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USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
Objectives
Course
Overview and relevance Agent characteristics and effects Patient presentation and management
This lecture
Overview 2
Overview
N
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview 3
Overview
Excluded by FM 8-285
Overview 4
Riot-control agents (CS, CN, DM) Chemical herbicides (e.g.. Agent Orange) Smoke and flame materials
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
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Overview
Riot-control Agents
Local irritants with high safety ratio Short onset (seconds to minutes) Short duration (15-30 minutes) In low concentrations, cause intense pain and lacrimation (tearing) with (Adamsite only) or without vomiting
Overview 6
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
Overview 7
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
Overview 8
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
Overview 10
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
Lung-damaging Agents
Chlorine (CL) Chloropicrin (PS) Phosgene (CG) Diphosgene (DP) [Mustard (HD, H ) Lewisite (L)] [Smokes] [isocyanates] [PFIB] [oxides of nitrogen]
Overview 11
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
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USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
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USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
CNS depressants
Barbiturates, opioids, antipsychotics, benzodiazepines
Psychedelics
LSD LSD-25, psilocybin, ibogaine, harmine, MDMA (ecstasy), PCP
Deliriants
Anticholinergic glycolates (BZ (BZ, , Agent 15) 15 )
Overview 16
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
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Overview
Persistence
Dependent on several factors
Agent volatility (determined by chemical structure) Temperature Wind Agent-surface interactions
Persistent agents
VX, L, HL, thickened nerve and blister agents (e.g., TGD, THD)
Overview 18
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
Overview 22
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
Toxicity of HD Vapor
HD vapor in eyes:
ICt50: 200 mg-min / m3
Inhaled HD vapor:
ICt50: 200 mg-min / m3
HD vapor on skin:
ICt50: 1000-2000 mg-min / m3
Overview 24
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
Toxicity of HD Vapor
HD vapor in eyes:
Permanent injury: > 800 mg-min/ m3
Inhaled HD vapor:
LCt50: 1000-1500 mg-min / m3
HD vapor on skin:
LCt50: 10,000 mg-min / m3
Overview 25
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
Ct50 (mg-min/m3)
CL
(L)
CG
(L)
AC
(L)
H
(L)
GB
(L)
VX
(L)
BZ
(E)
CS
(E)
Overview 26
USAMRICD
PROTECT, PROJECT, SUSTAIN
Exposure
Pre-exposure
Primary Prevention:
The most important phase!
Secondary Prevention:
After failure of 1 prevention
Tertiary Prevention:
After failure of 1 / 2 prevention
Military intelligence Detection in nearby areas True pretreatment Skin protectants Protective clothing Mask Soldier training (what to do) Soldier education (why to do it) Command emphasis!
Overview 27
Continued 1 prevention Early diagnosis Early decontamination Evacuation as appropriate Treatment to prevent or minimize later effects as possible
General supportive care Specific antidotal therapy Antidotal enhancement* *Given before exposure
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
Overview 29
USAMRICD
PROTECT, PROJECT, SUSTAIN
Overview
USAMRICD
PROTECT, PROJECT, SUSTAIN