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

Indexlegal barriers to acceptance as weapons, 431lethality of, 415medical care issues, 469–472medical management, 430methods of incapacitation, 414–425microwave effects, 414mortality from, 442nerve agents, 416neuropeptides and neuromodulators, 420–422new developments and future use, 472nonchemical methods of incapacitation, 414–415nonlethal land mines, 415nonmilitary uses, 342oleoresin capsicum, 443, 452–455olfactory devices, 414–4151-chloroacetophenone, 443, 460–464opioids, 418–419personal protection, 469phenethylamine-based psychedelics, 418physiological responses to, 348, 472–473police department use, 443policy perspective on, 431–432, 443production of, 59psychoactivity manifestations, 415purpose of, 442, 472research on, 55–56safety margin variations, 415safety of, 442safety of glycolates, 427sedative hypnotics, 418stimulants, 418summary of BZ and fentanyl derivatives (table), 429tranquilizers, 420treatment, 425–426, 471–472triage considerations, 520, 521, 522, 5232-chlorobenzylidene malononitrile, 416, 443, 444–452use of light, 414vesicants, 416Indiaaccidental release of methyl isocyanate in Bhopal, 131, 134,326, 347Individual chemical patient resuscitation devicescomposition and uses of, 587–588description, 587Individual protective ensemblebarrier creams and, 531cold weather and, 549heat injuries and, 528, 541–543M20 simplified collective protection equipment and, 586name and job markings for, 547removal of, 547Individual protective equipmentdecontamination personnel requirements, 543–544protective clothing, 569–574psychological factors in the use of, 575respiratory protection, 561–569toxic industrial material and, 580training in the use of, 575vapor penetration of, 543–544Individuals with physical or mental disabilitiesdecontamination issues, 551Indocyanine green fluorescence imagingmustard agent injury assessment, 283Indole-based psychedelics. See also specific agentsexperiments using, 3, 56“psychedelic” definition, 416Industrial chemicals. See Inhalational injury from toxic industrialchemicals; Toxic industrial chemicals; Toxic industrial materials;specific chemicalsInfants and children. See also Medical management of chemicaltoxicity in pediatricsaccidental exposures to mustard agent, 263cyanide poisoning and, 389–390, 394decontamination issues, 550–551treatment of nerve agent exposure, 1952-chlorobenzylidene malononitrile ingestion and, 452Inhalational exposure to nerve agent vapor. See also Pulmonarysystematropine treatment, 185compared with dermal exposure, 169–170effects of, 168–169long-term health effects, 324–327severe exposures, 168–169Inhalational injury from toxic industrial chemicalsairway compartments (figure), 355arterial blood gases and, 360biochemical responses, 351–353bronchoalveolar lavage and, 361carbon dioxide levels and, 361cell membrane destruction, 350centrally acting agents, 355–356, 359chemicals that act on both the central and peripheral airways,359chest radiographs and, 360clinical presentation and diagnosis, 355–361decreased body weight and, 348determination of the damaged compartment, 340diagnostic tests, 360–361“dry land drowning,” 357gaseous ammonia effects at various concentrations (table), 355general mechanisms of toxic gas exposure (figure), 347general schema for the study of acute and chronic lung injury(figure), 352glutathione and, 352–353inflammatory pathways, 350–351long-term health effects, 354–355, 365main inflammatory agents involved in acute lung injury, theirsource and action (table), 351mechanism of injury, 340, 355, 356–357mechanism of lung injury and repair (figure), 349mechanisms of lung injury of gaseous respiratory irritants(table), 346mechanistic effects, 346–353medical management, 361–365pathophysiological effects, 348–350patient transport and, 365peripherally acting agents, 356–360physiological responses, 347–348pulmonary capillary wedge pressure and, 361pulmonary function tests and, 360–361specific inhaled toxic-gas-induced effects and their treatments,353–355ventilation/perfusion scans and, 361Insecticides. See also Organophosphate insecticidesorganophosphorus compounds used as, 158–159, 316Institute of Medicinestudy on the effects of mustard agent and lewisite exposure,312–313, 314, 315, 316Interagency for Research on Cancerclassification of mustard as a human carcinogen, 315–316Intermediate syndromenerve agents and, 318–319organophosphate insecticides and, 318–319International Classification of Epileptic Seizuresxliii