Treating Chemical and Biological Agent Casualties
Lesson 2: Treating
Nerve Agent Poisoning
Section II: Treat Casualty
2-10
2-10. ADMINISTER FOLLOW-ON TREATMENT
a. Administer Additional Atropine. If all three sets of the casualty's Mark I have been given and severe respiratory distress or convulsions persist, relief does not occur, and bronchial secretions and salivation do not decrease, administer additional atropine autoinjectors as frequently as required to achieve atropinization. Maintain atropinization by administering an additional autoinjector every 10 to 30 minutes as long as needed.
b. Administer Additional Convulsant Antidote For Nerve Agent. If the casualty continues to convulse after the first injection of CANA, wait 10 minutes; then administer the second CANA. Observe the casualty for about 10 more minutes and administer the third CANA if needed.
CAUTION: The injections will be limited to three CANA prior to being evacuated to
the medical treatment facility.
c. Check Respiration. Listen for breathing difficulties. Check for cyanosis (bluish coloring of skin caused by lack of oxygen due to respiratory difficulty). Check the skin around the casualty's eyes through the mask eyelets. Watch the rise and fall of the chest. Turn the casualty onto his side to facilitate breathing.
(1) If the casualty is unconscious and you cannot see the chest rising and falling, cover the mask's inlet valve. The mask will collapse if the casualty is breathing.
(2) If the patient is experiencing difficultly in breathing, evacuate him immediately.
d. Document Treatment. Initiate a field medical card (DD Form 1380) on the casualty, if time permits. Be sure to indicate the total amount of antidote the casualty received. Procedures for initiating the card are given in subcourse MD0920, Medical Records and Sick Call Procedures.
e. Evacuate the Casualty. If the casualty exhibits signs and symptoms of severe nerve agent poisoning or has difficulty breathing, evacuate the casualty to a medical treatment facility. Evacuate the casualty by litter if possible. Procedures for evacuation are given in subcourse MD0001, Evacuation in the Field.
