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

IndexTreatment of nerve agent exposure. See also Field management ofchemical casualties; Neuroprotection as a treatment for nerveagent survivors; specific nerve agents and drugsanticonvulsive therapy, 189–190antidote treatment nerve agent autoinjector, 182–186, 192, 193,194atropine therapy, 182–186, 244cardiac arrhythmia treatment, 190challenges of administration, 244, 253decontamination of the patient, 180–181effect of therapy on median lethal dose in monkeys exposed tosoman (table), 199general principles, 180–190, 244, 316mild exposure, 192minimal exposure, 191–192moderate exposure, 192moderately severe exposure, 192–193oxime therapy, 186–189, 197–198pediatric population and, 663–665pretreatment considerations, 197–204, 244protection of the rescuer, 180, 193psychogenic casualties and, 196recommended therapy for casualties of nerve agents (table),191regimen of antidotal therapy, 223, 244severe exposure, 193–194suspected exposure, 191terminating the exposure, 180–181timing of administration, 244, 252treatment by exposure category, 190–194value of aggressive treatment, 197ventilatory support, 181–182, 186“Treatment of Status Epilepticus in Adults: Columbia UniversityProtocol,” 231Treatment of toxic industrial chemical exposure. See also Fieldmanagement of chemical casualties; specific agents and drugsacute medical management, 362–365airway secretion management, 363–364clinical care, 365establishing an airway, 362–363history assessment for casualties exposed to lung-damagingagents (exhibit), 362hypotension treatment and prevention, 364–365hypoxia prevention and treatment, 364patient history, 361patient transport, 365physical assessment for casualties of lung-damaging chemicalagents (exhibit), 363physical examination, 361–362pulmonary edema treatment, 364rest from physical exertion, 363termination of exposure, 362triage for casualties of lung-damaging toxic industrial chemicals(exhibit), 364Treaty of Versaillesdescription, 136Trench mortarsattacks on the AEF (exhibit), 26CWS standardization of, 119–120description, 26Stokes mortars, 118, 119Triage of chemical casualtiesalternative areas for, 678benefit of assistance issues, 512–513challenges unique to, 516combined injuries and, 522–523conventional wounds contaminated with chemical agents,522–523cyanide and, 518–519, 521, 522, 523cyanide poisoning, 386decontamination, 513–514delayed treatment category, 516, 521, 577development of a pharmaceutical cache of medications, 678division triage stations, 94dynamic nature of, 513, 524emergent category, 516essential information for, 512evacuation issues, 516–517expectant treatment category, 516, 522, 577immediate treatment category, 516, 520–521, 577incapacitating agents and, 520, 521, 522, 523levels of care, 513lung-damaging agents and, 519–520, 522, 523medical management issues, 517–520minimal treatment category, 516, 521–522, 577national site setup and control zones for a hazardous materialssite (figure), 515natural course of disease and, 512–513nerve agents and, 518, 520–521, 522–523nonemergent category, 516pediatric population and, 677placement of teams, 514–516, 547principles and processes, 512–516, 524Sacco triage method, 517START system, 517treatment, decontamination, and transport linkage, 514–516triage and treatment area (cold zone), 506triage area (warm side), 504–505triage by category and agent, 520–522“triage” definition, 512triage for casualties of lung-damaging toxic industrial chemicals(exhibit), 364US military triage categories, 516–517vesicants and, 519, 521–522, 523Triazolamincapacitating effects, 420Trichloromethyl chloroformate. See ChloropicrinTrilon group of nerve agents. See Sarin; Soman; TabunTropical ataxic neuropathycyanide exposure and, 323Truman, Pres. Harry SUnited States ratification of the Geneva Protocol and, 60, 137Tsuchihashi, H.VX nerve agent research, 695TTX. See TetrodotoxinTurpin, Eugenesecret weapon developed by, 8022nd Chemical Battalionmission of, 59721st centuryOperation Enduring Freedom, 65Operation Iraqi Freedom, 65–66Russia’s use of fentanyl in the Chechen hostage situation, 3,65, 41320th Support Commanddomestic preparedness role, 7632-aminothiazoline-4-carboxylic acidcyanide poisoning and, 3762-chlorobenzylidene malonitrilenonmilitary uses, 342overall effects of, 342Yemen Civil War and, 3412-oxothiazolidine-4-carboxylic acidchemical structure (figure), 736lxiii