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

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

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IndexShaw, F.H.organophosphate insecticide exposure research, 319, 320Shellfish poisoning. See Brevetoxin; Saxitoxin; TetrodotoxinShih, T.M.dizocilpine research, 228memantine research, 228Shryock, RichardVedder’s comments on, 108Sibert, Maj. Gen. William L.Chemical Warfare Service leadership, 22, 90Silver nitrate solutiontreatment of mustard agent injuries, 280Silver sulfadiazine creamtreatment of mustard agent injuries, 281, 670, 671Silverlonmustard agent injury dressing, 280Simple triage and rapid treatment systemdescription, 517Six-Day War. See Arab-Israeli Six-Day WarSkeletal muscle systembrevetoxin effects, 630effects of nerve agent exposure, 174–175, 188, 318effects of organophosphate insecticide exposure, 317–318muscle necrosis and, 317–318paralytic shellfish poisoning effects, 626saxitoxin effects, 627tetrodotoxin effects, 627Skin cancermustard exposure and, 313Skin effects of chemical agents. See also specific agentsactive barrier creams, 531–532active topical skin protectant and, 531–532barrier skin creams and, 530–532classes of barrier creams, 531factors affecting the absorption of agent, 529–530patents covering work on active topical skin protectant at theUS Army Medical Research Institute of Chemical Defense(table), 532pediatric population and, 659skin “compartments,” 529skin exposure reduction paste against chemical warfareagents, 530–531Skin effects of incapacitating agentschloropicrin, 457dibenz[b,f]-1,4-oxazepine, 468diphenylaminearsine, 466oleoresin capsicum, 454–4551-chloroacetophenone, 461, 462–463treatment, 4712-chlorobenzylidene malononitrile, 448, 450–451Skin effects of lewisite exposureblistering, 292–293erythema, 292Skin effects of mustard agent exposurebulla description, 267, 671compared with toxic epidermal necrosis, 278, 279cosmetic and/or functional deficits, 278current treatments, 278–281cutaneous sensitivity, 315cytopathology, 269–270erythema, 267, 268, 279, 667healing time for skin lesions, 268, 270, 278hyperpigmentation, 268–269, 315, 672immediate treatment improvements, 281–282improved therapies, 281–287injury assessment, 282–283models and histopathology, 270–271onset of symptoms, 267, 312penetration of the skin, 529return to duty considerations, 291scarring of epithelial surfaces, 315skin cancer, 313, 315skin proteins and immunohistopathology, 272–274thermal burns compared with, 278–279, 290threshold amount needed to produce skin lesions, 267, 312treatments, 278–287, 290ultrastructural pathology, 271–272vesication, 267, 270–274, 279–281Skin effects of toxin intoxicationbrevetoxin, 630palytoxin, 620, 621tetrodotoxin, 627Skin exposure reduction paste against chemical warfare agentsapplication of, 531barrier properties, 530–531components, 530, 532development of, 530effectiveness, 531effects on decontamination, 531function, 531M291 skin decontamination kits and, 652Skin exposure to liquid nerve agentsatropine treatment, 185–186compared with inhalational exposure, 169–170effects of dermal exposure to liquid nerve agents (table), 169factors in effects of, 169Skin substitutesadvantages of, 286mustard agent injury treatment, 286–287selection of, 286Sleep-Ezedescription and uses, 421Small Business Innovative Research Programfunding for seizure detectors, 223Smokingcyanide levels and, 323, 324, 374, 731endogenous cyanide concentrations for smokers and nonsmokers(table), 381SNS. See Strategic National StockpileSnyder, Solomonmorphine research, 418Soap and water (hydrolysis)infants and children and, 551, 677mechanism of action, 533–534patient thorough decontamination and, 534, 544skin decontamination method, 533–534water concerns, 546Sodium channel toxins. See also Batrachotoxin; Brevetoxin; Pumiliotoxin;Saxitoxin; Tetrodotoxinthree-dimensional representation of a voltage-gated sodiumchannel sitting in a phospholipid bilayer membrane (figure),624Sodium nitritecyanide poisoning treatment, 383–384, 394–395, 675–676hydrogen cyanide inhalation treatment, 353limitations of, 396side effects, 394use in children, 390Sodium thiosulfatecombined with hydroxocobalamin, 396, 676cyanide poisoning treatment, 383, 386, 390, 391, 396, 397,675–676dosage considerations, 396hydrogen cyanide inhalation treatment, 353lix

Medical Aspects of Chemical WarfareSolomon, I.2-chlorobenzylidene malononitrile research, 452Somanadditives for, 135aging half-time, 316assays for, 699atropine treatment, 179barrier creams and, 531behavioral effects of exposure, 176capture of research documents, 51carboxylesterase and, 246case report: accidental exposure of a man to liquid soman(exhibit), 162–163, 312central nervous system effects, 416chemical structure (figure), 694diazepam treatment, 179effect of therapy on median lethal dose in monkeys exposed tosoman (table), 199effects of soman on acetylcholinesterase activity in wholeblood from human volunteers who had taken pyridostigminebromide (figure), 706effects of soman on acetylcholinesterase activity in wholeblood from human volunteers who were given an increasingdose of huperzine A (figure), 707fetal bovine serum AChE and, 245hydrolysis pathway of sarin, soman, and cyclosarin (figure),696incapacitating effects, 416median lethal dose, 694–695molecular model (figure), 166muscle necrosis and, 318neuropsychiatric effects, 320oxime treatment and, 189plasma-derived human butyrylcholinesterase and, 245–249pulmonary system effects, 174pyridostigmine bromide pretreatment, 179, 199, 201, 704red blood cell and acetylcholinesterase protection studies usingpyridostigmine bromide and huperzine A after ex-vivoexposure to soman (table), 705seizure-related brain damage, 224–225, 226–232, 244severe exposure to, 161synthesis of, 48, 157, 693toxicity and lethality of, 47, 693toxicological studies, 322volatility of, 168Somme, Battle of the“white star” mixture of phosgene and chlorine and, 19Sommervell, Maj. William V.symptomology of gas poisoning, 91Sommervillier, Battle ofphosgene and chloropicrin attacks, 25–26Soviet Union. See also RussiaAfghanistan War and, 62Biological Weapons Convention and, 61–62capture of soman research documents, 51chemical weapons threat, 56“Foliant” chemical agent program, 3Memorandum of Understanding with the United States onprohibiting chemical weapons, 63nerve agent weaponization, 3no-first-use policy on chemical weapons during World War II,51–52sarin and tabun production, 156US-Soviet weapons destruction agreement, 138use of chemical warfare agents in the 1970s, 61–62SpainBerber war, 42–43Spanish influenzaeffects of, 101Speer, Albertviews on chemical warfare, 49–50Spray deliverydescription, 132nerve agents, 120, 157SRBD. See Seizure-related brain damageSS John Harveymustard agent disaster at Bari, Italy and, 21, 53, 262Stafford Actfederal department or agency support to state and local governmentsand, 758–759overview of the initial federal involvement under the StaffordAct (figure), 760Stahl, C.J.1-chloroacetophenone research, 463Stalin, Josefno-first-use policy on chemical weapons during World War II,51–52Stander, T.1-chloroacetophenone research, 463Standoff detectorsearly warning for line-of-sight distances, 577joint services lightweight standoff chemical agent detectors,579M21 remote sensing chemical agent alarms, 578–579Stanton, Secretary of War Edwin M.Doughty’s chemical warfare proposal and, 12Staphylococcal enterotoxin BCDC categorization as a category B threat agent, 616Stark, Col. A.N.emergency gas teams and, 97START triage systemdescription, 517Status epilepticusbrain damage cause, 223definition of, 223nonconvulsive type, 223pediatric population and, 664therapeutic window, 223Steenland, K.organophosphate insecticide exposure research, 319Stein, A.A.1-chloroacetophenone research, 462Stenhouse, Johnsynthesis of chloropicrin, 117Steroids. See also Corticosteroidspalytoxin intoxication treatment, 621Stimson, Secretary of State Henry L.letter from Gen. MacArthur, 44–45Stimulantsdescription and effects of, 418STM. See Sacco triage methodStokes mortarsdescription, 118, 119Stoughton, R.W.2-chlorobenzylidene malononitrile research, 444Strasbourg Agreement of 1675description, 136Strategic National Stockpiledescription and role, 765pediatric-ready medications and, 678“push packages” of pharmaceutical and supplies, 765Strategy for Homeland Defense and Civil Supportobjectives, 758Strokelx

IndexShaw, F.H.organophosphate insecticide exposure research, 319, 320Shellfish poisoning. See Brevetoxin; Saxitoxin; TetrodotoxinShih, T.M.dizocilpine research, 228memantine research, 228Shryock, RichardVedder’s comments on, 108Sibert, Maj. Gen. William L.<strong>Chemical</strong> <strong>Warfare</strong> Service leadership, 22, 90Silver nitrate solutiontreatment <strong>of</strong> mustard agent injuries, 280Silver sulfadiazine creamtreatment <strong>of</strong> mustard agent injuries, 281, 670, 671Silverlonmustard agent injury dressing, 280Simple triage and rapid treatment systemdescription, 517Six-Day War. See Arab-Israeli Six-Day WarSkeletal muscle systembrevetoxin effects, 630effects <strong>of</strong> nerve agent exposure, 174–175, 188, 318effects <strong>of</strong> organophosphate insecticide exposure, 317–318muscle necrosis and, 317–318paralytic shellfish poisoning effects, 626saxitoxin effects, 627tetrodotoxin effects, 627Skin cancermustard exposure and, 313Skin effects <strong>of</strong> chemical agents. See also specific agentsactive barrier creams, 531–532active topical skin protectant and, 531–532barrier skin creams and, 530–532classes <strong>of</strong> barrier creams, 531factors affecting the absorption <strong>of</strong> agent, 529–530patents covering work on active topical skin protectant at theUS Army <strong>Medical</strong> Research Institute <strong>of</strong> <strong>Chemical</strong> Defense(table), 532pediatric population and, 659skin “compartments,” 529skin exposure reduction paste against chemical warfareagents, 530–531Skin effects <strong>of</strong> incapacitating agentschloropicrin, 457dibenz[b,f]-1,4-oxazepine, 468diphenylaminearsine, 466oleoresin capsicum, 454–4551-chloroacetophenone, 461, 462–463treatment, 4712-chlorobenzylidene malononitrile, 448, 450–451Skin effects <strong>of</strong> lewisite exposureblistering, 292–293erythema, 292Skin effects <strong>of</strong> mustard agent exposurebulla description, 267, 671compared with toxic epidermal necrosis, 278, 279cosmetic and/or functional deficits, 278current treatments, 278–281cutaneous sensitivity, 315cytopathology, 269–270erythema, 267, 268, 279, 667healing time for skin lesions, 268, 270, 278hyperpigmentation, 268–269, 315, 672immediate treatment improvements, 281–282improved therapies, 281–287injury assessment, 282–283models and histopathology, 270–271onset <strong>of</strong> symptoms, 267, 312penetration <strong>of</strong> the skin, 529return to duty considerations, 291scarring <strong>of</strong> epithelial surfaces, 315skin cancer, 313, 315skin proteins and immunohistopathology, 272–274thermal burns compared with, 278–279, 290threshold amount needed to produce skin lesions, 267, 312treatments, 278–287, 290ultrastructural pathology, 271–272vesication, 267, 270–274, 279–281Skin effects <strong>of</strong> toxin intoxicationbrevetoxin, 630palytoxin, 620, 621tetrodotoxin, 627Skin exposure reduction paste against chemical warfare agentsapplication <strong>of</strong>, 531barrier properties, 530–531components, 530, 532development <strong>of</strong>, 530effectiveness, 531effects on decontamination, 531function, 531M291 skin decontamination kits and, 652Skin exposure to liquid nerve agentsatropine treatment, 185–186compared with inhalational exposure, 169–170effects <strong>of</strong> dermal exposure to liquid nerve agents (table), 169factors in effects <strong>of</strong>, 169Skin substitutesadvantages <strong>of</strong>, 286mustard agent injury treatment, 286–287selection <strong>of</strong>, 286Sleep-Ezedescription and uses, 421Small Business Innovative Research Programfunding for seizure detectors, 223Smokingcyanide levels and, 323, 324, 374, 731endogenous cyanide concentrations for smokers and nonsmokers(table), 381SNS. See Strategic National StockpileSnyder, Solomonmorphine research, 418Soap and water (hydrolysis)infants and children and, 551, 677mechanism <strong>of</strong> action, 533–534patient thorough decontamination and, 534, 544skin decontamination method, 533–534water concerns, 546Sodium channel toxins. See also Batrachotoxin; Brevetoxin; Pumiliotoxin;Saxitoxin; Tetrodotoxinthree-dimensional representation <strong>of</strong> a voltage-gated sodiumchannel sitting in a phospholipid bilayer membrane (figure),624Sodium nitritecyanide poisoning treatment, 383–384, 394–395, 675–676hydrogen cyanide inhalation treatment, 353limitations <strong>of</strong>, 396side effects, 394use in children, 390Sodium thiosulfatecombined with hydroxocobalamin, 396, 676cyanide poisoning treatment, 383, 386, 390, 391, 396, 397,675–676dosage considerations, 396hydrogen cyanide inhalation treatment, 353lix

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