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

Medical Aspects of Chemical Warfarecase history: mustard gas exposure in 14 children and teenagersfrom Halabja, Iraq (exhibit), 667case history: nerve agent exposure in Nazhmar, Iran (exhibit),662challenges to, 657–661Chemical Warfare Involving Kids Response Project, 681clinical cases of mustard exposure from Mofid Medical Centerfollowing the Halabja, Iraq, attack on March 17, 1988 (exhibit),668–669color coding system, 681–683decontamination equipment and treatment supplies, 661dermatologic vulnerability, 659developing a family emergency plan (exhibit), 680effects of specific agents, 661–676example of a pediatric-specific hospital emergency drug cache(table), 679family emergency plan, 678, 680general principles of chemical exposure, 657history of chemical attacks involving children, 656–657logistical time increase, 681–682management of mild to moderate nerve agent exposures(table), 665management of severe nerve agent exposure (table), 667management of vesicant exposures (table), 671managing pulmonary agent exposures (table), 674metabolic vulnerability, 660National Center for Disaster Preparedness, 683neurobehavioral vulnerability, 660neurological vulnerability, 659organ maturity and, 660pediatric signs of mustard exposure (table), 670pediatric vulnerabilities and implications for clinical management(table), 658plasma protein binding and, 659preoperative care of children with nerve agent intoxication,665, 667preparing for a chemical event, 678–680psychological impact, 678, 680psychological vulnerability, 660resources, 681–684respiratory vulnerability, 659steps involved in administering a dose of medication (figure),682strategies to help children cope with terrorist events (exhibit),680traumatic injury vulnerability, 660uncooperative or nonverbal children, 678unique vulnerabilities, 656volume of distribution and, 659–660volume status and, 659Medical surveillance for chemical agent workersdiagram (figure), 598factors determining the type and frequency of surveillance,599heat stress physiologic monitoring, 603–604medical surveillance compared with personnel reliability, 599periodic medical examinations, 600–601potential exposure evaluations, 602preplacement examinations, 599–600, 603–604respirator clearances, 602screening, 599substance abuse and dependency screening, 602–603termination examinations, 601–602Meier, H.L.PARP inhibitor treatment, 227MemantineAlzheimer’s disease treatment, 228pharmacokinetics of, 228soman-induced seizure-related brain damage treatment,228–229Memorandum on Gas Poisoning in Warfare with Notes on its Pathologyand Treatment, 90Mendelson, J.A.treatment of mustard agent injuries, 281Mescalineclinical effect research, 56Metabolic systemcyanide poisoning and, 376pediatric vulnerability to toxic agents and, 660Metal fume feverhexachloroethane smoke and, 327, 358Metcalf, D.R.organophosphate insecticide exposure research, 319, 320Methemoglobin formers. See also specific agentscyanide poisoning treatment, 383–384, 386, 390, 394–396Methotrexatesimilarity of mustard agent to, 313Methyl isocyanateaccidental release of in Bhopal, India, 131, 134, 326, 347Methylprednisolonetoxic industrial chemical exposure treatment, 363Meuse-Argonne offensivearmy-level gas hospitals, 97chemical attacks, 33, 36overview of (figure), 35Spanish influenza and, 101Meyer, Victormustard agent research, 117, 260Michel, H.O.electrometric ChE assay research, 704Midazolambrevetoxin intoxication treatment, 630developmental concerns, 653FDA approval issues, 653nerve agent exposure treatment, 190, 223, 664Military medicine. See also Medical management of chemicalcasualtieschemical accident and incident preparedness, 142–143chemical weapon implications, 145–146preparation for chemical attacks, 132Minami, M.sarin research, 695, 696Mion, G.ketamine research, 230Mirzayanov, Vladimirnerve agent development by Russia and, 3Mission-oriented protective posturebarrier creams and, 531gear for levels 1-4 (figure), 570levels of (exhibit), 570–571levels of protection, 569patient thorough decontamination and, 543soap and water decontamination and, 534triage of chemical casualties and, 513, 514water issues, 546Mitochondrial permeability transition inhibitorsneuroprotectant use, 232MITS JPMO. See Medical identification and treatment systemsjoint product management officeMK-801. See DizocilpineMMB4 dimethanesulfonatedevelopment of, 653stability concerns, 653Modular general purpose tent system chemical-biological protec-xlviii