinesterase, 245–249Cholinolytic 3-quinuclidinyl benzilateperfluoroisobutylene inhalation treatment, 354Church, Maj. J.R.Chemical Warfare Service leadership, 90Churchill, Sir Winstonplans for gas warfare during World War II, 52City of New York Bureau of Emergency Medical Servicesxxxiii