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PREVENTION AND TREATMENT OF Nerve Agent Poisoning
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BLISTER  AGENTS


Establishing a patient airway (for example, with a cricothyroidotomy or endotracheal tube) and administering assisted ventilation, if required. Only qualified personnel can perform these procedures. You should use oxygen if available. NERVE AGENT ANTIDOTES Atropine sulfate and 2 PAM Cl remain essential drugs in the treatment of nerve agent poisoning. When exposed, each member of the Navy and Marine Corps is issued three 2 mg auto injectors of atropine and three 600 mg auto injectors of 2 PAM Cl (fig. 13-30). Do not give nerve agent antidotes for preventive purposes before contemplated exposure to a nerve agent. The atropine auto injector consists of a hard plastic tube containing 2 mg (0.7 ml) of atropine in solution. It has a pressure activated coiled spring mechanism that triggers  the  needle  for  injection  of  the  antidote solution. The 2 PAM Cl auto injector is a hard plastic tube, which dispenses 600 mg of 2 PAM Cl (300 mg/ml) solution when activated. It also has a pressure activated coiled spring mechanism identical to that in the  atropine  auto  injector.  Diazepam  (CANA)  is administered as a single-dose 10 mg autoinjector. General Usage Principles for Nerve Agent Antidotes Certain   general   usage   principles   should   be followed   in   the   administration   of   nerve   agent antidotes. Complete instructions for the administration of nerve agent antidotes are found on the auto injectors and also in the Navy NAVMED P-5041. SELF-AID.—If you experience most or all of the mild symptoms of nerve agent poisoning, you should IMMEDIATELY hold your breath (without first inhaling) and put on your protective mask. Then, administer  one  set  of  (atropine  and  2  PAM  Cl) injections into your lateral thigh muscle or buttocks as illustrated in figures 13-31 and 13-32. Position the Figure 13-31.—Thigh injection site. needle  end  of  the  atropine  injector  against  the injection  site  and  apply  firm,  even  pressure  (not jabbing motion) to the injector until it pushes the needle into your thigh (or buttocks). Make sure you  do not hit any buttons or other objects. Using a jabbing motion may result in an improper injection or injury to the thigh or buttocks. Figure 13-32.—Buttocks injection sites. Figure 13-30.—Nerve agent antidotes. 13-32

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